The reflection on an AIDS patient with asymptomatic COVID-19

Abstract We reported the process of exposure, clinical characteristics, diagnosis and prognosis of an AIDS patient with asymptomatic COVID-19. In our report, we found the asymptomatic is still shedding virus for at least 29 days. Therefore, we suggested that for individuals who had close contact with diagnosed or suspected COVID-19 patients, in addition to isolation, medical observation, and further related testing if clinical symptoms appear in the observation period, it is best to collect nasopharyngeal and throat swab specimens and test for COVID-19 nucleic acid as early as possible. The purpose of this active detection is to screen out COVID-19 asymptomatic patients, and to avoid further transmission through recessive source of infection. Our findings will facilitate understanding of asymptomatic COVID-19 and improve prevention strategies against COVID-19 transmission.

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Efficacy and Safety of Lianhuaqingwen Capsules for the Prevention of Coronavirus Disease 2019: A Prospective Open-Label Controlled Trial

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2021/7962630 ◽

2021 ◽

Vol 2021 ◽

pp. 1-9

Author(s):

Xiaowei Gong ◽

Boyun Yuan ◽

Yadong Yuan ◽

Fengju Li

Keyword(s):

Nucleic Acid ◽

Treatment Group ◽

Close Contact ◽

Controlled Trial ◽

Control Group ◽

Open Label ◽

Medical Observation ◽

Observation Period ◽

Close Contacts ◽

Nucleic Acid Tests

Coronavirus disease 2019 (COVID-19) has become a global pandemic. Community and close contact exposures continue to drive the COVID-19 pandemic. There is no confirmed effective treatment for suspected cases and close contacts. Lianhuaqingwen (LH) capsules, a repurposed Chinese herbal product that is currently on the market, have proven effective for influenza and COVID-19. To determine the safety and efficacy of LH capsules for the prevention of COVID-19, we conducted a prospective open-label controlled trial of LH capsules on subjects who had close contact with people infected with COVID-19. Subjects received LH capsules (4 capsules, three times daily) or the usual medical observation for 14 days. The primary endpoint was the rate of positive nucleic acid tests of nasal and pharyngeal swabs during the quarantine medical observation period. We included 1976 patients, including 1101 in the treatment group and 875 in the control group. The rate of positive nucleic acid tests in the treatment group was significantly lower than that in the control group (0.27% vs. 1.14%, respectively; mean difference: −0.87%; 95% CI: −1.83 to −0.13; p = 0.0174 ) during the quarantine medical observation period (14 days). Among subjects with different close contact states, there was no significant difference in the rate of positive nucleic acid test results among close contacts in the treatment group and the control group (6.45% vs. 11.43%, respectively; p = 0.6762 ). Among secondary close contacts, the rate of positive nucleic acid tests in the treatment group was significantly lower than that in the control group (0.09% vs. 0.71%, respectively; p = 0.0485 ). No serious adverse events were reported. Taken together, and in light of the safety and effectiveness profiles, these results show that LH capsules can be considered to prevent the progression of COVID-19 after close contact with an infected person. This trial is registered with ChiCTR2100043012.

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Clinical Characteristics of Asymptomatic Patients with SARS-CoV-2 in Zhejiang: An Imperceptible Source of Infection

Canadian Respiratory Journal ◽

10.1155/2020/2045341 ◽

2020 ◽

Vol 2020 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Wei Dai ◽

Xinmiao Chen ◽

Xiaoting Xu ◽

Zhefeng Leng ◽

Wenwen Yu ◽

...

