scholarly journals Rate of reinfections after SARS-CoV-2 primary infection in the population of an Italian province: a cohort study

2021 ◽  
Author(s):  
M E Flacco ◽  
C Acuti Martellucci ◽  
G Soldato ◽  
R Carota ◽  
P Fazii ◽  
...  
Keyword(s):  
Cohort Study ◽  
Primary Outcome ◽  
Current Data ◽  
Local Health ◽  
Chain Reaction ◽  
Positive Polymerase Chain Reaction ◽  
Local Health Unit ◽  
Polymerase Chain ◽  
Italian Province

Abstract Background Current data suggest that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfections are rare, but no information are available on minors and after 12 months of follow-up. Methods This retrospective cohort study included all the population of an Italian Province, diagnosed with a SARS-CoV-2 infection from March 2020 to May 2021. The primary outcome was the incidence of a reinfection, defined as a new positive polymerase chain reaction (PCR) test occurring ≥90 days after complete resolution of the first infection, and data were retrieved from the official datasets (coronavirus disease 2019 [COVID-19], demographic, hospital and co-pay exemption) of the Local Health Unit (LHU) of Pescara. Results After an average of 201 days of follow-up (max. 414), we recorded 24 reinfections ≥90 days after the resolution of the first 7173 infections (0.33%). Four reinfections required hospitalization, one was lethal. Most of the reinfections (n = 13) occurred 6–9 months after the resolution of the first infection; no new infection was detected 12 or more months later and among the 832 minors. Conclusions This study confirms previous findings on a low risk of SARS-CoV-2 reinfection. If confirmed, these findings suggest that more targeted restriction policies can be applied to the subjects that recovered after a first infection.

scholarly journals Hydroxychloroquine and Tocilizumab Therapy in COVID-19 Patients – An Observational Study

2020 ◽  
Author(s):  
Andrew Ip ◽  
Donald A. Berry ◽  
Eric Hansen ◽  
Andre H. Goy ◽  
Andrew L Pecora ◽  
...  
Keyword(s):  
Cohort Study ◽  
Primary Outcome ◽  
Observational Cohort Study ◽  
Hospitalized Patients ◽  
Icu Patients ◽  
Positive Polymerase Chain Reaction ◽  
Observational Cohort ◽  
Polymerase Chain ◽  
Retrospective Observational Cohort Study

AbstractBackgroundHydroxychloroquine has been touted as a COVID-19 treatment. Tocilizumab, an inhibitor of IL-6, has been proposed as a treatment of critically ill patients.ObjectiveTo describe the association between mortality and hydroxychloroquine or tocilizumab therapy among hospitalized COVID-19 patients.DesignRetrospective observational cohort study of electronic health records Setting: 13-hospital network spanning the state of New Jersey.ParticipantsPatients hospitalized between March 1, 2020 and April 22, 2020 with positive polymerase chain reaction results for SARS-CoV-2. Follow up was through May 5, 2020.Main OutcomesThe primary outcome was death.ResultsAmong 2512 hospitalized patients with COVID-19 there have been 547 deaths (22%), 1539 (61%) discharges and 426 (17%) remain hospitalized. 1914 (76%) received at least one dose of hydroxychloroquine and 1473 (59%) received hydroxychloroquine with azithromycin. After adjusting for imbalances via propensity modeling, compared to receiving neither drug, there were no significant differences in associated mortality for patients receiving any hydroxychloroquine during the hospitalization (HR, 0.99 [95% CI, 0.80-1.22]), hydroxychloroquine alone (HR, 1.02 [95% CI, 0.83-1.27]), or hydroxychloroquine with azithromycin (HR, 0.98 [95% CI, 0.75-1.28]). The 30-day unadjusted mortality for patients receiving hydroxychloroquine alone, azithromycin alone, the combination or neither drug was 25%, 20%, 18%, and 20%, respectively. Among 547 evaluable ICU patients, including 134 receiving tocilizumab in the ICU, an exploratory analysis found a trend towards an improved survival association with tocilizumab treatment (adjusted HR, 0.76 [95% CI, 0.57-1.00]), with 30 day unadjusted mortality with and without tocilizumab of 46% versus 56%.ConclusionsThis observational cohort study suggests hydroxychloroquine, either alone or in combination with azithromycin, was not associated with a survival benefit among hospitalized COVID-19 patients. Tocilizumab demonstrated a trend association towards reduced mortality among ICU patients. Our findings are limited to hospitalized patients and must be interpreted with caution while awaiting results of randomized trials.Trial RegistrationClinicaltrials.gov Identifier: NCT04347993

scholarly journals Repurposing FIB-4 index as a predictor of mortality in patients with hematological malignancies and COVID-19

