scholarly journals An increased ratio of SARS-CoV-2 positive to negative sense genomic and subgenomic RNAs within routine diagnostic upper respiratory tract swabs may be a marker of virion shedding

2021 ◽  
Author(s):  
Anthony Chamings ◽  
Tarka Raj Bhatta ◽  
Soren Alexandersen
Keyword(s):  
Clinical Symptoms ◽  
Nasopharyngeal Swab ◽  
Upper Respiratory Tract ◽  
Genome Length ◽  
Subgenomic Rna ◽  
Negative Strand ◽  
Subgenomic Rnas ◽  
Positive Individual ◽  
Global Population ◽  
Genomic Length

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread rapidly in the global population since its emergence in humans in late 2019. Replication of SARS-CoV-2 is characterised by transcription and replication of genomic length RNA and shorter subgenomic RNAs to produce virus proteins and ultimately progeny virions. Here we explore the pattern of both genome-length and subgenomic RNAs and positive and negative strand SARS-CoV-2 RNAs in diagnostic nasopharyngeal swabs using sensitive probe based PCR assays as well as Ampliseq panels designed to target subgenomic RNAs. Using these assays, we measured the ratios of genomic to subgenomic RNAs as well as the ratios of positive to negative strand RNAs in SARS-CoV-2 positive nasopharyngeal swab samples. We found that while subgenomic RNAs and negative strand RNA can be readily detected in swab samples taken up to 19 and 17 days post symptom onset respectively, and therefore their detection alone is not likely an indicator of active SARS-CoV-2 replication. However, the ratios of genomic-length to subgenomic RNA and also of positive to negative strand RNA were elevated in some swabs, particularly those collected around the onset of clinical symptoms or in an individual with decreasing PCR Cts in successive swab samples. We tentatively conclude that it may be possible to refine such molecular assays to help determine if active replication of virus is occurring and progeny virions likely present in a SARS-CoV-2 positive individual. Assays targeting subgenomic N or ORF7a RNAs as well as strand specific ORF7a total genome-length and subgenomic RNAs may be the most sensitive for this purpose as these targets were consistently the most abundant in the swab samples.

scholarly journals SARS-CoV-2 Detection in Fecal Sample from a Patient with Typical Findings of COVID-19 Pneumonia on CT but Negative to Multiple SARS-CoV-2 RT-PCR Tests on Oropharyngeal and Nasopharyngeal Swab Samples

Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 290
Author(s):  
Barbara Brogna ◽  
Carlo Brogna ◽  
Mauro Petrillo ◽  
Adriana Modestina Conte ◽  
Giulio Benincasa ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Clinical Symptoms ◽  
Nasopharyngeal Swab ◽  
Upper Respiratory Tract ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Negative Results ◽  
Upper Respiratory ◽  
Polymerase Chain ◽  
Pcr Test

Reverse transcriptase polymerase chain reaction (RT-PCR) negative results in the upper respiratory tract represent a major concern for the clinical management of coronavirus disease 2019 (COVID-19) patients. Herein, we report the case of a 43-years-old man with a strong clinical suspicion of COVID-19, who resulted in being negative to multiple severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RT-PCR tests performed on different oropharyngeal and nasopharyngeal swabs, despite serology having confirmed the presence of SARS-CoV-2 IgM. The patient underwent a chest computed tomography (CT) that showed typical imaging findings of COVID-19 pneumonia. The presence of viral SARS-CoV-2 was confirmed only by performing a SARS-CoV-2 RT-PCR test on stool. Performing of SARS-CoV-2 RT-PCR test on fecal samples can be a rapid and useful approach to confirm COVID-19 diagnosis in cases where there is an apparent discrepancy between COVID-19 clinical symptoms coupled with chest CT and SARS-CoV-2 RT-PCR tests’ results on samples from the upper respiratory tract.