Keyword(s):

Clinical Characteristics ◽

Clinical Symptoms ◽

Laboratory Data ◽

Clinical Manifestations ◽

Transmission Risk ◽

Asymptomatic Group ◽

Symptomatic Group ◽

Source Of Infection ◽

Asymptomatic Patients ◽

Novel Coronavirus

Objective. Coronavirus disease 2019 (COVID-19), caused by the novel coronavirus SARS-CoV-2, was first identified in December 2019 in Wuhan, China, and has since spread globally, resulting in an ongoing pandemic. However, the study of asymptomatic patients is still rare, and the understanding of its potential transmission risk is still insufficient. In this study, epidemiological investigations were conducted in the Zhejiang province to understand the epidemiology and clinical characteristics of asymptomatic patients with COVID-19. Methods. This retrospective study was carried out on 22 asymptomatic patients and 234 symptomatic patients with COVID-19 who were hospitalized in Zhejiang Duodi Hospital from January 21 to March 16, 2020. The characteristics of epidemiology, demography, clinical manifestations, and laboratory data of mild patients were compared and analyzed. Results. The median age was 28 years in asymptomatic patients and 48 years in symptomatic patients. The proportion who were female was 77.3% in asymptomatic patients and 36.3% in symptomatic patients (p<0.001). The proportion of patients with coexisting diseases was 4.5% in asymptomatic patients and 38.0% in symptomatic patients (p=0.002). The proportion of patients with increased CRP was 13.6% in the asymptomatic group and 61.1% in the symptomatic group (p<0.001). The proportion of patients received antiviral therapy was 45.5% in the asymptomatic group and 97.9% in the symptomatic group (p<0.001). The proportion of patients received oxygen therapy was 22.7% in the asymptomatic group and 99.1% in symptomatic patients (p<0.001). By March 16, 2020, all patients were discharged from the hospital, and no symptoms had appeared in the asymptomatic patients during hospitalization. The median course of infection to discharge was 21.5 days in asymptomatic patients and 22 days in symptomatic patients. Conclusions. Asymptomatic patients are also infectious; relying only on clinical symptoms, blood cell tests, and radiology examination will lead to misdiagnosis of most patients, leading to the spread of the virus. Investigation of medical history is the best strategy for screening asymptomatic patients, especially young people, women, and people without coexisting disease, who are more likely to be asymptomatic when infected. Although the prognosis is good, isolation is critical for asymptomatic patients, and it is important not to end isolation early before a nucleic acid test turns negative.

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Epidemic prevention strategies for COVID-19 key populations

10.31219/osf.io/cb8xv ◽

2021 ◽

Author(s):

Yuanyuan Cheng

Keyword(s):

Nucleic Acid ◽

Mainland China ◽

Infection Risk ◽

Health Surveillance ◽

Cross Infection ◽

Key Populations ◽

Prevention Strategies ◽

Surveillance Period ◽

Medical Observation ◽

Observation Period

AbstractBackgroud: Since 2021, all outbreaks of COVID-19 within mainland China have been associated with imported cases from abroad. The outbreak in Putian, Fujian province, occurred without obvious loopholes in the implementation of epidemic prevention, indicating loopholes in the current epidemic prevention strategies in mainland China. The loopholes should be identified and the epidemic prevention strategies should be improved as soon as possible.Methods: Is there a need to further extend the medical observation period and community health surveillance period for key populations? Is there a need to increase the number of nucleic acid screenings? Is there a need to change the methods of extraction of nucleic acid screening samples? Is there a need to expand the scope of the population for routine epidemic prevention surveillance? The analysis of these questions would contribute to the improvement of the COVID-19 epidemic prevention strategies.Results: There are larger outbreaks following the current intensive isolation medical observation period and community health surveillance period, the phenomenon shows that the loopholes in the assessment of cross-infection risk and health surveillance in China's current COVID-19 prevention and control strategies, especially during health surveillance after the entry of undetected infected individuals into the community when they emerge during isolation medical observation, and during health surveillance in the community for those who regain positive status after case cure.Conclusions: The key points to improve epidemic prevention strategies includ that a scientific and rational assessment around the mean incubation period, cross-infection risk, and surveillance efficiency of COVID-19, and updating routine epidemic prevention surveillance measures for key populations, recently cured patients of COVID-19, and immersion populations. Keywords: COVID-19, epidemic prevention strategy, incubation period, cross-infection

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Case Example: Adjacent Segment Disease: What Is It, and How Is It Rated?

