scholarly journals ASYMPTOMATIC SARS-CoV-2 INFECTION IN CHILDREN

2021 ◽  
Author(s):  
Andjelka Stojkovic Andjelkovic ◽  
Katerina Dajic ◽  
Andrijana Kostic ◽  
Nevena Folic ◽  
Marija Radovanovic ◽  
...  
Keyword(s):  
Predictive Factors ◽  
H1n1 Influenza ◽  
Biochemical Changes ◽  
Strong Increase ◽  
Influenza Like Illness ◽  
Erythrocyte Indices ◽  
Asymptomatic Children ◽  
Test Result ◽  
Pcr Test ◽  
Ldh Value

The aim was to determine hematological and biochemical changes in children who are carriers of SARS-CoV-2. Unlike H1N1 influenza-like illness the predictive factors of SARS-CoV-2 in asymptomatic children (carriers of SARS-CoV-2) are distinctive ratio between lymphocytes and monocytes more than 2, with occasional eosinophila, and a dicrease in erythrocyte indices (MCH and MCV), and a rapid and strong increase in serum LDH value. The predictive factors are, presumably, useful for fast and cheap triage of children “from contact” until a PCR test result for SARS-CoV-2 arrives.

scholarly journals The Impact of Changing to an Algorithm-Based Clostridioides difficile Test on the Decision to Treat Clostridioides difficile

2020 ◽  
Vol 41 (S1) ◽  
pp. s407-s407
Author(s):  
Lana Dbeibo ◽  
Joy Williams ◽  
Josh Sadowski ◽  
William Fadel ◽  
Vera Winn ◽  
...  
Keyword(s):  
Critical Care ◽  
Toxic Megacolon ◽  
Adverse Outcomes ◽  
Clinical Criteria ◽  
Testing Method ◽  
Clostridioides Difficile ◽  
Critical Care Admission ◽  
The Impact ◽  
Test Result ◽  
Pcr Test

Background: Polymerase chain reaction (PCR) testing for the diagnosis of Clostridioides difficile infection (CDI) detects the presence of the organism; a positive result therefore cannot differentiate between colonization and the pathogenic presence of the bacterium. This may result in overdiagnosis, overtreatment, and risking disruption of microbial flora, which may perpetuate the CDI cycle. Algorithm-based testing offers an advantage over PCR testing as it detects toxin, which allows differentiation between colonization and infection. Although previous studies have demonstrated the clinical utility of this testing algorithm in differentiating infection from colonization, it is unknown whether the test changes CDI treatment decisions. Our facility switched from PCR to an algorithm-based testing method for CDI in June 2018. Objective: In this study, we evaluated whether clinicians’ decisions to treat patients are impacted by a test result that implies colonization (GDH+/Tox−/PCR+ test), and we examined the impact of this decision on patient outcomes. Methods: This is a retrospective cohort study of inpatients with a positive C. diff test between June 2017 and June 2019. The primary outcome was the proportion of patients treated for CDI. We compared this outcome in 3 groups of patients: those with a positive PCR test (June 2017–June 2018), those who had a GDH+/Tox−/PCR+ or a GDH+/Tox+ test result (June 2018–June 2019). Secondary outcomes included toxic megacolon, critical care admission, and mortality in patients with GDH+/Tox−/PCR+ who were treated versus those who were untreated. Results: Of patients with a positive PCR test, 86% were treated with CDI-specific antibiotics, whereas 70.4% with GDH+/Tox+ and 29.25% with GDH+/Tox−/PCR+ result were treated (P < .0001). Mortality was not different between patients with GDH+/Tox−/PCR+ who were treated versus those who were untreated (2.7% vs 3.4%; P = .12), neither was critical care admission within 2 or 7 days of test result (2% vs 1.4%; P = .15) and (4.1% vs 5.4%, P = .39), respectively. There were no cases of toxic megacolon during the study period. Conclusions: The change to an algorithm-based C. difficile testing method had a significant impact on the clinicians’ decisions to treat patients with a positive test, as most patients with a GDH+/Tox−/PCR+ result did not receive treatment. These patients did not suffer more adverse outcomes compared to those who were treated, which has implications for testing practices. It remains to be explored whether clinicians are using clinical criteria to decide whether or not to treat patients with a positive algorithm-based test, as opposed to the more reflexive treatment of patients with a positive PCR test.Funding: NoneDisclosures: None

