scholarly journals Corticosteroid injections during the COVID-19 pandemic

2020 ◽  
Vol 1 (9) ◽  
pp. 605-611 ◽  
Author(s):  
David McKean ◽  
Siok Li Chung ◽  
Rory Fairhead ◽  
Oliver Bannister ◽  
Malgorzata Magliano ◽  
...  

Aims To describe the incidence of adverse clinical outcomes related to COVID-19 infection following corticosteroid injections (CSI) during the COVID-19 pandemic. To describe the incidence of positive SARS-CoV-2 reverse transcriptase polymerase chain reaction (RT-PCR) testing, positive SARS-COV2 IgG antibody testing or positive imaging findings following CSI at our institution during the COVID-19 pandemic. Methods A retrospective observational study was undertaken of consecutive patients who had CSI in our local hospitals between 1 February and 30June 2020. Electronic patient medical records (EPR) and radiology information system (RIS) database were reviewed. SARS-CoV-2 RT-PCR testing, SARS-COV2 IgG antibody testing, radiological investigations, patient management, and clinical outcomes were recorded. Lung findings were categorized according to the British Society of Thoracic Imaging (BSTI) guidelines. Reference was made to the incidence of lab-confirmed COVID-19 cases in our region. Results Overall, 1,656 lab-confirmed COVID-19 cases were identified in our upper tier local authority (UTLA), a rate of 306.6 per 100,000, as of 30June 2020. A total of 504 CSI injections were performed on 443 patients between 1 February and 30June 2020. A total of 11 RT-PCR tests were performed on nine patients (2% of those who had CSI), all of which were negative for SARS-CoV-2 RNA, and five patients (1.1%) received an SARS-CoV-2 IgG antibody test, of which 2 (0.5%) were positive consistent with prior COVID-19 infection, however both patients were asymptomatic. Seven patients (1.6%) had radiological investigations for respiratory symptoms. One patient with indeterminate ground glass change was identified. Conclusion The incidence of positive COVID-19 infection following corticosteroid injections was very low in our cohort and no adverse clinical outcomes related to COVID-19 infection following CSI were identified. Our findings are consistent with CSI likely being low risk during the COVID-19 pandemic. The results of this small observational study are supportive of the current multi-society guidelines regarding the judicious use of CSI. Cite this article: Bone Joint Open 2020;1-9:605–611.

2020 ◽  
Vol 9 (1) ◽  
pp. 78-86
Author(s):  
Ömer ACER ◽  
Osman ÖZÜDOĞRU

In the present study, we compared the real-time reverse-transcription polymerase chain reaction (RT-PCR) and total IgM-IgG antibody tests for diagnosis SARS-CoV-2 patients. SARS-CoV-2 patients were divided into four additional subgroups according to clinical examination, and Computed Tomography (CT) for SARS-CoV-2. Groups were included 60 mild cases, 111 moderate cases, 53 severe cases, and 105 normal cases. In a mild group, 52.5% of 60 cases were found to be male, 45.9% female, and the average age was found as 38.4 ±2.011. The positive ratio was found as 80.3% in the RT-PCR test, while 39.3% in total IgM/IgG. In a moderate group, 49.1% of 111 cases were found to be male, 50% female, and the average age was 45.05 ±1.519. The positive ratio was found as 85.7% in the RT-PCR test while 54.5% in total IgM/IgG. In a severe group, 53.7%of 53 cases were found to be male, 44.4% female, and the average age was 55.5±2.122. The positive ratio was found as 75.9% both in RT-PCR and total IgM/IgG tests. In a normal group with no involvement according to Computed Tomography (CT), 49.1%of 105 cases were found to be male, 50% female, and the average age was found as 34.8±1.391. The positive ratio was found as 95.3% in the RT-PCR test while 5.7% in total IgM/IgG. Chronic diseases were detected more in severe cases, suggesting that persons who have chronic diseases or decreased immunity, such as diabetes mellitus, cardiovascular diseases, hypertension, and lung disease, are at a higher risk for developing severe COVID-19 if they are infected with SARS-CoV-2. According to our results, we can suggest a higher detection sensibility in RT-PCR than in total IgM/IgG antibody test for mild, moderate and normal group, while the detection sensibility of IgM/IgG antibody increases in a severe group with bilateral diffuse involvement according to CT.


