scholarly journals Is Viral Load a Prognostic Indicator for Outcome of Covid-19 Patients? A Prospective Cohort Study in Iran

2021 ◽  
Author(s):  
Mohammad Hosein Taziki Balajelini ◽  
Abdolhalim Rajabi ◽  
Masoud Mohammadi ◽  
Alijan Tabarraei ◽  
Seyed Mohammad Hadi Razavi Nikoo ◽  
...  
Keyword(s):  
Cohort Study ◽  
Viral Load ◽  
Clinical Symptoms ◽  
Study Groups ◽  
Prognostic Indicator ◽  
Nasopharyngeal Swab ◽  
Ct Value ◽  
The Mean ◽  
Severity Of The Disease ◽  
Time Of Admission

Abstract Background: Covid-19 has different clinical symptoms and severity. Predicting its progress and results is clinically important. Hence, in this study, we investigated the relationship between virus load and the outcomes in Golestan Province. Methodology: We conducted a retrospective cohort study of COVID-19 diagnosed with RT-PCR testing from May 2020 to December 2020. According to the severity of the disease, the study groups were divided into three groups: outpatient, inpatient, and inpatient with death. SARS-CoV-2 viral load was assessed using cycle threshold (Ct) values from a reverse transcription-polymerase chain reaction assay applied to nasopharyngeal swab samples. Demographic properties, Clinical characteristics, and CT values of the studied patients were compared. Data were analyzed using STATA Version 16.0 software.Results: Of 1318 included subjects, 599 were outpatient, and 719 were hospitalized. Of the hospitalized patients, 487 were recovered and 232 died. The mean age (year) of patients was 48.81±18.40 and 51.9% were female. There were significant differences between the age and the severity of the disease, the mean age of patients who died was higher than other patients (p<0.001). The mean CT value of all patients was 26.80±4.43, which was higher in outpatients than inpatients' cases (p <0.001). We did not find any significant differences for the Ct values between recovered and dead cases (p=0.66). CT value levels were not significantly different between age and sex groups. Conclusions: According to the results of the study, CT value can be used only as a factor to determine the severity of the disease at the time of admission, but the load of the virus is not a factor to predict the outcome.

scholarly journals Virus Load and Incidence Olfactory, Gustatory, Respiratory, Gastrointestinal Disorders in COVID-19 Patients: A Retrospective Cohort Study

2021 ◽  
Author(s):  
Mohammad Hosein Taziki Balajelini ◽  
Abdolhalim Rajabi ◽  
Masoud Mohammadi ◽  
Hadi Razavi Nikoo ◽  
Alijan Tabarraei ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Cohort Study ◽  
Viral Load ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Gastrointestinal Symptoms ◽  
Chain Reaction ◽  
Ct Value ◽  
The Mean ◽  
Polymerase Chain

Objectives: This study investigated the relationship between viral load and the incidence and recovery of olfactory and gustatory dysfunction (OD and GD), incidence of respiratory and gastrointestinal symptoms in COVID-19 patients. Design: A Retrospective Cohort Study. Setting and Participants: In total 599 outpatients’ cases polymerase chain reaction (PCR)–confirmed COVID-19-positive patients in Golestan province were included in the study. Main Outcome Measures: The incidence of OD, GD, their severity and the time of recovery was determined. The association of these variables with cycle threshold (CT) values of SARS-CoV-2 polymerase chain reaction was assessed. Results: The mean age of patients was 38.27 ± 13.62 years. The incidence of general symptoms included myalgia 70.1%, headache 51.8%, fever 47.7%, and dyspnea 21.4%. 41.9% of patients had gastrointestinal symptoms, including abdominal pain 26.5%, diarrhea 25.2%, nausea 20.5%, and vomiting 12.9%. 12.2% of patients had comorbidity. The trimester recovery rates of OD and GD were 93.94% and 94.74%, respectively. The mean recovery time of OD and GD was 14.56±13.37 and 13.8±3.77 days, respectively. The mean CT value in all patients was 27.45±4.55. There were significant associations between CT value with headache (P=0.04), GD (P=0.002) and OD (P=0.001). Conclusions: The intensity and the recovery of OD and GD in Covid-19 patients may be affected by initial viral load. Unlike to respiratory and gastrointestinal symptoms, the OD and GD were associated with lower viral load. Therefore, it may be recommended to use these clinical symptoms as an indicator in the initial screening of patients during pandemics.