Death and COVID-19 Anxiety in Home-Quarantined Individuals Aged 65 and Over During the Pandemic

2021 ◽  
pp. 003022282110598
Author(s):  
Hümeyra Aslaner ◽  
Betül Özen ◽  
Zeliha K. Erten ◽  
Mebrure Beyza Gökçek
Keyword(s):  
Polymerase Chain Reaction ◽  
Death Anxiety ◽  
Short Form ◽  
Anxiety Score ◽  
Test Results ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Polymerase Chain ◽  
Test Result ◽  
Pcr Test

Urgent measures were taken for those at the age of 65 and over who were at the risk group all over the world due to the COVID-19 pandemic. It is known that many individuals at the age of 65 and over have experienced anxiety due to the uncertainties. This study aimed to determine the anxiety and death anxiety in individuals aged 65 and over who were isolation at home due to being diagnosed with COVID-19 or being in contact during the pandemic process. The study is descriptive and cross-sectional. It was performed with 656 home-quarantined individuals aged between 65–80 years with positive or negative real-time polymerase chain reaction (RT-PCR) test result. A form including questions about the death anxiety and the Coronavirus Anxiety Scale Short Form prepared by the researchers were administered to the individuals by phone call. Of the participants, 49.5% were male. Median COVID-19 anxiety score was 4 (0–18). Anxiety scores of the male and female participants were similar. Participants with negative polymerase chain reaction (PCR) results and those with death anxiety had higher COVID anxiety scores. Death anxiety has increased by 1.661 times in male gender, 1.983 times in RT-PCR positivity and 0.146 times in the presence of symptoms. Individuals with positive COVID-19 test results or those aged 65 and over who had death anxiety and negative COVID-19 test result but who were in home-isolation due to being a contact had higher anxiety score. For this reason, those with death anxiety can be supported in line with their religious beliefs to reduce anxiety. Those with negative PCR test results in quarantine can be adequately informed about the COVID-19.

scholarly journals Maternal and Perinatal Outcomes in Patients with Suspected COVID-19 and Their Relationship with a Negative RT-PCR Result

2020 ◽  
Vol 9 (11) ◽  
pp. 3552 ◽  
Author(s):  
Yolanda Cuñarro-López ◽  
Óscar Cano-Valderrama ◽  
Pilar Pintado-Recarte ◽  
Ignacio Cueto-Hernández ◽  
Blanca González-Garzón ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Oxygen Therapy ◽  
Perinatal Outcomes ◽  
Tertiary Hospital ◽  
Monocyte Count ◽  
Rt Pcr ◽  
Negative Test ◽  
Negative Test Result ◽  
Test Result ◽  
Pcr Test

This study was designed to examine maternal-perinatal outcomes in pregnant women with suspected coronavirus disease 2019 (COVID-19) according to the result of a real-time reverse transcription polymerase chain reaction (RT-PCR) test and to investigate possible variables that could be useful for predicting a negative RT-PCR result. Participants of this retrospective cohort study were obstetrics patients with suspected COVID-19 who underwent an RT-PCR test in a tertiary hospital in Madrid, Spain. Maternal-perinatal features were analysed according to the results of this test. Clinical, radiological and analytical characteristics that could be associated with a negative result were also explored. In a final subgroup analysis, patients were included if they had pneumonia and a negative test result for the virus. Out of the 111 obstetric patients with suspected COVID-19 that were enrolled, 38.7% returned a negative result. In this RT-PCR-negative group, we recorded lower rates of pneumonia (21.4% vs. 45.6%, p = 0.009), severe or critical clinical features (4.7% vs. 11.8% and 0.0% vs. 5.9%, p = 0.02, respectively), lower lactate dehydrogenase (LDH) levels (168 UI/L vs. 224.5 UI/L, p = 0.003), a greater need for maternal treatment (60.3% vs 24.4%, p < 0.001), a reduced need for oxygen therapy (2.4% vs 28.8%, p < 0.001) and a lower rate of intensive care unit admission (0.0% vs. 3.7%, p = 0.046) than the RT-PCR-positive group. While no differences were found in other variables, the monocyte count was higher (946.2/μL vs. 518.8/μL, p = 0.022) in this group. The predictive model for a negative test result included the monocyte count, LDH level and no need for oxygen therapy. This model was able to identify 73.5% of patients with a negative RT-PCR result. Only 11% of the patients with pneumonia testing negative for the virus had IgG antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The proportion of pregnant women with suspected COVID-19 and a negative RT-PCR result was nearly 39%. In these patients, the symptoms were mild and the systemic severity of the disease was lower. The monocyte count, LDH level and no need for oxygen therapy were the factors that were more related to a negative test result in this group. These variables could be used to guide the management of patients with suspected COVID-19, mainly while waiting for RT-PCR results or in settings where this test is not available.

