Antibody response to SARS-CoV-2 infection over six months among Nicaraguan outpatients

ABSTRACTNew information is emerging about SARS-CoV-2 epidemiology and immunity, but little of this information comes from low- and middle-income countries or from patients receiving care in the outpatient setting. The current study investigated the SARS-CoV-2 infection status and antibody responses in 157 patients seeking care for a respiratory disease suggestive of COVID-19 in private healthcare clinics during the first wave (June–October 2020) of infections in Nicaragua. We examined nasal swabs for the presence of viral RNA via RT-PCR and longitudinally collected sera for the changes in SARS-CoV-2 Spike antibody levels over six months. Among patients with confirmed SARS-CoV-2 infections, we evaluated if clinical symptoms were associated with age, hematological parameters and co-morbidities. The combination of PCR and paired serology identified 60 (38%) of the 157 outpatients as acute COVID-19. While both PCR and serology identified the majority (n = 38, 64%) of the acute infections, a notable number of outpatients were identified by RT-qPCR (n = 13, 22%) or by serology (n = 9, 14%) only. During the longitudinal study, we identified 6 new infections by serology among the 97 non-COVID-19 subjects. In conclusion, this study report that more than one third of the outpatients seeking care for acute respiratory disease during the first epidemic wave of SARS-CoV-2 in Nicaragua had an acute mild COVID-19 infection that correlate with prolonged humoral response. This immune response to the RBD antigen, more likely IgG dependent, significantly increased between the acute to convalescent and decay in the late convalescent but still remained seropositive.

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Smoking cessation and respiratory disease in low-income and middle-income countries

The Lancet Respiratory Medicine ◽

10.1016/s2213-2600(13)70123-1 ◽

2013 ◽

Vol 1 (5) ◽

pp. e23-e24 ◽

Cited By ~ 7

Author(s):

Omara Dogar ◽

Chris Bullen ◽

Thomas E Novotny ◽

Kamran Siddiqi

Keyword(s):

Smoking Cessation ◽

Respiratory Disease ◽

Low Income ◽

Middle Income ◽

Middle Income Countries

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Schizophrenia outcome measures in the wider international community

The British Journal of Psychiatry ◽

10.1192/bjp.191.50.s71 ◽

2007 ◽

Vol 191 (S50) ◽

pp. s71-s77 ◽

Cited By ~ 62

Author(s):

Mohan Isaac ◽

Prabhat Chand ◽

Pratima Murthy

Keyword(s):

Outcome Measures ◽

Clinical Symptoms ◽

Outcome Studies ◽

Future Research ◽

Sociocultural Factors ◽

Middle Income ◽

Middle Income Countries ◽

Low And Middle Income

BackgroundOutcome of schizophrenia has been described as favourable in low-and middle-income countries. Recently, researchers have questioned these findingsAimsTo examine the outcome studies carried out in different countries specifically looking atthose from low-and middle-income countriesMethodsLong-term course and outcome studies in schizophrenia were reviewedResultsA wide variety of outcome measures are used. The most frequent are clinical symptoms, hospitalisation and mortality (direct indicators), and social/ occupational functioning, marriage, social support and burden of care (indirect indicators). Areas such as cognitive function, duration of untreated psychosis, quality of life and effect of medication have not been widely studied in low-and middle-income countriesConclusionsThe outcome of schizophrenia appears to be better in low-and middle-income countries. A host of sociocultural factors have been cited as contributing to this but future research should aim to understand this better outcome. There is a need for more culture-specific instruments to measure outcomes

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Systematic scoping review protocol of methodologies of chronic respiratory disease surveys in low/middle-income countries

npj Primary Care Respiratory Medicine ◽

10.1038/s41533-019-0129-7 ◽

2019 ◽

Vol 29 (1) ◽

Author(s):

Dhiraj Agarwal ◽

◽

Nik Sherina Hanafi ◽

Soumya Chippagiri ◽

Evelyn A. Brakema ◽

...

Keyword(s):

Respiratory Disease ◽

Scoping Review ◽

Chronic Respiratory Disease ◽

Middle Income ◽

Middle Income Countries ◽

Low Middle Income Countries ◽

Disease Surveys ◽

Review Protocol

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Humoral Response after Vaccination with Half-Dose of BNT162b2 in Subjects under 55 Years of Age

Vaccines ◽

10.3390/vaccines9111277 ◽

2021 ◽

Vol 9 (11) ◽

pp. 1277

Author(s):

Krzysztof Lukaszuk ◽

Amira Podolak ◽

Grzegorz Jakiel ◽

Jolanta Kiewisz ◽

Izabela Woclawek-Potocka ◽

...