Author(s):  
Morihito Takita ◽  
Tomoko Matsumura ◽  
Kana Yamamoto ◽  
Erika Yamashita ◽  
Kazutaka Hosoda ◽  
...  

AbstractThe serosurvey is an alternative way to know the magnitude of the population infected by coronavirus disease 2019 (COVID-19) since the expansion of capacity of the polymerase chain reaction (PCR) to detect the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was delayed. We herein report seroprevalence of COVID-19 accessed in the two community clinics in Tokyo. The point-of-care immunodiagnostic test was implemented to detect the SARS-CoV-2 specific IgG antibody in the peripheral capillary blood. The overall positive percentage of SARS-CoV-2 IgG antibody is 3.83% (95% confidence interval: 2.76-5.16) for the entire cohort (n =1,071). The central Tokyo of 23 special wards exhibited a significantly higher prevalence compared to the other area of Tokyo (p =0.02, 4.68% [95%CI: 3.08-6.79] versus 1.83 [0.68-3.95] in central and suburban Tokyo, respectively). The seroprevalence of the cohort surveyed in this study is low for herd immunity, which suggests the need for robust disease control and prevention. A community-based approach, rather than state or prefectural levels, is of importance to figure out profiles of the SARS-COV-2 outbreak.


Author(s):  
Tapas Bandyopadhyay ◽  
Abhinav Sharma ◽  
Pratima Kumari ◽  
Arti Maria ◽  
Rahul Choudhary

Abstract Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-19) has emerged as a public health emergency in recent times. The reported data on the mode of transmission of coronavirus disease 2019 (COVID-19) are largely through contact, droplet, airborne and fomite transmission methods with vertical transmission being a rare entity. We hereby report a case of a probable vertical transmission of SARS-CoV-19 from an infected pregnant female to her neonate. The transmission has been confirmed by a positive RT-PCR at 16 h of life along with a positive IgG antibody test for SARS-CoV-19 in the baby and after excluding the possible environmental contamination of the sample. The baby was asymptomatic during the course of hospital stay and was discharged from the facility on Day 9 of life.


BJGP Open ◽  
2021 ◽  
pp. BJGPO.2021.0038
Author(s):  
Michael Edmund O'Callaghan ◽  
Elizabeth Ryan ◽  
Cathal Walsh ◽  
Peter Hayes ◽  
Monica Casey ◽  
...  

Background: SARS-CoV-2 antibody testing in community settings may help us better understand the immune response to this virus and therefore help guide public health efforts. Aim: Conduct a seroprevalence study of IgG antibodies in Irish GP clinics. Design and Setting: Participants were 172 staff and 799 patients of 15 general practices in the Midwest region of Ireland. Methods: This seroprevalence study utilised 2 manufacturers’ point-of-care (POC) SARS-CoV-2 IgM-IgG combined antibody tests, offered to patients and staff in general practice from mid-June to mid-July 2020. Results: Immunoglobulin G (IgG) seroprevalence was 12.6% in patients attending general practice and 11.1% in staff working in general practice, with administrative staff having the lowest seroprevalence at 2.5% and nursing staff having the highest at 17.6%. Previous symptoms suggestive of SARS-CoV-2 and history of a polymerase chain reaction (PCR) test were associated with higher seroprevalence. IgG antibodies were detected in approximately 80% of participants who had a previous PCR-confirmed infection. Average length of time between participants’ positive PCR test and positive IgG antibody test was 83 days. Conclusion: Patients and healthcare staff in general practice in Ireland had relatively high rates of IgG to SARS-CoV-2 compared to the national average at the time (1.7%). Four-fifths of participants with a history of confirmed COVID-19 disease still had detectable antibodies an average of 12 weeks post-infection. While not proof of immunity, SARS-CoV-2 POC testing can be used to estimate IgG seroprevalence in general practice settings.


