scholarly journals Effect of Lopinavir/Ritonavir Treatment On COVID-2019 Transmissibility: A Possible Option To Reduce Isolation Time

2021 ◽  
Author(s):  
Dong-Min Kim ◽  
Jae Keun Chung ◽  
Choon-Mee Kim ◽  
Mi-Seon Bang ◽  
Misbah Tariq ◽  
...  
Keyword(s):  
Viral Load ◽  
Lower Respiratory Tract ◽  
Antiviral Agent ◽  
Healthcare Systems ◽  
Rt Pcr ◽  
Load Duration ◽  
Viral Shedding ◽  
Number Of Patients ◽  
The Mean ◽  
Hospital Wards

Abstract Owing to the coronavirus disease 2019 (COVID-19) pandemic, there is a shortage of hospital wards to accommodate the increasing number of patients, especially in intensive care units. Healthcare systems are collapsing in many countries. Therefore, it is necessary to reduce isolation time. We examined the effect of lopinavir/ritonavir administration in patients with SARS-CoV-2. To assess the viral load, duration and clearance of viable virus; cell culture and RT-PCR were performed in parallel. No viable SARS-CoV-2 could be detected after administration of lopinavir/ritonavir with median time of viable viral clearance being one day after administration. The mean viral load in both upper and lower respiratory tract samples of lopinavir/ritonavir administered group was significantly lower than the group who were not treated with any antiviral agent. The duration of viable viral shedding was shorter in patients with lopinavir/ritonavir treatment compared with those without treatment. This study suggests that lopinavir/ritonavir treatment offers a possible method to reduce isolation time of patients infected with the SARS-CoV-2.

scholarly journals Effect of Lopinavir/ritonavir Treatment on COVID-2019 Transmissibility: a Possible Option to Reduce Isolation Time

2021 ◽  
Author(s):  
Dong-Min Kim ◽  
Jae Keun Chung ◽  
Choon-Mee Kim ◽  
Mi-Seon Bang ◽  
Misbah Tariq ◽  
...  
Keyword(s):  
Viral Load ◽  
Lower Respiratory Tract ◽  
Antiviral Agent ◽  
Healthcare Systems ◽  
Rt Pcr ◽  
Load Duration ◽  
Viral Shedding ◽  
Number Of Patients ◽  
The Mean ◽  
Hospital Wards

Abstract Background: Owing to the coronavirus disease 2019 (COVID-19) pandemic, there is a shortage of hospital wards to accommodate the increasing number of patients, especially in intensive care units. Healthcare systems are collapsing in many countries. Therefore, it is necessary to reduce isolation time.Methods: We examined the effect of lopinavir/ritonavir administration in patients with SARS-CoV-2. To assess the viral load, duration and clearance of viable virus; cell culture and RT-PCR were performed in parallel. Results: No viable SARS-CoV-2 could be detected after administration of lopinavir/ritonavir with median time of viable viral clearance being one day after administration. The mean viral load in both upper and lower respiratory tract samples of lopinavir/ritonavir administered group was significantly lower than the group who were not treated with any antiviral agent. The duration of viable viral shedding was shorter in patients with lopinavir/ritonavir treatment compared with those without treatment. Conclusion: This study suggests that lopinavir/ritonavir treatment offers a possible method to reduce isolation time of patients infected with the SARS-CoV-2.

scholarly journals Rapid Diagnosis of SARS-CoV-2 Pneumonia on Lower Respiratory Tract Specimens

2021 ◽  
Author(s):  
Vanessa De Pace ◽  
Patrizia Caligiuri ◽  
Valentina Ricucci ◽  
Nicola Nigro ◽  
Barbara Galano ◽  
...  
Keyword(s):  
Intensive Care ◽  
Viral Load ◽  
Respiratory Tract ◽  
Intensive Care Units ◽  
Lower Respiratory Tract ◽  
Clinical Decision Making ◽  
High Viral Load ◽  
Rt Pcr ◽  
Predictive Values ◽  
Rapid Pcr