Keyword(s):

Detection Limit ◽

Humoral Response ◽

Dose Schedule ◽

Efficient Manner ◽

Middle Income ◽

Half Dose ◽

The Difference ◽

Cost Efficient ◽

Antibody Levels ◽

Roche Diagnostics

In the context of the ongoing COVID-19 pandemic, using a half-dose schedule vaccination can help to return to normalcy in a cost-efficient manner, which is especially important for low and middle-income countries. We undertook a study to confirm that in adults up to 55 years old, the humoral response to the half-dose (15 µg, 35 participants between 18 and 55 years old) and to the recommended dose (30 µg, 155 participants) in the two-dose three-week interval schedule would be comparable. Antibody levels were measured by the Elecsys Anti-SARS-CoV-2 S assay (Roche Diagnostics, upper detection limit: 2570 BAU/mL) on the day of dose 2 of the vaccine and then 8–10 days later to assess peak response to dose 2. The difference in proportions between the participants who did and did not exceed the upper detection limit 8–10 days after dose 2 was not statistically significant (p = 0.152). We suggest that a half-dose schedule can help to achieve widespread vaccination coverage more quickly and cheaply.

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An Unusual Case of Tetanus Masquerading as an Acute Abdomen: A Case Report

Clinical Practice and Cases in Emergency Medicine ◽

10.5811/cpcem.2020.8.49073 ◽

2020 ◽

Vol 4 (4) ◽

pp. 599-602

Author(s):

Rahul Thakur ◽

Rajshree Singh ◽

Sabin Nepal ◽

Prasanna Ghimire

Keyword(s):

Case Report ◽

Clinical Symptoms ◽

Muscle Stiffness ◽

Uneventful Recovery ◽

Clostridium Tetani ◽

Diagnostic Dilemma ◽

Middle Income ◽

Middle Income Countries ◽

Uncommon Presentation ◽

Low And Middle Income

Introduction: Tetanus is an acute onset neurological disease that is often lethal. It has a high disease burden in low and middle-income countries. Tetanus is caused by a toxin made by spores of the bacterium Clostridium tetani, which are found in soil, dust, and animal feces. The toxin impairs the motor neurons leading to muscle stiffness. However, with the development of a toxoid vaccine, the incidence has sharply declined and is now categorized as a vaccine-preventable disease. The treatment of tetanus is primarily supportive and focuses on managing the complications until the effects of toxins resolve. Case Report: We report the case of a 67-year-old farmer who previously sustained a laceration injury approximately 45 days prior to presenting to the emergency department with abdominal pain and rigidity. After a comprehensive evaluation to rule out other items in the differential diagnoses, he was diagnosed with tetanus based on clinical symptoms and ultimately required mechanical ventilation. The patient was then managed in the intensive care unit and later made an uneventful recovery. Conclusion: This case illustrates an uncommon presentation of tetanus and the latency of the infectious process. Often when patients present with atypical symptoms, it poses a diagnostic dilemma to the clinicians. Thus, it is very important to carefully elicit a history of contaminated injury. This case also highlights the importance of prophylactic vaccine in low and middle-income countries, which can reduce disease-related mortality and morbidity.

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Chronic respiratory disease surveys in adults in low- and middle-income countries: A systematic scoping review of methodological approaches and outcomes

Journal of Global Health ◽

10.7189/jogh.11.04026 ◽

2021 ◽

Vol 11 ◽

Author(s):

Nik Sherina Hanafi ◽

Dhiraj Agarwal ◽

Soumya Chippagiri ◽

Evelyn A Brakema ◽

Hilary Pinnock ◽

...

Keyword(s):

Respiratory Disease ◽

Scoping Review ◽

Chronic Respiratory Disease ◽

Middle Income ◽

Middle Income Countries ◽

Disease Surveys ◽

Methodological Approaches ◽

Low And Middle Income

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A case study of three patients with mucopolysaccharidoses in Hue Central Hospital

SAGE Open Medical Case Reports ◽

10.1177/2050313x20938245 ◽

2020 ◽

Vol 8 ◽

pp. 2050313X2093824

Author(s):

Tran Kiem Hao ◽

Nguyen Thi Diem Chi ◽

Nguyen Thi Hong Duc ◽

Nguyen Thi Kim Hoa

Keyword(s):

Cell Function ◽

Clinical Symptoms ◽

Growth Failure ◽

Degradation Process ◽

Definitive Diagnosis ◽

Enzyme Assays ◽

Middle Income ◽

Mucopolysaccharidosis I ◽

Middle Income Countries ◽

Mucopolysaccharidosis Vi

Mucopolysaccharidosis is a group of rare metabolic disorders characterized by a deficiency of enzymes in the degradation of glycosaminoglycans. The incomplete degradation process leads to the accumulation of glycosaminoglycans in lysosomes of various tissues, which interferes with cell function. We report three cases that were classified as Hurler—Mucopolysaccharidosis I, Morquio—Mucopolysaccharidosis IV A, and Maroteaux–Lamy—Mucopolysaccharidosis VI. Clinical presentations of these cases vary, depending on each type of enzyme defect. All the patients appeared healthy at birth, and symptoms appear at around 1 or 2 years. Clinical features, radiological findings, and especially enzyme assays have allowed us to establish a definitive diagnosis in these cases. These cases highlight that abnormal clinical symptoms, such as growth failure, coarse facial features, and joint problems, are key points for further investigation relating to mucopolysaccharidosis disease. However, in low- and middle-income countries, it is difficult to have a definitive diagnosis of one of the mucopolysaccharidoses due to lacking enzyme assays.

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