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S849-S850
Author(s):  
David McCormick ◽  
Tracy Scott ◽  
Jesse Chavez ◽  
Kay Wilcox ◽  
Grace E Marx ◽  
...  

Abstract Background The COVID-19 pandemic has disproportionately affected people experiencing homelessness (PEH) residing in shelters. Initial and regular testing of PEH in communities with moderate or substantial SARS-CoV-2 transmission may limit spread in shelters. We analyzed factors associated with positive SARS-CoV-2 RNA and antibody tests for PEH staying in shelters or encampments in Denver, Colorado. Methods In May 2020, Denver Public Health collaborated with local leaders to identify 4 homeless shelters and 3 outdoor encampments for voluntary, universal SARS-CoV-2 testing. At each testing event, a short questionnaire including sociodemographic factors and symptoms was administered to PEH who consented to testing. SARS-CoV-2 RNA testing by reverse transcription polymerase chain reaction (RT-PCR) was performed on nasopharyngeal swabs; antibody testing was performed on venous blood samples. PEH reporting a prior positive RT-PCR test were not retested but were eligible for antibody testing. Statistical calculations were performed with an α of 0.05; all tests were two-sided. Results From June 2–July 28, 2020, 931 PEH were approached. A total of 863 RT-PCR tests were performed at 14 testing events, and 334 antibody tests were performed at 5 testing events. Overall, 604 and 259 RT-PCR tests were conducted in 4 shelters and 3 encampments, respectively; 189 and 145 antibody tests were conducted in 3 shelters and 2 encampments, respectively. PEH tested in shelters were older, more often men, less often Native American, and less likely to report COVID-19 symptoms than those tested at encampments (Table 1). Overall, 9% of PEH tested in shelters tested positive for SARS-CoV-2 compared to 3% of PEH tested in encampments (p=0.002); 8% of men had positive RT-PCR results compared to 2% of women (p=0.03) (Table 2). PEH tested at shelters had a higher percentage of detectable SARS-CoV-2 antibodies than those tested in encampments (24% vs 8%, p=0.0002; Table 3). Neither RT-PCR nor antibody test results differed significantly by race or ethnicity. Table 1. Demographics of participants residing in encampments compared with shelters in Denver, Colorado, May-July 2020 (n=931) Table 2. Comparison of participants testing positive or negative for SARS-CoV-2 RT-PCR* by location and demographics, in Denver, Colorado, May-July 2020 Table 3. Comparison of participants testing positive or negative for antibodies against SARS-CoV-2 by location and demographics in Denver, Colorado, May-July 2020 Conclusion A greater percentage of PEH tested positive for both SARS-CoV-2 RNA and antibodies at shelters than encampments, suggesting that continued assessment of mitigation strategies in shelters should be a priority. Disclosures All Authors: No reported disclosures


2021 ◽  
Author(s):  
Lisa Florin ◽  
Karel Maelegheer ◽  
Wouter Vandewal ◽  
Dirk Bernard ◽  
Johan Robbrecht

Abstract Objective In this study, the performance of 2 commercially available SARS-CoV-2 antibody assays is evaluated. Methods The Siemens SARS-CoV-2 Total (COV2T) and IgG (COV2G) antibody tests were evaluated on a Siemens Atellica IM1300 analyzer. Imprecision was assessed with the CLSI EP15 protocol using positive controls. Ninety control group specimens were analyzed for specificity, and 175 specimens from 58 patients with polymerase chain reaction–confirmed SARS-CoV-2 were measured for the sensitivity and kinetics of the antibody response. Results Within-run and total imprecision were acceptable for both assays. Both tests showed a specificity of 100%. Sensitivity earlier in the disease state was greater for the COV2T assay than for the COV2G assay, but sensitivity >14 days after onset of symptoms approached 100% for both. For all patients, antibody titers remained above the seroconversion cutoff for all follow-up specimens. Conclusion This study shows acceptable performance for both the Siemens COV2T and COV2G test, although seroconversion occurs earlier with the COV2T test.