Abstract Background: The ongoing pandemic of SARS-CoV-2 requires the availability of accurate and rapid diagnostic tests, especially in some clinical settings like emergency and intensive care units. The objective of this study was to evaluate the diagnostic performances of rapid PCR kit Vivalytic SARS-CoV-2 in lower respiratory tract (LRT) specimens.Methods: A consecutive sample of LRT specimens (bronchoalveolar lavage and bronchoaspirates) was collected from Intensive Care Units of San Martino Hospital (Genoa, Italy) between November 2020 and January 2021. All samples were tested in RT-PCR by using Allplex™ SARS-CoV-2 assay (Seegene Inc., South Korea). Based on RT-PCR results, specimens were categorized into negative, positive with high viral load [cycle threshold (Ct) ≤30] and positive with low viral load (Ct of 31–35). A quota 1:1:1 sampling was used to achieve a sample size of 75. Then, all specimens were tested in the rapid PCR assay Vivalytic SARS-CoV-2 (Bosch Healthcare Solutions GmbH, Germany). The diagnostic performance of the rapid PCR against RT-PCR was assessed through calculation of accuracy, Cohen’s κ, sensitivity, specificity and expected positive (PPV) and negative (NPV) predictive values.Results: The overall diagnostic accuracy of the Vivalytic SARS-CoV-2 was 97.3% (95% CI: 90.9–99.3%) with an excellent Cohen’s κ of 0.94 (95% CI: 0.72–1). The sensitivity and specificity were 96% (95% CI: 86.5–98.9%) and 100% (95% CI: 86.7–100%), respectively. Samples with high viral loads had a sensitivity of 100% (Table 1). The distributions of E gene Ct values were similar (Wilcoxon’s test: P=0.070) with medians of 35 (IQR: 25–36) and 35 (IQR: 25–35), respectively (Figure 1). NPV and PPV was 92.6% and 100%, respectively.Conclusions: This study shows Vivalytic SARS-CoV-2 can be used following the sample liquefaction on LRT specimens. It’s a feasible and highly accurate molecular procedure especially in high viral load samples. This assay allows having a result in about 40 min and therefore may accelerate the clinical decision making in urgent/emergency situations.

scholarly journals Covid-19 Re-infection vs Prolonged Viral Shedding

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Richard J. Barohn ◽  
Mary Hindle ◽  
Lauren Peck ◽  
Syed Hasan Raza Naqvi
Keyword(s):  
Polymerase Chain Reaction ◽  
Acquired Immunity ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Initial Infection ◽  
Viral Shedding ◽  
Number Of Patients ◽  
The World ◽  
Polymerase Chain ◽  
Spread Of Infection

  Since December 2019, COVID 19 pandemic has devastated communities across the world. As number of patients recovered from COVID 19 continue to rise, question of acquired immunity versus chances of re-infection becomes critical to understand the future spread of infection. Here, we present a case of a patient previously recovered from COVID-19, develops new symptoms concerning for possible re-infection with positive reverse transcriptase-polymerase chain reaction (RT-PCR) after few months of initial infection.  

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 Paired nasopharyngeal and deep lung testing for SARS-CoV2 reveals a viral gradient in critically ill patients: a multi-centre study

2020 ◽  
Author(s):  
Islam Hamed ◽  
Nesreen Shaban ◽  
Marwan Nassar ◽  
Sam Love ◽  
Martin D Curran ◽  
...  
Keyword(s):  
Viral Load ◽  
Respiratory Tract ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Lower Respiratory Tract ◽  
Limit Of Detection ◽  
Upper Respiratory Tract ◽  
Rt Pcr ◽  
Multi Centre Study ◽  
Upper Respiratory