scholarly journals How should a positive PCR test result for COVID-19 in an asymptomatic individual be interpreted and managed?

2020 ◽  
Vol 50 (8) ◽  
pp. 633-638
Author(s):  
C. Esteve ◽  
F.X. Catherine ◽  
P. Chavanet ◽  
M. Blot ◽  
L. Piroth
Keyword(s):  
Asymptomatic Individual ◽  
Test Result ◽  
Pcr Test

Study on Early Diagnosis of Invasive Aspergillosis in Patients with Hematological Diseases.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 4982-4982
Author(s):  
Ai-ning Sun ◽  
Jun Wang ◽  
De Pei Wu ◽  
Su-ning Chen
Keyword(s):  
Early Diagnosis ◽  
Invasive Aspergillosis ◽  
Antifungal Therapy ◽  
Predictive Value ◽  
Elisa Test ◽  
Hematological Disease ◽  
Sensitivity Specificity ◽  
Positive Results ◽  
Test Result ◽  
Pcr Test

Abstract Objective To evaluate the value of galactomannan(GM) detection and nest PCR for early diagnosis of invasive aspergillosis (IA) in patients with hematological disease. Methods GM ELISA and nest PCR was performed to serially screen for circulating galactomannan(GM) and DNA of Aspergillus ssp. Respectively, 96 patients were grouped according to case definitions of the EORTC, including 5 proven IA and 28 probable IA cases. Samples of the patients included serum twice weekly(326) and bronchoalveolar lavage fluid(BALF 12). Sensitivity, specificity and predictive values were calculated respectively and compared. Results According to the receiver operator characteristic curve(ROC), using a reduced cutoff of 0.5 O.D.I of two-positive GM test result, we can achieved the most optimal results. The sensitivity, specificity, positive predictive value (PPV)and negative predictive value (NPV) of the ELISA test were 85.7%,91.6%,85.7%,91.6%respectively. While for the BALF samples, a increased cutoff 1.0 maybe improve the value of this diagnosis, with sensitivity 50% and specificity 100%.Quantitive results of the serum-based GM antigen can represent the status of IA and were correlated with the prognosis Of IA.Galactomannanemia preceded the development of characteristic findings on CT about 6 days. The nest PCR assay amplifies specifically a region of the 18S rRNA gene that is highly conserved in Aspergillus species and allows detection of down to 5.0 fg/ml of Aspergillus DNA. When two-positive results were used to define an episode as ‘PCR positive’, the sensitivity, specificity, PPV and NPV of the PCR test were 92.9%, 100%,100%,96.0% respectively. For the BALF samples, the sensitivity and specificity decreased to 75%and 60%. The frequency of the consecutively positive results of a patient was correlated with prognosis Of IA. The antifungal therapy usually causes a intermittent positive PCR results. Positve PCR results preceded the development of characteristic findings on CT about 9 days. Conclusion The cutoff 0.5 of two-positive serum-based GM ELISA test result is the most optimal cutoff value. GM ELISA test is a rapid,reliable method for early diagnosis and treatment of IA, with good sensitivity(85.7%)and specificity(91.6%). GM ELISA test is a good direction for preemptive antifungal therapy in patients with hematological disease at risk. Using two-positive results to define an episode as ‘PCR positive’, great sensitivity(92.9%)and specificity(100%) could be achieved. The serum-based PCR test is useful for screening for Aspergillus spp. in patients with hematological disease at risk but without antifungal treatment.

scholarly journals Clinical Characteristics of Patients With Re-admitted of Novel Coronavirus 2019 (nCOVID-19) in Wenzhou, China

