scholarly journals Cell-based culture of SARS-CoV-2 informs infectivity and safe de-isolation assessments during COVID-19

2020 ◽  
Author(s):  
Kerri Basile ◽  
Kenneth McPhie ◽  
Ian Carter ◽  
Susan Alderson ◽  
Hossinur Rahman ◽  
...  
Keyword(s):  
Clinical Sample ◽  
Surrogate Marker ◽  
Upper Respiratory Tract ◽  
Limited Data ◽  
Icu Patients ◽  
Culture Positivity ◽  
The Mean ◽  
Upper Respiratory ◽  
Polymerase Chain ◽  
Virus Replication Cycle

Abstract Background The detection of SARS-CoV-2 RNA by real-time polymerase chain reaction (PCR) in respiratory samples collected from persons recovered from COVID-19 does not necessarily indicate shedding of infective virions. By contrast, the isolation of SARS-CoV-2 using cell-based culture likely indicates infectivity, but there are limited data on the correlation between SARS-CoV-2 culture and PCR. Methods One hundred and ninety-five patients with varying severity of COVID-19 were tested (outpatients [n=178]), inpatients [n=12] and critically unwell patients admitted to the intensive care unit [ICU; n=5]). SARS-CoV-2 PCR positive samples were cultured in Vero C1008 cells and inspected daily for cytopathic effect (CPE). SARS-CoV-2-induced CPE was confirmed by PCR of culture supernatant. Where no CPE was observed, PCR was performed on day four to confirm absence of virus replication. Cycle threshold (Ct) of the day four PCR (Ctculture) and the PCR of the original clinical sample (Ctsample) were compared, and positive cultures were defined where Ctsample - Ctculture was ≥3. Findings Of 234 samples collected, 228 (97%) were from the upper respiratory tract. SARS-CoV-2 was only successfully isolated from samples with Ctsample ≤32, including in 28/181 (15%), 19/42 (45%) and 9/11 samples (82%) collected from outpatients, inpatients, and ICU patients, respectively. The mean duration from symptom onset to culture positivity was 4.5 days (range 0-18). SARS-CoV-2 was significantly more likely to be isolated from samples collected from inpatients (p<0∙001) and ICU patients (p<0∙0001) compared with outpatients respectively, and in samples with lower Ctsample. Conclusion SARS-CoV-2 culture may be used as a surrogate marker for infectivity and inform de-isolation protocols.

scholarly journals Cell-based culture of SARS-CoV-2 informs infectivity and safe de-isolation assessments during COVID-19

2020 ◽  
Author(s):  
Kerri Basile ◽  
Kenneth McPhie ◽  
Ian Carter ◽  
Susan Alderson ◽  
Hossinur Rahman ◽  
...  
Keyword(s):  
Clinical Sample ◽  
Surrogate Marker ◽  
Upper Respiratory Tract ◽  
Limited Data ◽  
Icu Patients ◽  
Culture Positivity ◽  
The Mean ◽  
Upper Respiratory ◽  
Polymerase Chain ◽  
Virus Replication Cycle