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2011.marapr02 ◽

2011 ◽

Vol 16 (2) ◽

pp. 8-9

Author(s):

Marjorie Eskay-Auerbach

Keyword(s):

Clinical Symptoms ◽

Lumbar Fusion ◽

Adjacent Segment Degeneration ◽

Adjacent Segment Disease ◽

Adjacent Segment ◽

Disc Space Narrowing ◽

Disc Disease ◽

Disc Space ◽

Radiographic Findings ◽

Asymptomatic Patients

Abstract The incidence of cervical and lumbar fusion surgery has increased in the past twenty years, and during follow-up some of these patients develop changes at the adjacent segment. Recognizing that adjacent segment degeneration and disease may occur in the future does not alter the rating for a cervical or lumbar fusion at the time the patient's condition is determined to be at maximum medical improvement (MMI). The term adjacent segment degeneration refers to the presence of radiographic findings of degenerative disc disease, including disc space narrowing, instability, and so on at the motion segment above or below a cervical or lumbar fusion. Adjacent segment disease refers to the development of new clinical symptoms that correspond to these changes on imaging. The biomechanics of adjacent segment degeneration have been studied, and, although the exact mechanism is uncertain, genetics may play a role. Findings associated with adjacent segment degeneration include degeneration of the facet joints with hypertrophy and thickening of the ligamentum flavum, disc space collapse, and translation—but the clinical significance of these radiographic degenerative changes remains unclear, particularly in light of the known presence of abnormal findings in asymptomatic patients. Evaluators should not rate an individual in anticipation of the development of changes at the level above a fusion, although such a development is a recognized possibility.

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Possibilities of correction of menopausal disorders in women with the use of medicine Menopace

HEALTH OF WOMAN ◽

10.15574/hw.2016.111.95 ◽

2016 ◽

pp. 95-100

Author(s):

G.I. Reznichenko ◽

◽

N.Yu. Reznichenko ◽

V.Yu. Potebnya ◽

K.I. Kovalenko ◽

...

Keyword(s):

General Condition ◽

Clinical Symptoms ◽

Average Score ◽

Control Group ◽

Climacteric Syndrome ◽

Basic Subgroup ◽

Menopausal Syndrome ◽

Natural Menopause ◽

Surgical Menopause ◽

Observation Period

The objective: to determine the efficacy of medicine «Menopace» in treatment of women with natural and surgical menopause. Patients and methods. 20 women (I group) with a natural menopause were examined (basic subgroup consisted of 10 patients who used Menopace for 3 months; control subgroup consisted of 10 patients). 20 women (II group) with surgical menopause were examined (basic subgroup consisted of 10 patients who received Menopace for 3 months; control subgroup consisted of 10 patients). Results. The average score of neurovegetative and emotional manifestations of climacteric syndrome during the observation period decreased in women with natural and surgical menopause who used Menopace, compared with subgroups of patients who had not used the medicine. Conclusions. 1. The use of the medicine Menopace in women with natural menopause after 3 months showed the disappearance of clinical symptoms of climacteric syndrome in 70% of the cases, and significant improvement in general condition in 30% of cases. 2. During surgical menopause after 1 month of treatment with Menopace manifestations of sweating were observed 4.5 times less often than in control group, tides were observed 7 times less often than in control group. Neurovegetative and psychoemotional symptoms of menopause were absent in 80% of women after 3 months of treatment and in 20% of cases significant improvement was shown. 3. The obtained results give grounds to recommend wide use of Menopace in practical work for the treatment of menopausal syndrome during natural and surgical menopause. Key words: menopause, therapy, Menopace.