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257775
Author(s):  
Noorwati Sutandyo ◽  
Sri Agustini Kurniawati ◽  
Achmad Mulawarman Jayusman ◽  
Anisa Hana Syafiyah ◽  
Raymond Pranata ◽  
...  
Keyword(s):  
Retrospective Cohort ◽  
Posterior Probability ◽  
Primary Outcome ◽  
Hematological Malignancies ◽  
Independent Predictor ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Consecutive Sampling ◽  
Polymerase Chain

Background In this study, we aimed to investigate whether FIB-4 index is useful in predicting mortality in patients with concurrent hematological malignancies and COVID-19. We also aimed to determine the optimal cut-off point for the prediction. Methods This is a single-center retrospective cohort study conducted in Dharmais National Cancer Hospital, Indonesia. Consecutive sampling of adults with hematological malignancies and COVID-19 was performed between May 2020 and January 2021. COVID-19 screening test using the reverse transcriptase polymerase chain reaction (RT-PCR) of nasopharyngeal samples were performed prior to hospitalization for chemotherapy. FIB-4 index is derived from [age (years) × AST (IU/L)]/[platelet count (109/L) × √ALT (U/L)]. The primary outcome of this study is mortality, defined as clinically validated death/non-survivor during a 3-months (90 days) follow-up. Results There were a total of 70 patients with hematological malignancies and COVID-19 in this study. Median FIB-4 Index was higher in non-survivors (13.1 vs 1.02, p<0.001). FIB-4 index above 3.85 has a sensitivity of 79%, specificity of 84%, PLR of 5.27, and NLR of 0.32. The AUC was 0.849 95% CI 0.735–0.962, p<0.001. This cut-off point was associated with OR of 16.70 95% CI 4.07–66.67, p<0.001. In this study, a FIB-4 >3.85 confers to 80% posterior probability of mortality and FIB-4 <3.85 to 19% probability. FIB-4 >3.85 was associated with shorter time-to-mortality (HR 9.10 95% CI 2.99–27.65, p<0.001). Multivariate analysis indicated that FIB-4 >3.85 (HR 4.09 95% CI 1.32–12.70, p = 0.015) and CRP> 71.57 mg/L (HR 3.36 95% CI 1.08–10.50, p = 0.037) were independently associated with shorter time-to-mortality. Conclusion This study indicates that a FIB-4 index >3.85 was independent predictor of mortality in patients with hematological malignancies and COVID-19 infection.

scholarly journals Persistent SARS-CoV-2-positive over 4 months in a COVID-19 patient with CHB

Open Medicine ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. 749-753
Author(s):  
Wenyuan Li ◽  
Beibei Huang ◽  
Qiang Shen ◽  
Shouwei Jiang ◽  
Kun Jin ◽  
...  
Keyword(s):  
The Novel ◽  
Chain Reaction ◽  
Health Crisis ◽  
Public Health Crisis ◽  
Oxygen Inhalation ◽  
New Strategy ◽  
Polymerase Chain ◽  
Novel Coronavirus ◽  
Specific Symptoms

Abstract In recent months, the novel coronavirus disease 2019 (COVID-19) pandemic has become a major public health crisis with takeover more than 1 million lives worldwide. The long-lasting existence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has not yet been reported. Herein, we report a case of SARS-CoV-2 infection with intermittent viral polymerase chain reaction (PCR)-positive for >4 months after clinical rehabilitation. A 35-year-old male was diagnosed with COVID-19 pneumonia with fever but without other specific symptoms. The treatment with lopinavir-ritonavir, oxygen inhalation, and other symptomatic supportive treatment facilitated recovery, and the patient was discharged. However, his viral PCR test was continually positive in oropharyngeal swabs for >4 months after that. At the end of June 2020, he was still under quarantine and observation. The contribution of current antivirus therapy might be limited. The prognosis of COVID-19 patients might be irrelevant to the virus status. Thus, further investigation to evaluate the contagiousness of convalescent patients and the mechanism underlying the persistent existence of SARS-CoV-2 after recovery is essential. A new strategy of disease control, especially extending the follow-up period for recovered COVID-19 patients, is necessary to adapt to the current situation of pandemic.

scholarly journals Associations of MC4R, LEP, and LEPR Polymorphisms with Obesity-Related Parameters in Childhood and Adulthood