Background The detection of SARS-CoV-2 by real-time polymerase chain reaction (PCR) in respiratory samples collected from persons recovered from COVID-19 does not necessarily indicate shedding of infective virions. By contrast, the isolation of SARS-CoV-2 using cell-based culture likely indicates infectivity, but there are limited data on the correlation between SARS-CoV-2 culture and PCR. Here we review our experience using SARS-CoV-2 culture to determine infectivity and safe de-isolation of COVID-19 patients. Methods 195 patients with diverse severity of COVID-19 were tested (outpatients [n=178]), inpatients [n=12] and ICU [n=5]). SARS-CoV-2 PCR positive samples were cultured in Vero C1008 cells and inspected daily for cytopathic effect (CPE). SARS-CoV-2-induced CPE was confirmed by PCR of culture supernatant. Where no CPE was documented, PCR was performed on day four to confirm absence of virus replication. Cycle threshold (Ct) values of the day four PCR (Ctculture) and the PCR of the original clinical sample (Ctsample) were compared, and positive cultures were defined as a Ctsample - Ctculture value of greater than or equal to 3. Findings Of 234 samples collected, 228 (97%) were from the upper respiratory tract. SARS-CoV-2 was only successfully isolated from samples with Ctsample values <32, including in 28/181 (15%), 19/42 (45%) and 9/11 samples (82%) collected from outpatients, inpatients and ICU patients, respectively. The mean duration from symptom onset to culture positivity was 4.5 days (range 0-18 days). SARS-CoV-2 was significantly more likely to be isolated from samples collected from inpatients (p<0.001) and ICU patients (p<0001) compared with outpatients, and in samples with lower Ctsample values. Conclusion SARS-CoV-2 culture may be used as a surrogate marker for infectivity and inform de-isolation protocols.

scholarly journals Is it enough for COVID-19 screening test? Limitation of swab test and general characteristics of mild symptom patients

2021 ◽  
Vol 104 (2) ◽  
pp. 003685042110261
Author(s):  
Sungwoo Choi ◽  
Hyo Jeong Choi ◽  
Ho Jung Kim
Keyword(s):  
Screening Test ◽  
Community Treatment ◽  
Upper Respiratory Tract ◽  
Test Results ◽  
Rt Pcr ◽  
Pcr Assay ◽  
Positive Rate ◽  
Upper Respiratory ◽  
Polymerase Chain ◽  
Discharge Criteria

The most common method for SARS-CoV-2 testing is throat or nasal swabbing by real-time reverse transcription polymerase chain reaction (RT-PCR) assay. In South Korea, drive-through swab test is used for screening system and community treatment centers (CTCs), which admit and treat confirmed COVID-19 patients with mild symptoms, are being used. This retrospective study was conducted on patients admitted to a CTC on March 6, 2020. A total of 313 patients were admitted. The nasal and throat swabs were collected from the upper respiratory tract, and a sputum test was performed to obtain lower respiratory samples. The positive rate of the first set of test, sputum test was higher than that of the swab test ( p = 0.011). In the second set of test, 1 week after the first ones, the rate of positive swab tests was relatively high ( p = 0.026). In the first set of test, 66 of 152 (43.4%) patients showed 24-h consecutive negative swab test results, when the sputum test results were considered together, that number fell to 29 patients (19.1%) ( p < 0.001). Also, in the second set of test, 63 of 164 (38.4%) patients met the discharge criteria only when the swab test was considered; that number fell to 30 (18.3%) when the sputum test results were also considered ( p < 0.001). Using the swab test alone is insufficient for screening test and discharge decision. Patients who may have positive result in the sputum test can be missed.

scholarly journals Anosmia as a Screening Tool for COVID-19 Infection: A Prospective Cohort Study

2021 ◽  
pp. 1-6
Author(s):  
Esra AlHamadani ◽  
Sania Zia ◽  
Ali AlRahma ◽  
Firas AlNajjar
Keyword(s):  
Odds Ratio ◽  
Screening Tool ◽  
Index Finger ◽  
Upper Respiratory Tract ◽  
Chain Reaction ◽  
The Public ◽  
Single Center Study ◽  
Upper Respiratory ◽  
Polymerase Chain ◽  
Low Sensitivity

