scholarly journals A case report on COVID-19 associated multisystem inflammatory syndrome in children

2021 ◽  
Vol 8 (9) ◽  
pp. 1622
Author(s):  
Sachin Kumar ◽  
Deepak Sharma ◽  
Khushboo Tongaria ◽  
Naman Bansal
Keyword(s):  
Similar Case ◽  
High Titre ◽  
Igg Antibodies ◽  
Inflammatory Conditions ◽  
Intravenous Antibiotics ◽  
High Incidence ◽  
Inflammatory Syndrome ◽  
Second Wave ◽  
Different Parts ◽  
D Dimer

As severe acute respiratory syndrome coronavirus 2 continues to spread worldwide, there have been increasing reports from different parts of India during second wave of infection describing children and adolescents with COVID-19-associated multisystem inflammatory conditions. We describe clinical features and management in children with multisystem inflammatory syndrome children (MIS-C) from the Delhi metropolitan area, which had a high incidence of coronavirus disease 2019 (COVID-19). We report a similar case presenting with persisting fever, rashes, bulbar conjunctivitis, abdominal pain, decreased urine output and shock. Initial reports suggestive of high inflammatory markers, neutrophilic leukocytosis, high D-dimer and found to have COVID-19 IgG antibodies positive in high titre. Managed successfully in PICU with bolos fluids, intravenous antibiotics, steroids and anticoagulation. 

scholarly journals Post-COVID-19 Outbreak of Severe Kawasaki-like Multisystem Inflammatory Syndrome in Children

2021 ◽  
Vol 28 (1) ◽  
pp. 109-116
Author(s):  
Sadia Shakeel ◽  
Mohamed Azmi Ahmad Hassali
Keyword(s):  
Immune Response ◽  
Disease Management ◽  
Blood Vessels ◽  
Clinical Manifestations ◽  
The Body ◽  
Cardiac Complications ◽  
Novel Coronavirus ◽  
Inflammatory Syndrome ◽  
Second Wave ◽  
Different Parts

With the continuation of the second wave of a novel coronavirus disease (COVID-19), which is likely to be even more devastating, there are several associated health problems. COVID-19 is usually mild and non-fatal in children. However, in rare cases, children could severely be affected, and clinical manifestations may differ from adults. A multisystem inflammatory syndrome in children (MIS-C) is a rare but serious complication associated with COVID-19, initiated by an overactive immune response in kids that usually hits weeks after exposure to the COVID-19. MIS-C is a disorder in which inflammation could occur in different parts of the body. The disease puts pressure on the heart, as blood vessels leading towards the heart get inflamed and incapable of carrying adequate blood, hence producing cardiac complications in children hospitalised with MIS-C. The problem seems to be associated with COVID-19 in children; however, the association between MIS-C and COVID-19 is still unidentified. There is very little understanding of what triggers the MIS-C, which necessitates a rigorous mapping of the disease and associated risk elements for better disease management and navigating through this crisis.

scholarly journals Procoagulatory State in Inflammatory Bowel Diseases Is Promoted by Impaired Intestinal Barrier Function

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Luca Pastorelli ◽  
Elena Dozio ◽  
Laura Francesca Pisani ◽  
Massimo Boscolo-Anzoletti ◽  
Elena Vianello ◽  
...  
Keyword(s):  
Inflammatory Bowel Diseases ◽  
Intestinal Barrier ◽  
Systemic Circulation ◽  
Intestinal Barrier Function ◽  
Inflammatory Conditions ◽  
Immune Mediated ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Molecular Patterns ◽  
D Dimer