Detecting SARS-CoV-2 by Realtime RT-PCR in clinical samples collected in the North of Vietnam

2021 ◽  
Vol 30 (9) ◽  
pp. 11-17
Author(s):  
Hoang Vu Mai Phuong ◽  
Ung Thi Hong Trang ◽  
Nguyen Vu Son ◽  
Le Thi Thanh ◽  
Nguyen Le Khanh Hang ◽  
...  
Keyword(s):  
Viral Load ◽  
Average Rate ◽  
Clinical Samples ◽  
Viet Nam ◽  
Rt Pcr ◽  
Ct Value ◽  
The North ◽  
Viral Load Data ◽  
The Mean ◽  
High Level

From January to August 2020, Northern Viet Nam faced a COVID-19 outbreak, up to September 2020, there were 1122 confrmed cases of SARS-CoV-2, of which 465 cases were imported from Europe, America and Asia, 657 cases were identifed domestically. A total of 30,686 samples were collected during the SARS-CoV-2 outbreak in Northern Viet Nam and examined by Real-time RT-PCR using primers and probe from Charite - Berlin protocol. This study showed the initial results of SARS-CoV-2 detection and RNA quantitative in positive samples. The positive rate was 0.8%, ranging from 0.4 to 3.5% according to collection sites. Out of 251 positive samples, the mean Ct value was 28 (IQR: 22.3-32; range 14 - 38). The positive samples had a Ct value below 30 was 68.5%, there was no signifcant difference between the Ct value of the group ≤ 30 and > 30. The mean of the RNA copies/µl was 8.4.107, (IQR: 2.29.106 - 1.83.109 RNA copies/µl, range: 1.95.103 – 4.95.1011). In the group of imported COVID-19 cases, the rate of virus at low level was 29%, an average was 56% and at high level was 15%. In the community groups, the viral load data showed that the average rate at low, intermediate and high level were 20%, 63% and 17% respectively. The proportion of high-level viral load may raise an alert to start the quarantine process to reduce the transmission of SARS-CoV-2

scholarly journals Association of Viral Load in SARS-CoV-2 Patients With Age and Gender

2021 ◽  
Vol 8 ◽  
Author(s):  
Waleed H. Mahallawi ◽  
Ali Dakhilallah Alsamiri ◽  
Alaa Faisal Dabbour ◽  
Hamdah Alsaeedi ◽  
Abdulmohsen H. Al-Zalabani
Keyword(s):  
Viral Load ◽  
Clinical Symptoms ◽  
Age Groups ◽  
Global Public Health ◽  
Surveillance Network ◽  
Ct Value ◽  
Significant Difference ◽  
The Difference ◽  
Mean Differences ◽  
Age And Sex

Background: The coronavirus disease 2019 (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), is a global public health emergency. Age and sex are two important factors associated with risks and outcomes of various diseases. COVID-19 morbidity also seems to be affected by patient age and sex. It has been found that older age groups have more severe COVID-19 symptoms and higher fatality rates while children tend to have lower prevalence and milder symptoms than adults.Methods: The study reviewed electronic medical records of COVID-19 patients from Madinah city, Saudi Arabia. The study included all cases who tested positive (n = 3,006) between March 20 and May 22, 2020. Data were obtained from the Health Electronic Surveillance Network (HESN) database.Results: Approximately 80% of the study sample were males and half were in the 30–40-year-old age group. The Ct value of the whole sample ranged from 15.08 to 35, with a mean of 27.44 (SD: 5.23; 95% C.I. = 27.25–27.66). The means of Ct values varied between age groups from 27.05 to 27.82. Analysis of the mean differences between age groups using one-way ANOVA indicated no statistically significant difference among the groups (F6,2999 = 1.63; p-value = 0.135). A comparison of mean Ct values of males (n = 2,422) and females (n = 584) revealed that males had a statistically significant higher mean Ct value (27.61 ± 5.20) than females (26.72 ± 5.31). The difference between the means of the two groups was −0.89 (95% C.I. = −1.36 to −0.42; t-test −3.71; df = 3,004; p-value &lt; 0.001).Conclusion: The study found no statistically significant difference in viral loads between age groups. It showed that females had a higher SARS-CoV-2 viral load compared to males. The findings have implications for preventive strategies. Further studies are needed to correlate viral load with clinical symptoms and outcomes.