Scoring System for the Diagnosis of COVID-19

2020 ◽  
Vol 13 (1) ◽  
pp. 413-414 ◽  
Author(s):  
Mohamed Farouk Allam
Keyword(s):  
Scoring System ◽  
Clinical Symptoms ◽  
False Negative ◽  
Nasopharyngeal Swab ◽  
Rt Pcr ◽  
Pcr Assay ◽  
Negative Results ◽  
False Negative Results ◽  
Symptoms And Signs

Due to the international spread of COVID-19, the difficulty of collecting nasopharyngeal swab specimen from all suspected patients, the costs of RT-PCR and CT, and the false negative results of RT-PCR assay in 41% of COVID-19 patients, a scoring system is needed to classify the suspected patients in order to determine the need for follow-up, home isolation, quarantine or the conduction of further investigations. A scoring system is proposed as a diagnostic tool for suspected patients. It includes Epidemiological Evidence of Exposure, Clinical Symptoms and Signs, and Investigations (if available). This scoring system is simple, could be calculated in a few minutes, and incorporates the main possible data/findings of any patient.

scholarly journals Prevalence of BRD-Related Viral Pathogens in the Upper Respiratory Tract of Swiss Veal Calves

Animals ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1940
Author(s):  
Eveline Studer ◽  
Lutz Schönecker ◽  
Mireille Meylan ◽  
Dimitri Stucki ◽  
Ronald Dijkman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Welfare Economic ◽  
Economic Losses ◽  
Nasopharyngeal Swab ◽  
Upper Respiratory Tract ◽  
Convenience Sample ◽  
Veal Calves ◽  
Mixed Regression ◽  
Influenza C Virus ◽  
Syncytial Virus

The prevention of bovine respiratory disease is important, as it may lead to impaired welfare, economic losses, and considerable antimicrobial use, which can be associated with antimicrobial resistance. The aim of this study was to describe the prevalence of respiratory viruses and to identify risk factors for their occurrence. A convenience sample of 764 deep nasopharyngeal swab samples from veal calves was screened by PCR for bovine respiratory syncytial virus (BRSV), bovine parainfluenza-3 virus (BPI3V), bovine coronavirus (BCoV), influenza D virus (IDV), and influenza C virus (ICV). The following prevalence rates were observed: BRSV, 2.1%; BPI3V, 3.3%; BCoV, 53.5%; IDV, 4.1%; ICV, 0%. Logistic mixed regression models were built for BCoV to explore associations with calf management and housing. Positive swab samples were more frequent in younger calves than older calves (>100 days; p < 0.001). The probability of detecting BCoV increased with increasing group size in young calves. Findings from this study suggested that young calves should be fattened in small groups to limit the risk of occurrence of BCoV, although an extended spectrum of risk factors for viral associated respiratory disorders such as nutritional aspects should be considered in future studies.

Conjunctivitis as a sign of persistent SARS-COV-2 infection? An observational study and report of late symptoms

2021 ◽  
pp. 112067212110565
Author(s):  
Jose Luis Vallejo-Garcia ◽  
L Balia ◽  
R Raimondi ◽  
G Rustioni ◽  
FI Camesasca ◽  
...  
Keyword(s):  
Foreign Body ◽  
Observational Study ◽  
Respiratory Tract ◽  
Recovery Phase ◽  
Nasopharyngeal Swab ◽  
Upper Respiratory Tract ◽  
End Points ◽  
Body Sensation ◽  
Upper Respiratory ◽  
Mean Time

Purpose To investigate if symptomatic conjunctivitis during the recovery phase of the disease could be associated to a persistent presence of SARS-CoV-2 in the upper respiratory tract. Secondary end points were to analyze the presence of SARS-CoV-2 in the conjunctiva of ocular symptomatic patients and to record the presence of ocular disturbances at this point of the disease. Methods An observational study including consecutive COVID19 patients treated at Humanitas Clinical and Research Hospital who were attending for nasopharyngeal swab to confirm the resolution of SARS-CoV-2 infection and end of isolation. We examined 129 consecutive patients from May to June 2020. The primary end point was to determine if symptomatic conjunctivitis at this point of the disease could be associated to a persistent presence of SARS-CoV-2 in the upper respiratory tract. Secondary end points were to analyze the presence of SARS-CoV-2 in the conjunctiva of ocular symptomatic patients and to record the presence of ocular disturbances at this point of the disease. Results One hundred twenty eight patients were included, 9.38% had conjunctivitis, none resulted positive to conjunctival PCR swab test, while two of them had positive nasopharyngeal result. Mean time elapsed since the first COVID-19 positive swab to the time of examination was 6 weeks (  ± 3). The only significant association was the presence of conjunctivitis with older age (65.3  ±  12.7 vs 56.7  +  13.5. p  =  0.046). Nasopharyngeal swab resulted positive in 22 patients (17.19%). While 88 patients (68.2%) did not have any ocular complain during their COVID19 disease. The 40 patients (31.8%) reporting ocular disturbances complained about: redness (25.43%), tearing (19.53%), burning (18.35%), foreign body sensation (17.18%), itching (15.62%), and discharge (12.5%). Conclusion This study showed that late conjunctivitis cannot be considered as a marker of persistent infection when patients are sent to confirm the resolution of SARS-CoV-2 infection.