Inflammatory and immune mediated disorders are risk factors for arterial and venous thromboembolism. Inflammatory bowel diseases (IBD) confer an even greater risk of thromboembolic events than other inflammatory conditions. It has been shown that IBD patients display defective intestinal barrier functions. Thus, pathogen-associated molecular patterns (PAMPs) coming from the intestinal bacterial burden might reach systemic circulation and activate innate immunity receptors on endothelial cells and platelets, promoting a procoagulative state. Aim of the study was to test this hypothesis, correlating the presence of circulating PAMPs with the activation of innate immune system and the activation of the coagulatory cascade in IBD patients. Specifically, we studied lipopolysaccharide (LPS), Toll-like receptor (TLR) 2, TLR4, and markers of activated coagulation (i.e., D-Dimer and prothrombin fragmentF1+2) in the serum and plasma of IBD patients. We found that LPS levels are increased in IBD and correlate with TLR4 concentrations; although a mild correlation between LPS and CRP levels was detected, clinical disease activity does not appear to influence circulating LPS. Instead, serum LPS correlates with both D-Dimer andF1+2measurements. Taken together, our data support the role of an impairment of intestinal barrier in triggering the activation of the coagulatory cascade in IBD.

scholarly journals Dynamics of seroconversion of anti-SARS-CoV-2 IgG antibodies in the Czech unvaccinated population: nationwide prospective seroconversion (PROSECO) study

2021 ◽  
Author(s):  
Pavel Piler ◽  
Vojtěch Thon ◽  
Lenka Andrýsková ◽  
Kamil Doležel ◽  
David Kostka ◽  
...  
Keyword(s):  
Czech Republic ◽  
Population Based ◽  
Igg Antibodies ◽  
Rt Pcr ◽  
The Czech Republic ◽  
Global Pandemic ◽  
Government Data ◽  
Low Incidence ◽  
Study Participants ◽  
Second Wave

AbstractBackgroundAlthough the Czech Republic weathered the first wave of the COVID-19 epidemic with relatively low incidence, the second wave of the global pandemic saw it rank among countries bearing the greatest COVID-19 burden, both in Europe and on a worldwide scale. The aim of the nationwide prospective seroconversion (PROSECO) study was to investigate the dynamics of seroconversion of anti-SARS-CoV-2 IgG antibodies in the Czech population.MethodsAll clients of the second largest health insurance company in the Czech Republic were sent a written invitation to participate in this longitudinal study. The study includes the first 30,054 persons who provided a blood sample between October 2020 and March 2021. Seroprevalence was compared between calendar periods of blood sample collection, RT-PCR test results, sociodemographic factors, and other characteristics.FindingsThe data show a dramatic increase in seropositivity over time, from 28% in October/November 2020 to 43% in December 2020/January 2021 to 51% in February/March 2021. These trends were consistent with government data on cumulative viral antigenic prevalence in the population captured by PCR testing – although the seroprevalence rates established in this study were considerably higher than those listed in government data. Data pooled across the entire study period exhibited minor differences in seropositivity between sexes, age groups and body mass index categories; results were similar between test providing laboratories. Seropositivity was substantially higher among symptomatic vs. asymptomatic persons (76% vs. 34%). At least one third of all seropositive participants were asymptomatic, and 28% participants who developed antibodies against SARS-CoV-2 never underwent PCR testing.InterpretationAntibody response provides a better marker of past SARS-CoV-2 infection than PCR testing data. Our data on seroconversion confirm the rapidly increasing prevalence in the Czech population during the dramatically rising pandemic wave prior to the beginning of massive vaccination. The planned second and third assessment of the study participants (April 2021 – September 2021, October 2021 – March 2022) will provide valuable evidence on the seroprevalence changes following vaccination and persistence of antibodies resulting from natural infection and vaccination.Research in contextEvidence before this studySimilarly to most European countries, the first COVID-19 epidemic wave in the Czech Republic produced a relatively low incidence (86.9 confirmed cases per 100,000 persons over three months). At the peaks of the second wave, however, over 100 confirmed cases per 100,000 persons were diagnosed daily and the Czech Republic ranked among the countries with the greatest burden of COVID-19 in Europe and in the world. Only a few nationwide population-based studies have been published covering the second wave of the epidemic in Europe, and none of them from the Central and Eastern European region.Added value of this studyThe PROSECO study will provide key data from the heavily affected Central European region and contribute to the epidemiological and serological characteristics of the SARS-CoV-2 infection. All 30,054 study participants were recruited between October 2020 and March 2021, thus covering all three epidemic peaks (November 2020, January and March 2021) of the second COVID-19 epidemic wave. This allows us to follow the dynamics of seroconversion of anti-SARS-CoV-2 IgG antibodies in the immunologically naive and unvaccinated population during the COVID-19 pandemic. The study participants will be re-assessed in the second (April 2021 – September 2021) and third (October 2021 – March 2022) PROSECO phases to further study the post-infection/post-vaccination dynamics of seroconversion in/after a period of massive vaccination.Implications of all the available evidenceData from the first phase of the PROSECO study indicate that the percentage of the population that has been exposed to the SARS-CoV-2 may be substantially higher than estimates based on official data on cumulative viral positivity incidence as at least one third of seropositive participants were asymptomatic, and 28% of participants who developed antibodies against SARS-CoV-2 never underwent PCR testing. Regional seroprevalence data provide key information to inform, in combination with other surveillance data, public health policies and will be instrumental for the successful management of the subsequent phases of the global pandemic.The number of seropositive participants who never underwent RT-PCR testing demonstrates the importance of serological population-based studies describing the spread and exposure to the virus in the population over time.