Correlation between clinical outcome in the first 5 Days of treatment and on hospital discharge in patients with schizophrenia

2011 ◽  
Vol 26 (S2) ◽  
pp. 1350-1350
Author(s):  
L. San-Molina ◽  
G. Rubio ◽  
I. Bernardo-Fernández ◽  
S. Miguélez-Fernández
Keyword(s):  
Hospital Stay ◽  
Hospital Discharge ◽  
Clinical Improvement ◽  
Clinical Symptoms ◽  
Short Hospital Stay ◽  
Clinical Prognosis ◽  
The Mean ◽  
Clinically Significant ◽  
Personal Functioning ◽  
Time Of Admission

IntroductionIn patients with acute clinical symptoms, a short hospital stay and prevalent therapeutic objectives aimed at controlling symptoms overcome the clinician's concern for the functionality levels that will be even more significant after discharge.ObjectivesTo establish the clinical condition of patients admitted to acute/short-stay units in the first five days of hospital stay and on hospital discharge.MethodsA multicenter, naturalistic, retrospective, observational study to evaluate clinical assessment (CGI) obtained in patients with schizophrenia after treatment at the time of admission and on hospital discharge.ResultsThe mean score of the CGI questionnaire decreases from 5.3 recorded on admission to 4.3 on Day 5 and 3 on discharge. On Day 5 of hospital stay, symptoms had improved in 57.3% of cases. In 30.9% of cases there were no changes and in 1.7% symptoms had worsened. In 86.3% of patients symptoms had improved at discharge. 100% of patients with clinical improvement at Day 5 had a clinically significant improvement on hospital discharge.ConclusionsClinical improvement in the first five days after hospital admission appears to lead to a better clinical prognosis on hospital discharge. Hospital discharge should be scheduled from admission, so treatment choice should be geared to looking to control symptoms in the first few days and allow for better social and personal functioning after discharge.

scholarly journals Comparing the efficacy of 7%, 5% hypertonic saline and 0.9% normal saline in acute bronchiolitis: a randomized controlled trial

2018 ◽  
Vol 7 (5) ◽  
pp. 819
Author(s):  
Adel Ahadi ◽  
Manouchehr Barak ◽  
Fatemeh Amani
Keyword(s):  
Randomized Controlled Trial ◽  
Hypertonic Saline ◽  
Normal Saline ◽  
Clinical Symptoms ◽  
Controlled Trial ◽  
Study Groups ◽  
Acute Bronchiolitis ◽  
Randomized Controlled ◽  
Prospective Randomized Controlled Trial ◽  
The Mean

Background: The study aimed to investigate the effect of nebulized 5% and 7% Hypertonic Saline (HS) versus Normal Saline (NS) in acute viral bronchiolitis.Methods: This is a prospective, randomized controlled trial study that has been done on 90 infants presenting with acute bronchiolitis. All infants divided randomly in three equal size and matched groups (n=30). Subjects received 4ml nebulized 5% and 7% HS along with 0.15mg/kg Adrenaline or 4 ml 0.9%NS every 6 hours from enrolment until hospital discharge. For all patients, clinical symptoms such as sputum, wheezing, retraction rate, heart rate, fever, crackle, irritability, week nutrition and breathing were recorded in baseline and length of wheezing, cough, and crackle, length of stay (LOS), fever and sputum based on days in the end of study. Collected data analyzed by statistical methods in SPSS.19.Results: At baseline, study groups were similar in demographic and clinical characteristics. The mean age of all patients was 5.5±3.6 months, and 59 (65.6%) were male. The length of cough and crackle, and the length of LOS in 5% and 7% HS groups was significantly lower than NS group.Conclusions: Among infants admitted to the hospital with viral bronchiolitis, treatment with nebulized 5% HS and 7% HS had significant effect on decreasing clinical symptoms length and LOS when compared with NS.

scholarly journals The Effects of Succimer and Penicillamine on Acute Lead Poisoning Patients

2021 ◽  
Vol 11 (3) ◽  
pp. 33474-33474
Author(s):  
Gholamali Dorooshi ◽  
◽  
Negar Molavi ◽  
Rokhsareh Meamar ◽  
Akbar Hasanzadeh ◽  
...  
Keyword(s):  
Lead Poisoning ◽  
Clinical Symptoms ◽  
Blood Lead ◽  
Study Groups ◽  
Easy Access ◽  
Laboratory Findings ◽  
Treatment Groups ◽  
Significant Difference ◽  
Lead Levels ◽  
The Mean