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COVID-19 in an Asymptomatic Renal Transplant Recipient Employed in the Health Care Setting: A Case Report

International Journal of Angiology ◽

10.1055/s-0041-1725183 ◽

2021 ◽

Author(s):

Harsha Adnani ◽

Akshay Khatri ◽

Nirav Agrawal ◽

Ernesto Molmenti ◽

Madhu Bhaskaran

Keyword(s):

Health Care ◽

Renal Transplant ◽

Transplant Recipient ◽

Renal Transplant Recipient ◽

Clinical Symptoms ◽

Severe Disease ◽

Care Facility ◽

Health Care Facility ◽

Asymptomatic Patients

AbstractDuring the ongoing pandemic, there have been varying presentations of coronavirus disease 2019 (COVID-19) infection, with the concern that patients who are immunosuppressed (due to underlying medical conditions and/or therapies) are at higher risk of severe disease. We report the case of an elderly renal transplant recipient working in a long-term health care facility who was being monitored by weekly surveillance testing and tested positive for COVID-19 by polymerase chain reaction (PCR) testing, despite having no clinical symptoms. He recovered with supportive care, despite being on multiple long-term immunosuppressant drugs and having multiple comorbidities. Additionally, it was found that he did not mount an antibody response, when he tested negative by serologic testing. Through this case, we wish to highlight the unique clinical scenario of asymptomatic patients who may have an underwhelming immune response to COVID-19, but may nevertheless be an important source of dissemination. We further discuss the probable mechanism of such asymptomatic presentations in immunosuppressed patients, while reinforcing the importance of self-isolation of COVID-19 patients (particularly in asymptomatic health care workers).

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Retrospective analysis of pediatric patients with multiple rare-earth magnets ingestion: a single-center experience from China

BMC Pediatrics ◽

10.1186/s12887-021-02642-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yucan Zheng ◽

Zhihua Zhang ◽

Kunlong Yan ◽

Hongmei Guo ◽

Mei Li ◽

...

Keyword(s):

Rare Earth ◽

Digestive Tract ◽

Foreign Bodies ◽

Clinical Symptoms ◽

Medical Center ◽

Rare Earth Magnet ◽

Gastrointestinal Obstruction ◽

Asymptomatic Patients ◽

Significant Difference ◽

Surgical Group

Abstract Background The aim of this study was to characterize patients who ingested multiple rare-earth magnets, reveal the harm of rare-earth magnet foreign bodies in the digestive tract, and develop a clinical management algorithm. Methods This was a retrospective review of patients with rare-earth magnet foreign bodies in the digestive tract admitted to a university-affiliated pediatric medical center in China, between January 2016 and December 2019; the subset of medical data evaluated included clinical symptoms, signs, treatments and outcomes. Results A total of 51 cases were included in this study, including 36(70.6%) males and 15(29.4%) females. The magnets were passed naturally in 24(47.1%) patients and removed by intervention in 27(52.9%) patients, including 5(9.8%) cases by endoscopy and 22(43.1%) cases by surgery. Twenty-two (43.1%)cases had gastrointestinal obstruction, perforation, and fistula. Compared with the non-surgical group, the time of the surgical group from ingestion to arriving at the hospital was longer([80(5–336) vs 26(2–216)]hours, p < 0.001) while there was no significant difference in the mean age or the number of magnets swallowed. Conclusions Magnets are attractive to children, but lead to catastrophic consequences including gastrointestinal obstruction, perforation, and surgical interventions when ingested multiple magnets. Endoscopic resection should be urgently performed in the presence of multiple magnets as early as possible within 24 h, even in asymptomatic patients.

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Trans-hiatal herniation following esophagectomy or gastrectomy: retrospective single-center experiences with a potential surgical emergency

Hernia ◽

10.1007/s10029-021-02380-1 ◽

2021 ◽

Author(s):

P. U. Oppelt ◽

I. Askevold ◽

R. Hörbelt ◽

F. C. Roller ◽

W. Padberg ◽

...