Radioimmunoassay of lysergic acid diethylamide (LSD) in serum and urine by using antisera of different specificities.

1977 ◽  
Vol 23 (2) ◽  
pp. 169-174 ◽  
Author(s):  
W A Ratcliffe ◽  
S M Fletcher ◽  
A C Moffat ◽  
J G Ratcliffe ◽  
W A Harland ◽  
...  
Keyword(s):  
Biological Fluids ◽  
Cross Reactivity ◽  
High Titre ◽  
Lysergic Acid ◽  
Side Chain ◽  
Satisfactory Method ◽  
Related Compounds ◽  
Amide Side Chain ◽  
Different Parts ◽  
Serum And Urine

Abstract We raised high-titre antisera to two LSD-bovine serum albumin conjugates, one linked via the indole nitrogen, the other via the amide side-chain. The antisera were specific for different parts of the LSD molecule, as demonstrated by cross-reactivity studies with LSD, its metabolites, ergot alkoloids, and closely related compounds. The antisera were used to develop a double-antibody radioimmunoassay with a detection limit of about 0.4 mug of LSD per liter of unextracted urine or serum. We saw no nonspecific interference by urine, serum, or from a series of commonly used drugs. There was good correlation between immunoassay values obtained with the two antisera (r = 0.91). However, the antiserum linked via the indole nitrogen gave consistently higher results for samples from persons who had taken LSD, owing to greater cross-reactivity with LSD metabolites. Radioimmunoassay by use of two such antisera is a more specific screening procedure for LSD abuse than has been available previously. In addition, antisera cross-reacting with LSD metabolites allow measurement of these compounds, for which there is no satisfactory method at the concentrations found in biological fluids in man.

scholarly journals The New Fluoroquinolones: A Critical Review

1999 ◽  
Vol 10 (3) ◽  
pp. 207-238 ◽  
Author(s):  
George G Zhanel ◽  
Andrew Walkty ◽  
Lavern Vercaigne ◽  
James A Karlowsky ◽  
John Embil ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Metal Ion ◽  
Data Extraction ◽  
Limited Data ◽  
Intravenous Antibiotics ◽  
High Incidence ◽  
Bacteriodes Fragilis ◽  
Tract Infections