Introduction Samples for diagnostic tests for SARS-CoV-2 can be obtained from the upper (nasopharyngeal/oropharyngeal swabs) or lower respiratory tract (sputum or tracheal aspirate or broncho-alveolar lavage - BAL). Data from different testing sites indicates different rates of positivity. Reverse-transcriptase polymerase chain reaction (RT-PCR) allows for semi-quantitative estimates of viral load as time to crossing threshold (Ct) is inversely related to viral load. Objectives The objective of our study was to evaluate SARS-CoV2 RNA loads between paired nasopharyngeal (NP) and deep lung (endotracheal aspirate or BAL) samples from critically ill patients. Methods SARS-CoV-2 RT-PCR results were retrospectively reviewed for 51 critically ill patients from 5 intensive care units in 3 hospitals ; Addenbrookes Hospital Cambridge (3 units), Royal Papworth Cambridge (1 unit), and Royal Sunderland Hospital (1 unit). At the times when paired NP and deep lung samples were obtained, one patient had been on oxygen only, 6 patients on non-invasive ventilation, 18 patients on ECMO, and 26 patients mechanically ventilated. Results Results collected showed significant gradient between NP and deep lung viral loads. Median Ct value was 29 for NP samples and 24 for deep lung samples. Of 51 paired samples, 16 were negative (below limit of detection) on NP swabs but positive (above limit of detection) on deep lung sample, whilst 2 were negative on deep sample but positive on NP (both patients were on ECMO). Conclusions It has been suggested that whilst SARS-CoV1 tends to replicate in the lower respiratory tract, SARS-CoV2 replicates more vigorously in the upper respiratory tract. These data challenge that assumption. These data suggest that viral migration to, and proliferation in, the lower respiratory tract may be a key factor in the progression to critical illness and the development of severe acute respiratory syndrome (SARS). Factors which promote this migration should be examined for association with severe COVID-19. From a practical point of view, patients with suspected severe COVID-19 should have virological samples obtained from the lower respiratory tract where-ever possible, as upper respiratory samples have a significant negative rate.

scholarly journals Protracted viral shedding and viral load are associated with ICU mortality in Covid-19 patients with acute respiratory failure

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
L. Bitker ◽  
F. Dhelft ◽  
L. Chauvelot ◽  
E. Frobert ◽  
L. Folliet ◽  
...  
Keyword(s):  
Viral Load ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Antiviral Treatment ◽  
University Hospital ◽  
Rt Pcr ◽  
Viral Shedding ◽  
Icu Discharge ◽  
Independent Risk Factors ◽  
Lung Ct

Abstract Background Protracted viral shedding is common in hospitalized patients with COVID-19 pneumonia, and up to 40% display signs of pulmonary fibrosis on computed tomography (CT) after hospital discharge. We hypothesized that COVID-19 patients with acute respiratory failure (ARF) who die in intensive care units (ICU) have a lower viral clearance in the respiratory tract than ICU patients discharged alive, and that protracted viral shedding in respiratory samples is associated with patterns of fibroproliferation on lung CT. We, therefore, conducted a retrospective observational study, in 2 ICU of Lyon university hospital. Results 129 patients were included in the study, of whom 44 (34%) died in ICU. 432 RT-PCR for SARS-CoV-2 were performed and 137 CT scans were analyzed. Viral load was significantly higher in patients deceased as compared to patients alive at ICU discharge (p < 0.001), after adjustment for the site of viral sampling and RT-PCR technique. The median time to SARS-CoV-2 negativation on RT-PCR was 19 days [CI95 %:15–21] in patients alive at ICU discharge and 26 days [CI95 %:17-infinity] in non-survivors at ICU discharge. Competitive risk regression identified patients who died in ICU and age as independent risk factors for longer time to SARS-CoV-2 negativation on RT-PCR, while antiviral treatment was independently associated with shorter time. None of the CT scores exploring fibroproliferation (i.e., bronchiectasis and reticulation scores) were significantly associated with time to SARS-CoV-2 negativation. Conclusions Viral load in respiratory samples is significantly lower and viral shedding significantly shorter in ICU survivors of COVID-19 associated acute respiratory failure. Protracted viral shedding is unrelated to occurrence of fibrosis on lung CT.