Background: Lead poisoning was on the rise in recent years. There exists a lack of easy access to some of the main chelator drugs in developing countries. Thus, this study aimed to explore the comparative effects of Succimer and D-Penicillamine on acute lead poisoning patients from 2013 to 2018. Methods: This descriptive study was conducted in the Clinical Toxicology Department of Khorshid Hospital in Isfahan City, Iran. Adult patients with acute lead poisoning were included in the study. Patients in the 3 treatment groups of D-Penicillamine, D-Penicillamine with succimer, and succimer were compared concerning demographic characteristics as well as clinical and laboratory findings at admission time and two weeks later. Results: In total, 163 patients were evaluated in this research. There was no significant difference between the treatment groups respecting improvement in clinical symptoms. The mean blood lead levels during hospitalization and two weeks after the treatment did not significantly differ between the three groups; however, there was a significant reduction in all study groups after two weeks of treatment (P<0.05). The mean white blood cell count was significantly lower only in the D-Penicillamine group two weeks after hospitalization (P<0.05). In the D-Penicillamine group, the mean platelet, hematocrit, and hemoglobin levels were significantly lower two weeks after hospitalization, although within the healthy range. Conclusion: D-Penicillamine may be an acceptable chelator drug for treating patients with acute lead poisoning, especially in communities without access to drugs, like succimer.

scholarly journals Clinical and CT scan findings in patients with COVID-19 pneumonia: A comparison based on disease severity

2021 ◽  
Author(s):  
Sonia Hesam-Shariati ◽  
Susan Mohammadi ◽  
Morteza Abouzaripour ◽  
Behzad Mohsenpour ◽  
Bushra Zareie ◽  
...  
Keyword(s):  
Ct Scan ◽  
Disease Severity ◽  
Clinical Laboratory ◽  
Clinical Symptoms ◽  
White Blood Cells ◽  
Severe Pneumonia ◽  
Duration Of Hospitalization ◽  
The Mean ◽  
Severity Of The Disease ◽  
Interlobular Septal Thickening

Abstract Background The SARS-CoV-2 can cause severe pneumonia and highly impact general health. We aimed to investigate different clinical features and CT scan findings of patients with COVID-19 based on disease severity to have a better understanding of this disease. Methods 90 patients with coronavirus were divided into three categories based on the severity of the disease: mild/moderate, severe, and very severe. Clinical, laboratory and CT scan findings of the patients were examined retrospectively. Any association between these features and disease severity were assessed. Results The mean age and duration of hospitalization of patients increased with increasing the severity of disease. The most common clinical symptoms were shortness of breath, cough, and fever. As the severity of the disease increased from mild/moderate to very severe, there was an increase in neutrophile counts and a decrease in lymphocytes and white blood cells (WBC) showing excessive inflammation associated with severe forms of COVID-19. Subpleural changes (81%) and ground-glass opacification/opacity (GGO) lesions (73%) of the lung were the most common features among CT images of COVID-19 patients, and interlobular septal thickening (10%) was the lowest CT feature among patients. Regarding the affected parts of the lung in COVID-19 patients, bilaterial, peripheral and multiple lesions had the highest prevalence. Conclusions It has been shown that clinical, laboratory and CT scan findings varied in COVID-19 patients based on disease severity, which need to be considered carefully in timely diagnosis and treatment of this illness.

scholarly journals Viral Culture in Hospitalized Congregate Care Patients With Prolonged SARS-CoV-2 Viral RNA Detection

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 734-735
Author(s):  
Thilaka Arunachalam ◽  
Amit Singh ◽  
Kathleen Stellrecht ◽  
Sarah Elmendorf ◽  
Tarani K Barman ◽  
...  
Keyword(s):  
Viral Load ◽  
Symptom Onset ◽  
Clinical Symptoms ◽  
Academic Medical Center ◽  
Clinical Signs ◽  
Viral Rna ◽  
Nasopharyngeal Swab ◽  
Active Virus ◽  
Viral Culture ◽  
Congregate Care

Abstract Prolonged detection of SARS-CoV-2 viral RNA has been observed in hospitalized congregate care patients following resolution of clinical symptoms. It is unknown whether patients with persistent PCR positivity pose a risk for COVID-19 transmission. The purpose of this study was to examine the results of serial PCR testing, viral load, and viral culture in patients awaiting discharge prior to a negative PCR test. We sampled 14 patients who were admitted from skilled nursing and/or rehabilitation facilities to a large academic medical center, had clinical signs and symptoms of COVID-19, and had multiple PCR-positive tests separated by at least 14 days. PCR-positive nasopharyngeal swabs were obtained from each patient for viral load quantification and viral culture. The mean age of patients was 72.5 years (55 – 92), with a mean peak SOFA score of 5.6 (1 – 11). Patients were hospitalized for a mean of 37.0 days (25 – 60). RNA was detected by PCR for a mean of 32.9 days (19 – 47). Mean viral load for the first PCR-positive nasopharyngeal swab collected at our hospital was 5.81 genomic copies/mL (2.12 – 9.72). Viral load decreased significantly with days from clinical symptom onset (R = -0.69, 95% CI, -0.80 – -0.55). Four out of 28 samples grew active virus via culture, with no active virus isolates after 2 days of symptom onset. Our viral culture data suggests that persistent PCR positivity may not correlate with infectivity, which has important implications for COVID-19 infection control precautions among older congregate care patients.