OBJECTIVE: This paper reviews the literature available on the new fluoroquinolones – clinafloxacin, gatifloxacin, grepafloxacin, levofloxacin, moxifloxacin, sparfloxacin and trovafloxacin – to compare these agents with each other and contrast them with ciprofloxacin, an older fluoroquinolone.DATA SELECTION: Published papers used were obtained by searching MEDLINE for articles published between 1994 and 1998, inclusive. References of published papers were also obtained and reviewed. Abstracts from scientific proceedings were reviewed.DATA EXTRACTION: Due to the limited data available on several of the agents, criteria for study inclusion in the in vitro, pharmacokinetics and in vivo sections were not restrictive.DATA SYNTHESIS: The new fluoroquinolones offer excellent Gram-negative bacillary activity and improved Gram-positive activity (eg, againstStreptococcus pneumoniaeandStaphylococcus aureus) over ciprofloxacin. Clinafloxacin, gatifloxacin, moxifloxacin, sparfloxacin and trovafloxacin display improved activity against anaerobes (eg,Bacteriodes fragilis). All of the new fluoroquinolones have a longer serum half-life than ciprofloxacin (allowing for once daily dosing), and several are eliminated predominantly by nonrenal means. No clinical trials are available comparing the new fluoroquinolones with each other. Clinical trials comparing the new fluoroquinolones with standard therapy have demonstrated good efficacy in a variety of infections. Their adverse effect profile is similar to that of ciprofloxacin. Clinafloxacin and sparfloxacin cause a high incidence of phototoxicity (1.5% to 14% and 2% to 11.7%, respectively), grepafloxacin causes a high incidence of taste perversion (9% to 17%) and trovafloxacin causes a high incidence of dizziness (11%). They all interact with metal ion-containing drugs (eg, antacids), and clinafloxacin and grepafloxacin interact with theophylline. The new fluoroquinolones are expensive; however, their use may result in savings in situations where, because of their potent and broad spectrum of activity, they can be used orally in place of intravenous antibiotics.CONCLUSIONS: The new fluoroquinolones offer advantages over ciprofloxacin in terms of improved in vitro activity and pharmacokinetics. Whether these advantages translate into improved clinical outcomes is presently unknown. The new fluoroquinolones have the potential to emerge as important therapeutic agents in the treatment of respiratory tract and genitourinary tract infections.

scholarly journals Mean Platelet Volume inMycobacterium tuberculosisInfection

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Min Young Lee ◽  
Young Jin Kim ◽  
Hee Joo Lee ◽  
Sun Young Cho ◽  
Tae Sung Park
Keyword(s):  
Patient Group ◽  
Mean Platelet Volume ◽  
Inflammatory Marker ◽  
Control Group ◽  
Significant Relation ◽  
Platelet Volume ◽  
Positive Correlation ◽  
Inflammatory Conditions ◽  
High Incidence ◽  
Group A

Introduction.Mean platelet volume (MPV) has been thought as a useful index of platelet activation. It is supposed that MPV is also associated with several inflammatory and infectious diseases. Korea still has a high incidence of tuberculosis (TB). The aim of this study was to investigate MPV as an inflammatory marker in TB patients. Materials and Methods.MPV were determined in 221 patients with TB and 143 individuals for control group. MPV was estimated by an Advia 2120 (Siemens Healthcare Diagnostics, Tarrytown, NY, USA).Results.In the TB patient group, a positive correlation was found between CRP and MPV. Age and MPV had a positive correlation in TB patient group.Conclusions.We conclude that there is a significant relation between MPV and inflammatory conditions. MPV can be an inflammatory marker to determine the disease activity in TB patients.

scholarly journals The Inflammatory Markers of Multisystem Inflammatory Syndrome in children (MIS-C) and Adolescents During the COVID-19 Pandemic: A Meta-Analysis

2021 ◽  
Author(s):  
Yan Zhao ◽  
Li-juan Yin ◽  
Jenil Patel ◽  
Lei Tang ◽  
Ying Huang
Keyword(s):  
Inflammatory Markers ◽  
Meta Analysis ◽  
Absolute Lymphocyte Count ◽  
Older Children ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation ◽  
Quality Check ◽  
Inflammatory Syndrome ◽  
D Dimer

Abstract As per the indicated need in literature, we conducted a systematic review and meta-analysis to characterize inflammatory markers of MIS-C patients with COVID-19, Kawasaki disease (KD), and coronary artery abnormalities. We searched nine databases for studies on inflammatory markers of MIS-C. After quality check, data were pooled using a fixed- or random-effects model. Inflammatory markers included white blood cell count (WBC) or leukocytes, absolute lymphocyte count (ALC), absolute neutrophil count (ANC), platelet count (PLT), C-reactive protein (CRP), procalcitonin (PCT), ferritin, D-dimer, lactate dehydrogenase (LDH), fibrinogen and erythrocyte sedimentation rate (ESR) for comparisons by severity and age. Twenty studies with 2,990 participants yielded 684 MIS-C patients. Compared to non-severe COVID-19 patients, MIS-C patients had lower ALC and higher ANC, CRP and D-dimer levels. Compared to severe COVID-19 patients, MIS-C patients had lower LDH and PLT counts and higher ESR levels. Compared to KD patients, MIS-C patients had lower ALC and PLT, and higher CRP and ferritin levels. Severe MIS-C patients had higher levels of WBC, CRP, D-dimer and ferritin. For MIS-C, younger children had lower CRP and ferritin levels than medium-aged/older children. Measurement of inflammatory markers might assist clinicians in accurate evaluation and diagnosis of MIS-C and the associated disorders.