scholarly journals Infants have lower RT-PCR cycle threshold for SARS-CoV-2 in comparison with older children and adults

2021 ◽  
Author(s):  
Marcia Polese-Bonatto ◽  
Ivaine Tais Sauthier Sartor ◽  
Fernanda Hammes-Varela ◽  
Gabriela Luchiari Tumioto Gianinni ◽  
Thais Raupp Azevedo ◽  
...  
Keyword(s):  
Viral Load ◽  
Significant Role ◽  
Signs And Symptoms ◽  
Viral Dynamics ◽  
Older Children ◽  
Rt Pcr ◽  
Pcr Assay ◽  
Cycle Threshold ◽  
The Mean

Background: The viral dynamics and the role of children in the spread of SARS-CoV-2 are not completely understood. Our aim was to evaluate how RT-PCR Ct values among children with confirmed SARS-CoV-2 compared with that of adult subjects. Methods: Patients (aged from 2 months to ≤18 years, and adults) with signs and symptoms of acute SARS-CoV-2 infection for less than 7 days, were prospectively enrolled in the study from May to November 2020. All participants performed RT-PCR assay for SARS-CoV-2 detection; Ct values of ORF1ab, N, and S gene-targets, and the average of all the three probes were used as surrogates of viral load. Results: Of the total of 376 participants with confirmed SARS-CoV-2 infection there were 21 infants, 62 children and 293 adults. The RT-PCR Ct values of children under 18 were not significantly different from that of adults, as observed by the analyzed probes (namely ORF1ab, N, and S), and by the mean of all 3 gene-targets. However, infants had significantly lower Ct values compared to children and adults (P = 0.044). Discussion: Ct values for children were not significantly different than that of adults with positive SARS-CoV-2. Interestingly, infants had even lower Ct values when compared to older children and adults. Although viral load is not the only determinant of transmission, infants may play a significant role in the spread of SARS-CoV-2 in the community, especially if or when this population returns to regular daycare activities.

scholarly journals Rationing of Nursing Care on Example of Selected Health Care Facility

2021 ◽  
Vol 18 (23) ◽  
pp. 12824
Author(s):  
Katarzyna Tomaszewska ◽  
Bożena Majchrowicz ◽  
Dorota Ratusznik
Keyword(s):  
Health Care ◽  
Nursing Care ◽  
Care Facility ◽  
Health Care Facility ◽  
Health Determinants ◽  
Adequate Care ◽  
Number Of Patients ◽  
The Mean ◽  
Care Rationing ◽  
Hospital Wards

Contemporary health determinants require nurses to develop new competencies and skills while performing complex tasks in all forms of health care. The problem of rationing of care is present all over the world and usually occurs when available resources are too low to provide adequate care to all patients. The most common reasons for loss of care are shortages of nurses, use of modern treatment methods, increased demand for care by a large number of patients, and greater knowledge of patients about their rights. A questionnaire survey was conducted among 295 nurses employed in hospital wards. The survey was conducted from September to December 2020 using the standardized BERNCA (The Basel Extent of Rationing of Nursing Care) questionnaire to measure the level of rationing of nursing care. The research was hampered by the sanitation regime associated with the SARS CoV-2 pandemic. Nursing care rationing is dependent on seniority and place of work. The mean total BERNCA score of the degree of rationing of nursing care was 2.58 ± 0.96 on a scale of 0 to 4 (where 0 means “no need for it” and 4 means “often”. The median score was 2.69. The higher frequency of rationing nursing care was characteristic of those working on surgical wards. The mean score obtained by them was 2.72 ± 0.86, with the median equal to 2.88. In the case of nurses employed in non-surgical wards, the scores were 2.08 ± 1.07 and 2.28, respectively. Rationing of nursing care is dependent on seniority and work location, with a higher degree of rationing of care occurring in surgical units.

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