Keyword(s):

Hernia Repair ◽

Hiatal Hernia ◽

Surgical Repair ◽

Clinical Symptoms ◽

Gastrointestinal Symptoms ◽

Case Series ◽

Gastric Surgery ◽

Hiatal Hernia Repair ◽

Single Center ◽

Asymptomatic Patients

Abstract Purpose Trans-hiatal herniation after esophago-gastric surgery is a potentially severe complication due to the risk of bowel incarceration and cardiac or respiratory complaints. However, measures for prevention and treatment options are based on a single surgeon´s experiences and small case series in the literature. Methods Retrospective single-center analysis on patients who underwent surgical repair of trans-hiatal hernia following gastrectomy or esophagectomy from 01/2003 to 07/2020 regarding clinical symptoms, hernia characteristics, pre-operative imaging, hernia repair technique and perioperative outcome. Results Trans-hiatal hernia repair was performed in 9 patients following abdomino-thoracic esophagectomy (40.9%), in 8 patients following trans-hiatal esophagectomy (36.4%) and in 5 patients following conventional gastrectomy (22.7%). Gastrointestinal symptoms with bowel obstruction and pain were mostly prevalent (63.6 and 59.1%, respectively), two patients were asymptomatic. Transverse colon (54.5%) and small intestine (77.3%) most frequently prolapsed into the left chest after esophagectomy (88.2%) and into the dorsal mediastinum after gastrectomy (60.0%). Half of the patients had signs of incarceration in pre-operative imaging, 10 patients underwent emergency surgery. However, bowel resection was only necessary in one patient. Hernia repair was performed by suture cruroplasty without (n = 12) or with mesh reinforcement (n = 5) or tension-free mesh interposition (n = 5). Postoperative pleural complications were most frequently observed, especially in patients who underwent any kind of mesh repair. Three patients developed recurrency, of whom two underwent again surgical repair. Conclusion Trans-hiatal herniation after esophago-gastric surgery is rare but relevant. The role of surgical repair in asymptomatic patients is disputed. However, early hernia repair prevents patients from severe complications. Measures for prevention and adequate closure techniques are not yet defined.

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SALMONELLA BREDENEY MENINGITIS

PEDIATRICS ◽

10.1542/peds.9.5.597 ◽

1952 ◽

Vol 9 (5) ◽

pp. 597-601

Author(s):

HOWARD L. KANTOR

Keyword(s):

Blood Transfusion ◽

Carrier State ◽

Careful Examination ◽

Rapid Improvement ◽

Clinical Recovery ◽

Source Of Infection ◽

The Family ◽

Salmonella Meningitis ◽

Observation Period ◽

Multiple Antibiotics

A case of Salmonella bredeney meningitis with recovery in a 19 day old infant is reported. This is the youngest patient with Salmonella meningitis known to have recovered. This is the second known case of Salmonella meningitis with recovery in a patient less than one month of age. Treatment with multiple antibiotics and chemotherapy both parenterally and intrathecally produced rapid improvement. An equally effective supportive blood transfusion may have aided this recovery. The use of chloromycetin after discontinuance of all other antibiotics was effective in producing a clinical recovery without relapse. No sequelae were noted at the end of a three month observation period. Attempts at discovering the carrier state of the infesting organism by careful examination of the family revealed no source of infection.

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Targeted Surveillance to Identify Children Colonized with Vancomycin-Resistant Enterococcus in the Pediatric Intensive Care Unit

Infection Control and Hospital Epidemiology ◽

10.1086/649221 ◽

2010 ◽

Vol 31 (1) ◽

pp. 95-98 ◽

Cited By ~ 10

Author(s):

Aaron M. Milstone ◽

Lisa L. Maragakis ◽

Karen C. Carroll ◽

Trish M. Perl

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Pediatric Intensive Care Unit ◽

Infection Prevention ◽

Pediatric Intensive Care ◽

Vancomycin Resistant Enterococcus ◽

Prevention Strategies ◽

Asymptomatic Patients ◽

Vancomycin Resistant ◽

Pediatric Infection

Performing admission surveillance cultures is a resource-intensive strategy to identify asymptomatic patients with vancomycin-resistant Enterococcus (VRE) colonization. We measured VRE prevalence among children admitted to the pediatric intensive care unit. Targeted surveillance captured 94% of VRE-colonized children and may be an effective strategy to identify VRE carriers and facilitate pediatric infection prevention strategies.

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