scholarly journals Persistent pulmonary pathology after COVID-19 is associated with high viral load, weak antibody response, and high levels of matrix metalloproteinase-9

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tøri Vigeland Lerum ◽  
Niklas Nyboe Maltzahn ◽  
Pål Aukrust ◽  
Marius Trøseid ◽  
Katerina Nezvalova Henriksen ◽  
...  
Keyword(s):  
Viral Load ◽  
Matrix Metalloproteinase ◽  
Hospital Admission ◽  
Randomised Clinical Trial ◽  
High Viral Load ◽  
Chest Ct ◽  
Ct Findings ◽  
High Prevalence ◽  
Negative Effect ◽  
Antibody Levels

AbstractThe association between pulmonary sequelae and markers of disease severity, as well as pro-fibrotic mediators, were studied in 108 patients 3 months after hospital admission for COVID-19. The COPD assessment test (CAT-score), spirometry, diffusion capacity of the lungs (DLCO), and chest-CT were performed at 23 Norwegian hospitals included in the NOR-SOLIDARITY trial, an open-labelled, randomised clinical trial, investigating the efficacy of remdesivir and hydroxychloroquine (HCQ). Thirty-eight percent had a CAT-score ≥ 10. DLCO was below the lower limit of normal in 29.6%. Ground-glass opacities were present in 39.8% on chest-CT, parenchymal bands were found in 41.7%. At admission, low pO2/FiO2 ratio, ICU treatment, high viral load, and low antibody levels, were predictors of a poorer pulmonary outcome after 3 months. High levels of matrix metalloproteinase (MMP)-9 during hospitalisation and at 3 months were associated with persistent CT-findings. Except for a negative effect of remdesivir on CAT-score, we found no effect of remdesivir or HCQ on long-term pulmonary outcomes. Three months after hospital admission for COVID-19, a high prevalence of respiratory symptoms, reduced DLCO, and persistent CT-findings was observed. Low pO2/FiO2 ratio, ICU-admission, high viral load, low antibody levels, and high levels of MMP-9 were associated with a worse pulmonary outcome.

scholarly journals Viral load and antibody levels in patients with COVID-19

2021 ◽  
Vol 8 (3) ◽  
pp. 010-018
Author(s):  
Iva Christova ◽  
Iva Trifonova ◽  
Teodora Gladnishka ◽  
Elena Dragusheva ◽  
Georgi Popov ◽  
...  
Keyword(s):  
Viral Load ◽  
High Viral Load ◽  
Igg Antibodies ◽  
Rt Pcr ◽  
Serum Samples ◽  
Weekly Basis ◽  
Specific Antibody Response ◽  
Viral Loads ◽  
Antibody Levels ◽  
Kinetics Of

Relations between viral load, antibody levels and COVID-19 severity are not well studied and results from such investigations are controversial. In this study, we investigated kinetics of viral load and antibody responses to SARS-CoV-2 in 20 patients with COVID-19 and analysed the association with disease severity. The patients were followed on weekly basis within the first month after the onset and then once per month for the next 4 months. Serum samples were tested for IgA, IgM, and IgG antibodies against SARS-CoV-2 using ELISA tests. SARS-CoV-2 viral load in nasopharyngeal swabs was measured by quantitative Realtime RT-PCR. For vast majority of the patients, the viral loads were at their highest levels at presentation and then declined gradually. Despite development of specific antibody response 7-11 days after the onset of COVID-19, SARS-CoV-2 RNA was still detected in nasopharyngeal swabs of most of the patients. There was no direct link between viral load and severity of COVID-19: some of mild and some of severe cases started with a high viral load. There was a relationship between the time from the onset of the disease and the viral load: the highest viral load was in the first days. In more severe cases, there was a tendency for slower reduction in viral load and longer detection of SARS-CoV-2 virus. Levels of the specific antibodies increased earlier and to higher levels and were present for longer time in patients with more severe manifestations of COVID-19 than in those with milder disease.

scholarly journals Active immunization by COVID-19 mRNA vaccine results in rapid antibody response and virus reduction in breakthrough infection by Delta (B.1.617.2)

2021 ◽  
Author(s):  
Yosuke Hirotsu ◽  
Toshiharu Tsutsui ◽  
Yumiko Kakizaki ◽  
Yoshihiro Miyashita ◽  
Fumiaki Iwase ◽  
...  
Keyword(s):  
Viral Load ◽  
Antibody Response ◽  
Viral Antigen ◽  
Severe Disease ◽  
High Viral Load ◽  
Active Immunization ◽  
Breakthrough Infection ◽  
Serological Data ◽  
Antibody Levels ◽  
Rapid Antibody