<b><i>Objectives:</i></b> Several studies promoted anosmia as a possible isolated symptom for coronavirus disease 2019 (COVID-19). No studies used feasible methods of smell testing that the public would use to address the accuracy of these claims. <b><i>Methods:</i></b> This is a single-center study conducted between April 2020 and June 2020. The sense of smell was tested in vitally stable suspected COVID-19 patients with no/mild upper respiratory tract infection symptoms prior to nasopharyngeal swabbing for reverse-transcriptase polymerase chain reaction. Patients were instructed to close their eyes. Each nostril was tested separately while the other was blocked with the patient’s index finger. Patients inhaled from 2 concealed vials (coffee and strawberry essence) consecutively, kept within 30 cm of the nostril for 60 s. Patients who could not identify both odors with both nostrils were recorded as “anosmia.” <b><i>Results:</i></b> Out of 346 eligible subjects, 43 had anosmia of which 26 (60%) tested COVID-19 positive. χ<sup>2</sup> test showed a <i>p</i> value &#x3c;0.001. The test showed a sensitivity of 30% (95% confidence interval [CI] 21%, 41%) and specificity 94% (95% CI 90%, 96%). Logistic regression revealed an odds ratio of 5.9 (95% CI 3.0, 12) <i>p</i> value &#x3c;0.001. <b><i>Conclusion:</i></b> Given the low sensitivity (30%) of this method in detecting COVID-19 infection, we conclude that this method is not a useful screening tool for COVID-19 infection. The moderate negative predictive value (80%) is nongeneralizable.

scholarly journals An outbreak of SARS-CoV-2 with high mortality in mink (Neovison vison) on multiple Utah farms

2021 ◽  
Author(s):  
Chrissy Eckstrand ◽  
Tom Baldwin ◽  
Mia Kim Torchetti ◽  
Mary Lea Killian ◽  
Kerry A Rood ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Clinical Signs ◽  
Viral Transmission ◽  
Viral Rna ◽  
Upper Respiratory Tract ◽  
Tracheobronchial Lymph Node ◽  
Multiple Organs ◽  
Upper Respiratory ◽  
Polymerase Chain

The breadth of animal hosts that are susceptible to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and may serve as reservoirs for continued viral transmission are not known entirely. In August 2020, an outbreak of SARS-CoV-2 occurred in multiple mink farms in Utah and was associated with high mink mortality and rapid viral transmission between animals. The outbreak's epidemiology, pathology, molecular characterization, and tissue distribution of virus within infected mink is provided. Infection of mink was likely by reverse zoonosis. Once established, infection spread rapidly between independently housed animals and farms, and caused severe respiratory disease and death. Clinical signs were most notably sudden death, anorexia, and increased respiratory effort. Gross pathology examination revealed severe pulmonary congestion and edema. Microscopically there was pulmonary edema with moderate vasculitis, perivasculitis, and fibrinous interstitial pneumonia. Reverse transcriptase polymerase chain reaction (RT-PCR) of tissues collected at necropsy demonstrated the presence of SARS-CoV-2 viral RNA in multiple organs including nasal turbinates, lung, tracheobronchial lymph node, epithelial surfaces, and others. Whole genome sequencing from multiple mink was consistent with published SARS-CoV-2 genomes with few polymorphisms. The Utah mink SARS-CoV-2 strain fell into Clade GH, which is unique among mink and other animal strains sequenced to date and did not share other spike RBD mutations Y453F and F486L found in mink. Localization of viral RNA by in situ hybridization revealed a more localized infection, particularly of the upper respiratory tract. Mink in the outbreak reported herein had high levels of virus in the upper respiratory tract associated with mink-to-mink transmission in a confined housing environment and were particularly susceptible to disease and death due to SARS-CoV-2 infection.

Coronaviruses: HCoV, SARS-CoV, MERS-CoV, and COVID-19

2020 ◽  
Author(s):  
Michael G. Ison
Keyword(s):  
Middle East ◽  
Middle East Respiratory Syndrome ◽  
World Health ◽  
Upper Respiratory Tract ◽  
Viral Pathogens ◽  
Control And Prevention ◽  
The Common ◽  
Upper Respiratory ◽  
Polymerase Chain ◽  
Health Organization