Author(s):  
Xu Chen ◽  
Fang Zheng ◽  
Yanhua Qing ◽  
Shuizi Ding ◽  
Danhui Yang ◽  
...  

AbstractBackgroundThe clinical outcomes of COVID-19 patients in Hubei and other areas are different. We aim to investigate the epidemiological and clinical characteristics of patient with COVID-19 in Hunan which is adjacent to Hubei.MethodsIn this double-center, observational study, we recruited all consecutive patients with laboratory confirmed COVID-19 from January 23 to February 14, 2020 in two designated hospitals in Hunan province, China. Epidemiological and clinical data from patients’ electronic medical records were collected and compared between mild, moderate and severe/critical group in detail. Clinical outcomes were followed up to February 20, 2020.Findings291 patients with COVID-19 were categorized into mild group (10.0%), moderate group (72.8%) and severe/critical group (17.2%). The median age of all patients was 46 years (49.8% were male). 86.6% patients had an indirect exposure history. The proportion of patients that had been to Wuhan in severe/critical group (48.0% vs 17.2%, p=0.006) and moderate group (43.4% vs 17.2%, p=0.007) were higher than mild group. Fever (68.7%), cough (60.5%), and fatigue (31.6%) were common symptoms especially for severe and critical patients. Typical lung imaging finding were bilateral and unilateral ground glass opacity or consolidation. Leukopenia, lymphopenia and eosinopenia occurred in 36.1%, 22.7% and 50.2% patients respectively. Increased fibrinogen was detected in 45 of 58 (77.6%) patients with available results. 29 of 44 (65.9%) or 22 of 40 (55.0%) patients were positive in Mycoplasma pneumonia or Chlamydia pneumonia antibody test respectively. Compared with mild or moderate group, severe/critical group had a relative higher level of neutrophil, Neutrophil-to-Lymphocyte Ratio, h-CRP, ESR, CK, CK–MB, LDH, D-dimer, and a lower level of lymphocyte, eosinophils, platelet, HDL and sodium (all p<0.01). Most patients received antiviral therapy and Chinese Medicine therapy. As of February 20, 2020, 159 (54.6%) patients were discharged and 2 (0.7%) patients died during hospitalization. The median length of hospital stay in discharged patients was 12 days (IQR: 10-15).InterpretationThe epidemiological and clinical characteristics of COVID-19 patients in Hunan is different from patients in Wuhan. The proportion of patients that had been to Wuhan in severe/critical group and moderate group were higher than mild group. Laboratory and imaging examination can assist in the diagnosis and classification of COVID-19 patients.


2021 ◽  
Vol 14 (11) ◽  
Author(s):  
Borhan Moradveisi ◽  
Shirin Behzadi ◽  
Farima Zakaryaei ◽  
Ali Jalili ◽  
Khaled Rahmani ◽  
...  

Background: The knowledge of antibody’s significance and frequency in patients cured of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is extremely limited. Objectives: This study aimed to evaluate anti-SARS-CoV-2 IgG antibodies in patients exposed to SARS-CoV-2. Methods: Healthcare professionals infected with SARS-CoV-2 were enrolled in this study. The levels of anti-SARS-CoV-2 IgG antibodies were detected 15 days after the onset of symptoms and five months later. Results: A total of 167 patients with coronavirus disease 2019 (COVID-19) were evaluated, including 119 (71.3%) females and 48 (28.7%) males. Of the 88 polymerase chain reaction (PCR)-positive patients, 55 (62.5%) had IgG-positive antibodies, and of the 79 reverse transcriptase (RT)-PCR-negative patients, 12 (16.9%) had IgG-positive antibodies. Out of 23 anosmia cases, 19 (82.6%) had positive antibodies. There was a significant relationship between anosmia and positive antibody (P  =  0.001), but there was no correlation between antibody titers and gender and other disease symptoms. Immortally, 63 (94%) cases demonstrated high levels of anti-SARS-CoV-2 IgG antibodies after five months of infection. Moreover, 6.5% (N  =  11) of the total population were re-infected with COVID-19 six months later. Conclusions: Overall, anti-SARS-CoV-2 IgG antibodies detection may be an appropriate method to identify suspected patients with a negative RT-PCR test. Antibodies can remain high in most infected patients for up to five months after infection. Moreover, anosmia seems to be a valuable diagnostic factor, and the healthcare system should implement isolation measures for patients with anosmia.