Abstract Vaccination is expected to suppress COVID-19 infection. However, breakthrough infections have increased following vaccination because of the spread of variants of concern, notably Delta (B.1.617.2 lineage). Virological and serological data pertaining to post-vaccination infections are limited. Here, we conducted genome analysis determined the viral lineages that infected patients following vaccination. Changes in viral load, antibody levels, and viral antigen levels following infection were analyzed. At the time of infection, Delta-infected patients had a 6.2-fold and 12.3-fold higher viral load compared with Alpha and other lineages, respectively. Viral lineages (Delta:Alpha:Other) of infection were 0:12:0 in the fully vaccinated group, 1:11:0 in the partially vaccinated group, 9:16:0 in the shortly after vaccination group, and 254:229:165 in the unvaccinated group. Breakthrough infections occurred regardless of retention of high antibody titers following vaccination. At the time of diagnosis, Delta-infected patients showed high viral load with or without vaccination. However, no fully vaccinated patients developed severe disease, and the rapid increase in anti-spike antibodies occurred approximately 1 week after onset of symptoms. Concomitantly, a decrease in viral antigen levels was observed in fully vaccinated patients, shortening the time to negative result by approximately 2 days compared with unvaccinated patients. Collectively, even if breakthrough infection occurs, the rapid antibody response in fully vaccinated individuals contributes to prevention of severe disease, possibly because of suppression of viral replication.

scholarly journals Dyspnoea, lung function and CT findings three months after hospital admission for COVID-19

2020 ◽  
pp. 2003448 ◽  
Author(s):  
Tøri Vigeland Lerum ◽  
Trond Mogens Aaløkken ◽  
Eivind Brønstad ◽  
Bernt Aarli ◽  
Eirik Ikdahl ◽  
...  
Keyword(s):  
Lung Function ◽  
Pulmonary Function ◽  
Hospital Admission ◽  
Forced Expiratory Volume ◽  
Chest Ct ◽  
Icu Patients ◽  
Diffusion Capacity ◽  
Ct Findings ◽  
Impaired Lung Function ◽  
And Performance

The long-term pulmonary outcomes of coronavirus disease 2019 (COVID-19) are unknown. We aimed to describe self-reported dyspnoea, quality of life, pulmonary function, and chest CT findings three months following hospital admission for COVID-19. We hypothesised outcomes to be inferior for patients admitted to intensive care units (ICU), compared with non-ICU patients.Discharged COVID-19-patients from six Norwegian hospitals were consecutively enrolled in a prospective cohort study. The current report describes the first 103 participants, including 15 ICU patients. Modified Medical Research Council dyspnoea scale (mMRC), EuroQol Group's Questionnaire, spirometry, diffusion capacity (DLCO), six-minute walk test, pulse oximetry, and low-dose CT scan were performed three months after discharge.mMRC was >0 in 54% and >1 in 19% of the participants. The median (25th–75th percentile) forced vital capacity and forced expiratory volume in one second were 94% (76, 121) and 92% (84, 106) of predicted, respectively. DLCO was below the lower limit of normal in 24%. Ground-glass opacities (GGO) with >10% distribution in ≥1 of 4 pulmonary zones were present in 25%, while 19% had parenchymal bands on chest CT. ICU survivors had similar dyspnoea scores and pulmonary function as non-ICU patients, but higher prevalence of GGO (adjusted odds ratio [95% confidence interval] 4.2 [1.1, 15.6]) and performance in lower usual activities.Three months after admission for COVID-19, one fourth of the participants had chest CT opacities and reduced diffusion capacity. Admission to ICU was associated with pathological CT findings. This was not reflected in increased dyspnoea or impaired lung function.

Update in management of hepatitis B in pregnancy and prevention of mother to child hepatitis B transmission

2018 ◽  
Vol 1 (3) ◽  
pp. 1-8
Author(s):  
Naichaya Chamroonkul
Keyword(s):  
Chronic Hepatitis ◽  
Viral Load ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
High Viral Load ◽  
World Population ◽  
Hepatitis B Infection ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Mother To Child

Even with two decades of widespread using hepatitis B vaccination, chronic hepatitis B remains a major global health problem. In Thailand, the prevalence of chronic hepatitis B infection was down from 8 - 10% in last decade to 5% recently. Failure to control mother to child transmission is one of the important barriers to the total elimination of hepatitis B infection from world population. In the majority, vertical transmission can be prevented with a universal screening program, immunoprophylaxis by administration of hepatitis B vaccine and hepatitis B immunoglobulin (HBIg) for babies born to mothers with HBV. However, in mothers with a high viral load, the chance of immunoprophylaxis failure remains high. To date, there are standard recommendations by all international liver societies including AASLD, EASL and APASL suggest introducing an antiviral agent during the third trimester to CHB pregnant women with a high viral load. Previous US FDA pregnancy category B agents such as Tenofovir and Telbivudine are allowed through all trimesters of pregnancy and are effective for prevention of mother to child transmission. Breastfeeding for patients who receive antiviral agents can be allowed after a risk-benefit discussion with the patient and family.