Coronaviruses (CoVs) are a group of viral pathogens that infect mammals and birds. The presentation in humans is typically that of a mild upper respiratory tract infection, similar to the common cold. However, in recent years, dramatic attention has arisen for more lethal members of this viral family (e.g., severe acute respiratory syndrome [SARS-CoV], Middle East respiratory syndrome [MERS-CoV], and coronavirus disease 2019 [COVID-19]). The epidemiology, clinical presentation, diagnosis, and management of these viruses are discussed in this review. Importantly, new guideline tables from the Centers for Disease Control and Prevention, as well as the World Health Organization are provided at the conclusion of the review. This review contains 12 tables, 3 figure and 48 references. Keywords: Coronavirus, severe acute respiratory distress syndrome (SARS), Middle East respiratory syndrome (MERS), COVID-19, respiratory infection, antiviral, real-time polymerase chain reaction

Coronaviruses: HCoV, SARS-CoV, MERS-CoV, and COVID-19

2020 ◽  
Author(s):  
Michael G. Ison
Keyword(s):  
Middle East ◽  
Middle East Respiratory Syndrome ◽  
World Health ◽  
Upper Respiratory Tract ◽  
Viral Pathogens ◽  
Control And Prevention ◽  
The Common ◽  
Upper Respiratory ◽  
Polymerase Chain ◽  
Health Organization

Coronaviruses (CoVs) are a group of viral pathogens that infect mammals and birds. The presentation in humans is typically that of a mild upper respiratory tract infection, similar to the common cold. However, in recent years, dramatic attention has arisen for more lethal members of this viral family (e.g., severe acute respiratory syndrome [SARS-CoV], Middle East respiratory syndrome [MERS-CoV], and coronavirus disease 2019 [COVID-19]). The epidemiology, clinical presentation, diagnosis, and management of these viruses are discussed in this review. Importantly, new guideline tables from the Centers for Disease Control and Prevention, as well as the World Health Organization are provided at the conclusion of the review. This review contains 12 tables, 3 figure and 48 references. Keywords: Coronavirus, severe acute respiratory distress syndrome (SARS), Middle East respiratory syndrome (MERS), COVID-19, respiratory infection, antiviral, real-time polymerase chain reaction

Coronaviruses: HCoV, SARS-CoV, MERS-CoV, and COVID-19

2020 ◽  
Author(s):  
Michael G. Ison
Keyword(s):  
Middle East ◽  
Middle East Respiratory Syndrome ◽  
World Health ◽  
Upper Respiratory Tract ◽  
Viral Pathogens ◽  
Control And Prevention ◽  
The Common ◽  
Upper Respiratory ◽  
Polymerase Chain ◽  
Health Organization

Coronaviruses (CoVs) are a group of viral pathogens that infect mammals and birds. The presentation in humans is typically that of a mild upper respiratory tract infection, similar to the common cold. However, in recent years, dramatic attention has arisen for more lethal members of this viral family (e.g., severe acute respiratory syndrome [SARS-CoV], Middle East respiratory syndrome [MERS-CoV], and coronavirus disease 2019 [COVID-19]). The epidemiology, clinical presentation, diagnosis, and management of these viruses are discussed in this review. Importantly, new guideline tables from the Centers for Disease Control and Prevention, as well as the World Health Organization are provided at the conclusion of the review. This review contains 12 tables, 3 figure and 48 references. Keywords: Coronavirus, severe acute respiratory distress syndrome (SARS), Middle East respiratory syndrome (MERS), COVID-19, respiratory infection, antiviral, real-time polymerase chain reaction

Coronaviruses: HCoV, SARS-CoV, MERS-CoV, and COVID-19

2020 ◽  
Author(s):  
Michael G. Ison
Keyword(s):  
Middle East ◽  
Middle East Respiratory Syndrome ◽  
World Health ◽  
Upper Respiratory Tract ◽  
Viral Pathogens ◽  
Control And Prevention ◽  
The Common ◽  
Upper Respiratory ◽  
Polymerase Chain ◽  
Health Organization