2020 ◽  
Author(s):  
Danielle Dias Conte ◽  
Joseane Mayara Almeida Carvalho ◽  
Luciano Kleber de Souza Luna ◽  
Klinger Soares Faíco-Filho ◽  
Ana Helena Perosa ◽  
...  

AbstractSince the Coronavirus Disease 2019 (COVID-19) pandemic, Brazil has the third-highest number of confirmed cases and the second-highest number of recovered patients. SARS-CoV-2 detection by real-time RT-PCR is the gold standard in certified infrastructured laboratories. However, for large-scale testing, diagnostics should be fast, cost-effective, widely available, and deployed for the community, such as serological tests based on lateral flow immunoassay (LFIA) for IgM/IgG detection. We evaluated three different commercial point-of-care (POC) LFIAs for anti-SARS-CoV-2 IgM and IgG detection in capillary whole blood of 100 healthcare workers (HCW) previously tested by RT-PCR: 1) COVID-19 IgG/IgM BIO (Bioclin, Brazil), 2) Diagnostic kit for IgM/IgG Antibody to Coronavirus (SARS-CoV-2) (Livzon, China); and 3) SARS-CoV-2 Antibody Test (Wondfo, China). A total of 84 positives and 16 negatives HCW were tested. The data was also analyzed by the number of days post symptoms (DPS) in three groups: <30 (n=26), 30-59 (n=42), and >59 (n=16). Overall detection was 85.71%, 47.62%, and 44.05% for Bioclin, Livzon, and Wondfo, respectively, with a specificity of 100%, and 98.75% for Livzon on storage serum samples. Bioclin was more sensitive (p<0.01), regardless of the DPS. Thus, the Bioclin can be used as a POC test to monitor SARS-CoV-2 seroconversion in HCW.


2021 ◽  
Author(s):  
Hui YANG ◽  
Fan XIE ◽  
Yun Zhao ◽  
Guoqiang SUN ◽  
Yao CHENG ◽  
...  

Abstract Background COVID-19 has become a major public health problem around the world. There are limited data on maternal and neonatal outcomes of pregnant women with COVID-19 pneumonia. The purpose of this study is to investigate and analysis the clinical features, imaging findings, related laboratory indicators, treatments and outcomes of maternal-fetal for cases of suspected infection COVID-19 pregnant women in outbreak area in order to provide reference for clinical work. Methods A case-control study was conducted to compare clinical features, treatment, maternal and neonatal outcomes of pregnant women with and without COVID-19 pneumonia. Results One confirmed patient who was discharged from hospital after a negative RT-PCR result, was readmitted and subsequently tested positive on RT-PCR. The vaginal delivery rate and gestational week of confirmed case group showed significantly lower than 2019 control group. Pulmonary CT images were initially same between confirmed group and suspected group, but changed over time with different trends. The two case groups shared similar dynamic profiles on blood routine test. Four confirmed cases which had COVID-19 antibody test were all positive for IgG antibody and negative for IgM antibody, via both umbilical cord blood and the newborns. Fifteen of newborns (three confirmed and twelve suspected cases) at nearly three months old were tested negative by antibodies. Conclusions Pulmonary CT images showed different trends with the extending of time between confirmed group and suspected group. Blood test results weren’t strong enough to make differential diagnosis between two case groups. Perform antibody test can understand the antibody responses mounted in response to the virus, and to identify individuals who are potentially immune to re-infection. Infant obtain COVID-19 IgG antibody from maternal that only may last for less than three months.


Sign in / Sign up

Export Citation Format

Share Document