scholarly journals The association between clinical laboratory data and chest CT findings explains disease severity in a large Italian cohort of COVID-19 patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Simone Canovi ◽  
◽  
Giulia Besutti ◽  
Efrem Bonelli ◽  
Valentina Iotti ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Laboratory Data ◽  
Organ Damage ◽  
Cross Sectional Study ◽  
Chest Ct ◽  
Arterial Oxygen ◽  
Emergency Rooms ◽  
Cross Sectional ◽  
Ct Findings ◽  
Patient Prognosis

Abstract Background Laboratory data and computed tomography (CT) have been used during the COVID-19 pandemic, mainly to determine patient prognosis and guide clinical management. The aim of this study was to evaluate the association between CT findings and laboratory data in a cohort of COVID-19 patients. Methods This was an observational cross-sectional study including consecutive patients presenting to the Reggio Emilia (Italy) province emergency rooms for suspected COVID-19 for one month during the outbreak peak, who underwent chest CT scan and laboratory testing at presentation and resulted positive for SARS-CoV-2. Results Included were 866 patients. Total leukocytes, neutrophils, C-reactive protein (CRP), creatinine, AST, ALT and LDH increase with worsening parenchymal involvement; an increase in platelets was appreciable with the highest burden of lung involvement. A decrease in lymphocyte counts paralleled worsening parenchymal extension, along with reduced arterial oxygen partial pressure and saturation. After correcting for parenchymal extension, ground-glass opacities were associated with reduced platelets and increased procalcitonin, consolidation with increased CRP and reduced oxygen saturation. Conclusions Pulmonary lesions induced by SARS-CoV-2 infection were associated with raised inflammatory response, impaired gas exchange and end-organ damage. These data suggest that lung lesions probably exert a central role in COVID-19 pathogenesis and clinical presentation.

scholarly journals Maternally Derived Antibody Levels Influence on Vaccine Protection against PCV2d Challenge

Animals ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 2231
Author(s):  
István Kiss ◽  
Krisztina Szigeti ◽  
Zalán G. Homonnay ◽  
Vivien Tamás ◽  
Han Smits ◽  
...  
Keyword(s):  
Immune Response ◽  
Humoral Immune Response ◽  
Subunit Vaccine ◽  
Porcine Circovirus Type ◽  
Porcine Circovirus ◽  
Vaccine Protection ◽  
Humoral Immune ◽  
Negative Effect ◽  
Antibody Levels

Piglets from a porcine circovirus type 2 (PCV2) stable farm of low and high levels of maternally derived antibodies (MDA) against PCV2 were vaccinated either with a whole virus type or a PCV2 ORF2 antigen-based commercial subunit vaccine at three weeks of age. Two non-vaccinated groups served as low and high MDA positive controls. At four weeks post vaccination, all piglets were challenged with a PCV2d-2 type virus strain and were checked for parameters related to vaccine protection over a four-week observation period. MDA levels evidently impacted the outcome of the PCV2d-2 challenge in non-vaccinated animals, while it did not have a significant effect on vaccine-induced protection levels. The humoral immune response developed faster in the whole virus vaccinates than in the subunit vaccinated pigs in the low MDA groups. Further, high MDA levels elicited a stronger negative effect on the vaccine-induced humoral immune response for the subunit vaccine than for the whole virus vaccine. The group-based oral fluid samples and the group mean viraemia and faecal shedding data correlated well, enabling this simple, and animal welfare-friendly sampling method for the evaluation of the PCV2 viral load status of these nursery piglets.

scholarly journals Adapting the role of handheld echocardiography during the COVID-19 pandemic: A practical guide

Perfusion ◽  
2021 ◽  
pp. 026765912098653
Author(s):  
Hafiz Naderi ◽  
Shaun Robinson ◽  
Martin J Swaans ◽  
Nina Bual ◽  
Wing-See Cheung ◽  
...  
Keyword(s):  
Viral Load ◽  
Potential Role ◽  
Assessment Tool ◽  
High Viral Load ◽  
First Line ◽  
Scanning Time ◽  
Contagious Disease ◽  
Core Dataset ◽  
Clinical Questions

The COVID-19 pandemic has altered our approach to inpatient echocardiography delivery. There is now a greater focus to address key clinical questions likely to make an immediate impact in management, particularly during the period of widespread infection. Handheld echocardiography (HHE) can be used as a first-line assessment tool, limiting scanning time and exposure to high viral load. This article describes a potential role for HHE during a pandemic. We propose a protocol with a reporting template for a focused core dataset necessary in delivering an acute echocardiography service in the setting of a highly contagious disease, minimising risk to the operator. We cover the scenarios typically encountered in the acute cardiology setting and how an expert trained echocardiography team can identify such pathologies using a limited imaging format and include cardiac presentations encountered in those patients acutely unwell with COVID-19.

Initial Thin-Section Chest CT Findings in Patients With Inhalation Injury

CHEST Journal ◽  
2014 ◽  
Vol 145 (3) ◽  
pp. 250A
Author(s):  
In-Gyu Hyun ◽  
Cheol-Hong Kim
Keyword(s):  
Thin Section ◽  
Inhalation Injury ◽  
Chest Ct ◽  
Ct Findings
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