Genes ◽  
2021 ◽  
Vol 12 (6) ◽  
pp. 949
Author(s):  
Asta Raskiliene ◽  
Alina Smalinskiene ◽  
Vilma Kriaucioniene ◽  
Vaiva Lesauskaite ◽  
Janina Petkeviciene
Keyword(s):  
Gene Polymorphisms ◽  
Energy Homeostasis ◽  
Anthropometric Measurements ◽  
Gene Variants ◽  
Chain Reaction ◽  
Fat Level ◽  
Mc4r Rs17782313 ◽  
Polymerase Chain ◽  
Lep Gene

MC4R, LEP, and LEPR genes are involved in the hypothalamic leptin-melanocortin regulation pathway, which is important for energy homeostasis. Our study aimed to evaluate the associations between the MC4R rs17782313, LEP rs7799039, and LEPR rs1137101 polymorphisms with obesity-related parameters in childhood and adulthood. The data were obtained from the Kaunas Cardiovascular Risk Cohort study, which started in 1977 with 1082 participants aged 12–13 years. In 2012–2014, the follow-up survey was carried out. Genotype analysis of all respondents (n = 509) aged 48–49 years was performed for the gene polymorphisms using Real-Time Polymerase Chain Reaction. Anthropometric measurements were performed in childhood and adulthood. In childhood, only skinfold thicknesses were associated with gene variants being the lowest in children with MC4R TT genotype and LEP AG genotype. In adulthood, odds of obesity and metabolic syndrome was higher in MC4R CT/CC genotype than TT genotype carriers (OR 1.8; 95% CI 1.2–2.8 and OR 1.6; 95% CI 1.1–2.4, respectively). In men, physical activity attenuated the effect of the MC4R rs17782313 on obesity. The LEP GG genotype was associated with higher BMI, waist circumference, and visceral fat level only in men. No associations of the LEPR rs1137101 polymorphisms with anthropometric measurements and leptin level were found. In conclusion, the associations of the MC4R and LEP gene polymorphisms with obesity-related parameters strengthened with age.

Case Report: Progressive Dysphonia and Dysphagia due to Laryngeal Leishmaniasis

2021 ◽  
Author(s):  
Laura Renard ◽  
Adrien Lemaignen ◽  
Guillaume Desoubeaux ◽  
David Bakhos
Keyword(s):  
Polymerase Chain Reaction ◽  
Weight Loss ◽  
Case Report ◽  
Amphotericin B ◽  
Laryngeal Cancer ◽  
Complete Resolution ◽  
Chain Reaction ◽  
Polymerase Chain ◽  
Histopathology Examination

Laryngeal leishmaniasis is an unusual form of the disease. We report the case of a patient who consulted for dysphonia and dysphagia in a context of asthenia and weight loss. The patient had lesions that were suggestive of laryngeal cancer but were revealed to be leishmaniasis by histopathology examination and polymerase chain reaction. Treatment with amphotericin B and miltefosine permitted complete resolution of the lesions and no recurrence during the 18-month follow-up period.

scholarly journals A serological and molecular investigation of American cutaneous leishmaniasis in dogs, three years after an outbreak in the Northwest of Paraná State, Brazil

2009 ◽  
Vol 25 (1) ◽  
pp. 97-104 ◽  
Author(s):  
Gustavo Kiyoshi Massunari ◽  
Evandra Maria Voltarelli ◽  
Demilson Rodrigues dos Santos ◽  
Ademar Rodrigues dos Santos ◽  
Luiz Paschoal Poiani ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Cutaneous Leishmaniasis ◽  
Control Measures ◽  
Transmission Control ◽  
Chain Reaction ◽  
American Cutaneous Leishmaniasis ◽  
Molecular Investigation ◽  
Polymerase Chain ◽  
Pcr Techniques

Classic and molecular (polymerase chain reaction - PCR) techniques were used to diagnose American cutaneous leishmaniasis in 149 dogs from an area in the northwest of Paraná State, Brazil, where an American cutaneous leishmaniasis outbreak occurred in 2002. The results were compared to a set of previously obtained results. Twenty-five dogs had positive indirect immunofluorescence (IIF) (titers > 40), including two animals with suggestive lesions. The percentage of dogs with positive IIF was similar to that found in a previous study. The cultures of the lesion, blood and bone marrow were negative for Leishmania. A direct search for the parasite in the lesions proved negative, although PCR tests were positive. The PCR did not detect the DNA of Leishmania (Viannia) in the blood, even for those that had positive PCR in a previous study. The follow up of the 27 dogs showed that the majority of them had maintained the same levels of antibodies that had been detected previously. There was a reduction in the number of dogs with lesions, probably due to the transmission control measures that were adopted after the outbreak.

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