CLINIC AND COMPLICATIONS OF COVID-19 CORONAVIRUS DISEASE WITH PATHOGENESIS ELEMENTS

2020 ◽  
pp. 72-79
Author(s):  
I. V. Аndrusovich
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Tract ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Clinical Symptoms ◽  
Clinical Course ◽  
Clinical Manifestations ◽  
Second Phase ◽  
Upper Respiratory Tract

The longer the COVID−19 coronavirus pandemic lasts, the more information about its clinical manifestations is accumulated. The incubation period of COVID−19 ranges from 2 to 14 days, rarely up to 3 weeks, but in a significant number of cases an infection is not accompanied with the appearance of clinical symptoms. Currently, the following variants of the clinical course of COVID−19 can be identified as follows: viral load; subclinical; slight; uncomplicated with damage to only the upper respiratory tract; mild pneumonia, severe pneumonia, acute respiratory distress syndrome, etc. The clinical course of COVID−19 depends on the severity, the criteria of which are the intoxication manifestation, the degree of fever and the dominant syndrome. Mild / moderate forms are manifested by frequent increase in body temperature up to 38 ° C, respiratory symptoms, headache, myalgias, palpitations and general malaise. Patients stop distinguishing smells and feel the taste of food. Approximately from the 7th to the 9th days of the disease there are problems with breathing, which indicates the impairment of the lower respiratory tract and the beginning of the second phase of the disease, and its course is regarded as severe. Severe forms of the disease can also be manifested by impaired coordination of movements, slurred speech. In 1 to 4 % of patients there is developed the psychosis in the form of hallucinations. In the elderly, COVID−19 may be accompanied by delirium, lowering blood pressure. The risks of adverse disease are associated with somatic diseases: cardiovascular and nervous systems, respiratory tract, hormonal disorders, etc. Otitis, sinusitis, sepsis, bronchopulmonary infection, thrombosis, myocarditis etc. can be the complications of COVID−19. Computer tomography is an instrumental test that demonstrates the damage of lungs with coronavirus and allows to assess its severity. Key words: coronavirus infection, COVID−19, clinical variants, severity, pneumonia, acute respiratory distress syndrome.

scholarly journals Complex treatment of diseases of the nasal cavity and paranasal sinuses at the present time

2021 ◽  
pp. 134-139
Author(s):  
V. M. Svistushkin ◽  
K. V. Eremeeva
Keyword(s):  
Nasal Cavity ◽  
Paranasal Sinuses ◽  
Clinical Symptoms ◽  
Local Treatment ◽  
Silver Ions ◽  
Upper Respiratory Tract ◽  
Drug Induced ◽  
High Incidence ◽  
Upper Respiratory ◽  
Pain Symptoms

The search for rational treatment of diseases of the nasal cavity and paranasal sinuses is due to the high incidence among the world's population. Despite the absolutely clear recommendations that would seem to greatly facilitate the choice and scope of therapy, it is extremely important to have a differentiated approach to each patient, depending on age, concomitant pathology, the nature of the course of the disease, the severity of clinical, primarily pain symptoms, and the presence of rhinogenic complications. Differential diagnosis of viral and bacterial acute rhinosinusitis (ARS) allows to avoid unreasonable prescription of antibiotics in the former case and choose therapy in such a way as to help relieve clinical symptoms, timely cure the disease and prevent complications. A systematic review of the literature was conducted with the analysis of scientific research data on the evaluation of the effectiveness of protargol or silver proteinate in the local treatment of upper respiratory tract diseases. A review of studies shows that silver proteinate has astringent, antiseptic and anti-inflammatory effects. The spectrum of antimicrobial action of silver is much wider than many antibiotics and sulfonamides. At the same time, pathogenic microflora is more sensitive to silver ions than non-pathogenic microflora. The analysis of the works also demonstrates the absence of adverse reactions when using this drug. The obtained data allow us to recommend preparations based on silver proteinate as a complex therapy for acute and chronic diseases of the nasal cavity and nasopharynx. The vasoconstrictive effect of protargol allows it to be used as an alternative to decongestants in order to avoid the development of drug-induced rhinitis and tachyphylaxis. Sialor® is a new, convenient, affordable, longer-shelf-life form of silver proteinate.