scholarly journals SARS-CoV-2 serostatus of healthcare worker in the Austrian state Vorarlberg between June 2020 and January 2021

2021 ◽  
Author(s):  
Michele Atzl ◽  
Axel Muendlein ◽  
Thomas Winder ◽  
Peter Fraunberger ◽  
Eva-Maria Brandtner ◽  
...  
Keyword(s):  
Specific Antibody ◽  
Working Environment ◽  
Federal State ◽  
Igg Antibodies ◽  
Strong Response ◽  
High Increase ◽  
Specific Antibody Response ◽  
Care Workers ◽  
Second Wave ◽  
Very High

AbstractBackgroundAustria, and particularly its westernmost federal state Vorarlberg, developed an extremely high COVID-19 incidence rate in November 2020. Health care workers (HCW) may be at higher risk of contracting the disease within the working environment and therefore the seroprevalence in this population is of particular interest. Here, we analyzed SARS-CoV-2-specific antibody response in Vorarlberg HCW in a prospective cohort study.MethodsA total of 395 HCW have been tested at three different time points for the prevalence of anti-SARS-CoV-2 IgG antibodies specific for NP and RBD. Enrollment started in June 2020 (t1), two months after the end of the first wave. Re-testing took place between October to November at the beginning of the second wave (t2), and again at the end of the second wave in January 2021 (t3).ResultsAt t1, 3% of HCW showed a strong IgG-specific responses to either NP or RBD. At t2, the rate increased to 4%, and after the second wave in January 2021, 14% had a strong response, which was assessed to be stable for up to ten months. The amount of HCW with anti-SARS-CoV-2 IgG antibodies was 38% higher than the number of infections found by RT-PCR.ConclusionWe found low numbers of SARS-CoV-2-seropositive HCW in a hotspot setting after the first wave but a very high increase during the second massive wave. Though the seroprevalence in HCW was comparable to the general population. Our findings offer support for the routine application of serological testing in management of the ongoing COVID-19 pandemic.Main summaryA relatively low percentage of 3% SARS-CoV-2 seropositive HCW with strong IgG-specific antibody responses was found in the Austrian federal state Vorarlberg after the first wave increasing to 14% after the second massive wave lasting until January 2021.

scholarly journals COVID-19 Reinfection in a Young Medical Doctor: A Case Report

2021 ◽  
Vol 59 (239) ◽  
Author(s):  
Dhruba Gaire ◽  
Muneshwar Sah ◽  
Bishnu Singh
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Pleural Effusion ◽  
Medical Doctor ◽  
Medical Professionals ◽  
Cytokine Storm ◽  
Cost Of Treatment ◽  
Inflammatory Syndrome ◽  
D Dimer ◽  
Monthly Salary

There is hardly any report of reinfection due to coronavirus disease 2019 (COVID-19) in medical professionals from Nepal. We report a case of a 32-year-old doctor with COVID-19 reinfection. Symptoms during the first infection were mild. After one month, he was reinfected and developed diarrhea as well as a continuous high fever. His d-dimer and ferritin were much increased. Computed tomography chest showed bilateral lymph nodes, minimal pleural effusion, and scattered linear fibrosis. After discharge, his depression and myalgia persisted for one month. During reinfection, his symptoms were more severe and cost of treatment was almost eight times his monthly salary and he could not work for six weeks. Possible reasons for severe reinfection and differential diagnoses like cytokine storm, multisystem inflammatory syndrome, reactivation of COVID-19, and infection due to new variants were discussed. Whether infected or vaccinated or not, all should take recommended vaccination and primary-preventive as well as health-promotive measures.

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