Coronaviruses (CoVs) are a group of viral pathogens that infect mammals and birds. The presentation in humans is typically that of a mild upper respiratory tract infection, similar to the common cold. However, in recent years, dramatic attention has arisen for more lethal members of this viral family (e.g., severe acute respiratory syndrome [SARS-CoV], Middle East respiratory syndrome [MERS-CoV], and coronavirus disease 2019 [COVID-19]). The epidemiology, clinical presentation, diagnosis, and management of these viruses are discussed in this review. Importantly, new guideline tables from the Centers for Disease Control and Prevention, as well as the World Health Organization are provided at the conclusion of the review. This review contains 12 tables, 3 figure and 48 references. Keywords: Coronavirus, severe acute respiratory distress syndrome (SARS), Middle East respiratory syndrome (MERS), COVID-19, respiratory infection, antiviral, real-time polymerase chain reaction

Coronaviruses: HCoV, SARS-CoV, MERS-CoV, and COVID-19

2020 ◽  
Author(s):  
Michael G. Ison
Keyword(s):  
Middle East ◽  
Middle East Respiratory Syndrome ◽  
World Health ◽  
Upper Respiratory Tract ◽  
Viral Pathogens ◽  
Control And Prevention ◽  
The Common ◽  
Upper Respiratory ◽  
Polymerase Chain ◽  
Health Organization

Coronaviruses (CoVs) are a group of viral pathogens that infect mammals and birds. The presentation in humans is typically that of a mild upper respiratory tract infection, similar to the common cold. However, in recent years, dramatic attention has arisen for more lethal members of this viral family (e.g., severe acute respiratory syndrome [SARS-CoV], Middle East respiratory syndrome [MERS-CoV], and coronavirus disease 2019 [COVID-19]). The epidemiology, clinical presentation, diagnosis, and management of these viruses are discussed in this review. Importantly, new guideline tables from the Centers for Disease Control and Prevention, as well as the World Health Organization are provided at the conclusion of the review. This review contains 12 tables, 3 figure and 48 references. Keywords: Coronavirus, severe acute respiratory distress syndrome (SARS), Middle East respiratory syndrome (MERS), COVID-19, respiratory infection, antiviral, real-time polymerase chain reaction

Malignant sinonasal tumors in Stockholm, 2000-2005.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e17001-e17001
Author(s):  
Mattias Jangard
Keyword(s):  
Malignant Melanoma ◽  
Squamous Cell ◽  
Cell Cancer ◽  
Undifferentiated Carcinoma ◽  
Treatment Modalities ◽  
Upper Respiratory Tract ◽  
Malignant Tumours ◽  
The Mean ◽  
Upper Respiratory

e17001 Background: Between2000-2005 58 patients developed malignant sinonasal tumours in the region of Stockholm that consist of 2.5 million people. Sinonasal malignant tumours are uncommon and account for approximately 3% to 5% of all upper respiratory tract malignancies and 0.2% of all malignancies. Because these tumours are rare and the treatment varies internationally and also in different parts of Sweden; our aim was to follow up these patients to get a better picture of this group and also find out which treatment modalities that had the best outcome. Methods: All the patients have been identified through a database that register all new malignant head and neck tumours in Stockholm. We identified the patients from 2000-2005 and studied all the medical charts for the patients. Results: 10-15 patients develop malignant sinonasal tumour per year in the region of Stockholm. The mean age at diagnosis was 67 year (21-95 year). The distribution between men and women where equal. We found that 50 % was squamous cell carcinoma, 20% was malignant melanoma, 10 % adenocarcinoma, 10 % SNUC (Sino Nasal Undifferentiated Carcinoma) and 10 % other tumours. The 3-year survival was 50 % between 2000-2005. The prognosis varies between differnet tumour types. Squamous cell cancer and adenocarcinoma has a better prognosis than malignant melanoma and SNUC. Conclusions: This study brings light to the distribution of the different tumour types and also we found that malignant melanoma has a tendency to increase if you compare to a study from Sweden 2003. We were not able to analyse which treatment modality to prefer in this study due to short follow up and a small material.

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