scholarly journals COVID-19 pandemic in children of Сhernivtsi region: clinical features and annual treatment experience

2021 ◽  
Vol 16 (3) ◽  
pp. 225-232
Author(s):  
O.K. Кoloskova ◽  
T.M. Bilous ◽  
N.V. Gopko ◽  
M.B. Myroniuk
Keyword(s):  
Dynamic Analysis ◽  
Clinical Features ◽  
Odds Ratio ◽  
Inpatient Treatment ◽  
Clinical Symptoms ◽  
Community Acquired Pneumonia ◽  
Upper Respiratory Tract ◽  
The Third ◽  
Upper Respiratory ◽  
Inflammatory Syndrome

Background. The pandemic of coronavirus disease (COVID-19) has been going on for more than a year and is a problem for the health care system worldwide. At the same time, there are few studies on the peculiarities of COVID-19 in children, in particular how clinical symptoms have changed during the year with the change of types of coronavirus SARS-CoV-2. Objective was to conduct a retrospective generalized analysis of the clinical course, laboratory markers and features of treatment in pediatric cases of ­COVID-19 in Chernivtsi region. Materials and me­thods. Using the retrospective cohort method, 263 clinical cases of ­COVID-19 in children of the Chernivtsi region hospitalized for the period of March 2020 — March 2021 were analyzed. Results. In this work, a dynamic analysis was performed of the clinical features of ­COVID-19 course in the population of children of Chernivtsi region, who were hospitalized during March 2020 — March 2021 at inpatient departments with signs of infection caused by ­SARS-CoV-2. The first group included 65 patients who were treated in the second quarter of 2020, the second group consisted of 90 children who underwent inpatient treatment in the third quarter of 2020, the third group included 87 children who were treated in the fourth quarter of 2020, and the fourth group consisted of 21 children who underwent inpatient treatment in the first quarter of 2021. It was found that the frequency of complaints of malaise was due to infectious-inflammatory, intoxication and catarrhal symptom complexes, although in contrast to the onset of the pandemic, the complaints and signs of intoxication and asthenic syndromes, infectious-inflammatory syndromes, nonspecific neurological symptoms increased with a relatively stable rate of lesions of the upper respiratory tract. In the first quarter of 2021, there was an increase in cases of multisystem inflammatory syndrome (odds ratio = 6.5) and community-acquired pneumonia (odds ratio = 2.7). Conclusions. A dynamic analysis of the course of COVID-19 in children has demonstrated phenotypic deviations of the disease with torpidity to the prescribed treatment for nonspecific symptoms of disorders of the nervous system and gastrointestinal tract with a decrease in duration and severity of fever, increased incidence of pneumonia (odds ratio = 2.7) and multisystem inflammatory syndrome (odds ratio = 6.5).

Otorhinolaryngological manifestations of COVID-19

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Jarosław Wysocki
Keyword(s):  
Respiratory Tract ◽  
Distress Syndrome ◽  
Clinical Symptoms ◽  
Wide Spectrum ◽  
Multiple Organ ◽  
Upper Respiratory Tract ◽  
Equilibrium System ◽  
Similar Frequency ◽  
Upper Respiratory ◽  
Loss Of Strength

COVID-19 manifests itself in a wide spectrum of clinical symptoms, both in terms of their variety and severity. It can be asymptomatic or abortive, mild, moderate, severe and lightning, as septic with multiple organ failure and shock Typical leading symptoms of COVID-19 are: high fever poorly responding to drugs, severe loss of strength, chest pain, dyspnoea, pain headaches, bone and joint pain and muscle pain, until the onset of acute respiratory distress syndrome (ARDS). However, many publications mention among the possible symptoms also others, not related to the involvement of the lower respiratory tract. These are gastrointestinal disorders, damage to the central and peripheral nervous system, catarrh of the upper respiratory tract and dysfunctions of the sensory organs. The aim of this literature review was to determine the frequency of various head and neck dysfunctions that are part of COVID-19. Symptoms of conjunctivitis, nasal mucosa, pharynx and larynx are reported by about of patients, but they do not always occur at the same time, as in infections caused, for example, by rhinoviruses. Anosmi / hyposmia or ageusia / hypogeusia occur with a similar frequency. Symptoms of damage to the equilibrium system, such as dizziness, are reported by approx. 1/3, vertigo and hearing loss approx. 5-6%, tinnitus approx. 10% of patients. Reports of coexistence with COVID-19 of peripheral paresis of the facial nerve are so far relatively few and often included in the neurological disorders, the frequency of which is also about 1/3 of COVID-19 cases. Importantly, both catarrhal symptoms and the others listed here may precede, co-occur or follow the appearance of the leading symptoms of COVID-19. They can also be the only symptoms of this disease. This should prompt otorhinolaryngologists to be particularly vigilant in this regard

scholarly journals Two-year Efficacy and Safety of Etanercept in Pediatric Patients with Extended Oligoarthritis, Enthesitis-related Arthritis, or Psoriatic Arthritis