scholarly journals Multicenter evaluation of the Panbio™ COVID-19 Rapid Antigen-Detection Test for the diagnosis of SARS-CoV-2 infection

2020 ◽  
Author(s):  
Paloma Merino-Amador ◽  
Jesús Guinea ◽  
Irene Muñoz-Gallego ◽  
Patricia González-Donapetry ◽  
Juan-Carlos Galán ◽  
...  
Keyword(s):  
Viral Load ◽  
Clinical Symptoms ◽  
False Negative ◽  
Rapid Test ◽  
Antigen Detection ◽  
Nasopharyngeal Swab ◽  
Diagnostic Strategy ◽  
Rt Pcr ◽  
University Hospitals ◽  
Kappa Score

AbstractThe standard RT-PCR assay for COVID-19 is laborious and time-consuming, limiting the availability of testing. Rapid antigen-detection tests are faster and less expensive; however, the reliability of these tests must be validated before they can be used widely. The objective of this study was to determine the reliability of the PanbioTM COVID-19 Ag Rapid Test Device (PanbioRT) (Abbott) for SARS-CoV-2 in nasopharyngeal swab specimens. This was a prospective multicenter study in ten Spanish university hospitals of patients from hospital units with clinical symptoms or epidemiological criteria for COVID-19. Patients whose onset of symptoms or exposure was more than 7 days earlier were excluded. Two nasopharyngeal exudate samples were taken to perform the PanbioRT and a diagnostic RT-PCR test. Among the 958 patients studied, 359 (37.5%) were positive by RT-PCR and 325 (33.9%) were also positive by the PanbioRT. Agreement was 95.7% (kappa score: 0.90). All 34 false-negative PanbioRT results were in symptomatic patients, with 23.5% of them at 6–7 days since the onset of symptoms and 58.8% presenting CT >30 values for RT-PCR, indicating a low viral load. Overall sensitivity and specificity for the PanbioRT were 90.5% and 98.8%, respectively. The PanbioRT provides good clinical performance as a point-of-care test, with even more reliable results for patients with a shorter clinical course of the disease or a higher viral load. While this study has had a direct impact on the national diagnostic strategy for COVID-19 in Spain, the results must be interpreted based on the local epidemiological context.

scholarly journals Nationwide Screening for Important Bee Viruses in Belgian Honey Bees

Proceedings ◽  
2020 ◽  
Vol 50 (1) ◽  
pp. 54
Author(s):  
Severine Matthijs ◽  
Nick De Regge
Keyword(s):  
Viral Load ◽  
Honey Bee ◽  
Honey Bees ◽  
Clinical Symptoms ◽  
Deformed Wing Virus ◽  
Ct Value ◽  
Increased Risk ◽  
The Impact ◽  
Bee Colonies ◽  
Paralysis Virus

The ecological and economic importance of bees for pollination and biodiversity is well established. The health of bees is, however, threatened by a multitude of factors, including viruses. In this study, we screened 557 colonies from 155 beekeepers distributed all over Belgium to monitor the prevalence and distribution of seven widespread viruses in Belgian honey bees (Apis mellifera). Several of these viruses have been linked with an increased risk for colony loss. Although these viruses can severely impact honey bees and can even cause the death of larvae or adults, colonies with a low viral load usually appear asymptomatic (covert infection). The presence of viruses was determined by real-time RT-PCR. The three most prevalent viruses in Belgian honey bees are Deformed wing virus B (DWV-B or VDV-1), Black queen cell virus (BQCV), and Sacbrood virus (SBV). These viruses were found in more than 90% of the honey bee colonies, but often with a high Ct value, which indicates that they are present at low viral loads (less than 3 log10 genome copies per bee). In certain colonies, however, DWV-B, BQCV, or SBV was detected with a low Ct value, representing a high viral load (in some cases, more than 7 log10 genome copies per bee) and with an increased likelihood of development of clinical symptoms. Deformed wing virus A (DWV-A), Acute bee paralysis virus (ABPV), and Chronic bee paralysis virus (CBPV) were found in less than 40% of the colonies. Kashmir bee virus (KBV) was not found in any of the analyzed Belgian honey bees. Most of the honey bee colonies are infected with multiple viruses, albeit with low virus loads. The impact of viruses can however become critical in the presence of other detrimental factors such as parasites (Nosema sp., Varroa sp.) and pesticides.

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