2016 ◽  
Vol 43 (4) ◽  
pp. 816-824 ◽  
Author(s):  
Tamas Constantin ◽  
Ivan Foeldvari ◽  
Jelena Vojinovic ◽  
Gerd Horneff ◽  
Ruben Burgos-Vargas ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Clinical Symptoms ◽  
Inactive Disease ◽  
Upper Respiratory Tract ◽  
Open Label ◽  
Safety Issues ◽  
Enthesitis Related Arthritis ◽  
Intention To Treat ◽  
American College Of Rheumatology ◽  
Demyelinating Disorders

Objective.The main objective was to determine the 2-year clinical benefit and safety of etanercept (ETN) in children with the juvenile idiopathic arthritis (JIA) categories of extended oligoarthritis (eoJIA), enthesitis-related arthritis (ERA), or psoriatic arthritis (PsA).Methods.CLIPPER was a 96-week, phase IIIb, open-label, multicenter study. Patients with eoJIA, ERA, or PsA received ETN 0.8 mg/kg once weekly (50 mg max) for up to 96 weeks. The proportions of patients reaching the JIA American College of Rheumatology (ACR) 30/50/70/90/100 and inactive disease responses at Week 96 were calculated. Adverse events (AE) were collected throughout the study (intention-to-treat sample).Results.There were 127 patients (eoJIA n = 60, ERA n = 38, PsA n = 29) who received ≥ 1 dose of ETN. The mean disease duration was 31.6 (eoJIA), 23.0 (ERA), and 21.8 (PsA) months. At Week 96, JIA ACR 30/50/70/90/100/inactive disease responses (95% CI) were achieved by 84.3% (76.7, 90.1), 83.5% (75.8, 89.5), 78.7% (70.6, 85.5), 55.1% (46.0, 63.9), 45.7% (36.8, 54.7), and 27.6% (20.0, 36.2) of patients, respectively. The most common AE (no. events, events per 100 patient-yrs) overall were headache (23, 10.7), pyrexia (12, 5.6), and diarrhea (10, 4.6). The most common infections were upper respiratory tract infection (83, 38.6), pharyngitis (50, 23.2), gastroenteritis (22, 10.2), bronchitis (19, 8.8), and rhinitis (17, 7.9). No cases of malignancy, active tuberculosis, demyelinating disorders, or death were reported.Conclusion.Over 96 weeks of therapy, ETN demonstrated sustained efficacy at treating the clinical symptoms of all 3 JIA categories, with no major safety issues.

scholarly journals A Case Report of Prolonged COVID-19 Positive RT-PCR for five months

2020 ◽  
Author(s):  
Zeinab Siami ◽  
Alireza Soleimani ◽  
Armin Khavandegar
Keyword(s):  
Assessment Tool ◽  
Nasopharyngeal Swab ◽  
Upper Respiratory Tract ◽  
Rt Pcr ◽  
Case Presentation ◽  
Treatment Regimens ◽  
Standard Assessment ◽  
Appropriate Treatment ◽  
Upper Respiratory ◽  
Old Persian

Abstract Background: The COViD-19 gold standard assessment tool remained the RT-PCR of upper respiratory tract specimen extracted by the nasopharyngeal swab. A positive result would dwindle through a three-week course and, eventually, would be undetectable. The most prolonged period of detectable viral RNA was 37 days. Besides, COViD-19 RT-PCR remained positive for 74 days in a patient suffering from lymphoma Case presentation: In this study, we have presented a 56-year-old Persian male patient, a known case of lymphoma since 2015, who experiences many episodes of chemotherapy with a five-month positive RT-PCR COViD-19 laboratory test and finally was intubated and then died of opportunistic pulmonary infections. Conclusion: COViD-19 patients who have concurrent lymphoma failed to remove the virus thoroughly, despite providing appropriate treatment regimens.

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