2021 ◽  
Vol 9 ◽  
Author(s):  
Xinchun Ye ◽  
Yuping Yuan ◽  
Risheng Huang ◽  
Aiqiong Cheng ◽  
Zhijie Yu ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Treatment Strategies ◽  
Ct Imaging ◽  
Negative Results ◽  
Medical Observation ◽  
Primary Focus ◽  
Novel Coronavirus ◽  
Clinical Records ◽  
Test Result ◽  
Pcr Test

Background: During the COVID-19 pandemic, many patients admitted to hospital for treatment have recovered and been discharged; however, in some instances, these same patients are re-admitted due to a second fever or a positive COVID-19 PCR test result. To ascertain whether it is necessary to treat these patients in hospitals, especially in asymptomatic cases, we summarize and analyze the clinical and treatment characteristics of patients re-admitted to hospital with a second COVID-19 infection.Methods: Of the 141 COVID-19 cases admitted to the Wenzhou Central Hospital between January 17, 2020, to March 5, 2020, which were followed until March 30, 2020, 12 patients were re-admitted with a second COVID-19 infection. Data was collected and analyzed from their clinical records, lab indexes, commuted tomography (CT), and treatment strategies.Results: Most of the 141 patients had positive outcomes from treatment, with only 12 (8.5%) being re-admitted. In this sub-group: one (8.3%) had a fever, a high white blood cell count (WBC), and progressive CT changes; and one (8.3%) had increased transaminase. The PCR tests of these two patients returned negative results. Another 10 patients were admitted due to a positive PCR test result, seven of which were clinically asymptomatic. Compared to the CT imaging following their initial discharge, the CT imaging of all patients was significantly improved, and none required additional oxygen or mechanical ventilation during their second course of treatment.Conclusions: The prognoses of the re-admitted patients were good with no serious cases. We conclude that home treatment with concentrated medical observation is a safe and feasible course of treatment if the patient returns a positive PCR test result but does not display serious clinical symptoms. During medical observation, patients with underlying conditions should remain a primary focus, but most do not need to be re-admitted to the hospital.

scholarly journals Is the Portable Chest Radiographic More Reliable to Reveal Covid19 in Highly Suspicion Patient before Real-Time Reverse Transcription Polymerase Chain Reaction (RT-PCR) Test?

2021 ◽  
Vol 6 (03) ◽  
pp. 228-236
Author(s):  
Bushra A. A. Albazi ◽  
Dr Noof. Albaz ◽  
Dr Nayef. Alqahtani ◽  
Dr. Angham Salih ◽  
Dr Rafat Mohtasab
Keyword(s):  
Polymerase Chain Reaction ◽  
Retrospective Study ◽  
Predictive Value ◽  
Rt Pcr ◽  
Chain Reaction ◽  
X Ray ◽  
Polymerase Chain ◽  
Rate Type ◽  
Test Result ◽  
Pcr Test

A large number of patients with coronavirus disease 2019 (COVID-19) present at hospitals. There are a limited number of isolation rooms open, and patients must often wait a long time to get a reverse transcription-polymerase chain reaction (RT-PCR) test done. This necessitates the introduction of effective triage plans. A patient with suspicions is referred to an emergency room (ED) depending on their medical record for a simple physical assessment, blood test findings, and chest imaging.A retrospective study design was conduct at Prince Sultan Medical Military City (PSMMC). Ethical approval was obtained from the institutional board to wave the consent forms since it is a retrospective study. Only the primary investigator has had the data access to the patients’ medical records. The collected patient records were under specific categories, including symptoms score starts from 5 and above, RT-PCR test result done after CXRP imaging, the patient admitted to the emergency department (ED). Excluding all CXRP done after RT-PCR TEST, positive Covid 19 admitted to the intensive care unit (ICU), pediatric patients, and patients with score symptoms were less than five. Two experienced radiologists reviewed the images blindly, and the inter-observer reliability of observations noted by the radiologists was calculated. As for the relationship between the x-ray reading and the RT-PCR test result, our results showed a high correlation between the variables (chi-square χ² = 12.44, with df =1, and p<0.001). The sensitivity of x-ray diagnosing covid19 was 65.52 %, while the specificity was 54.51 %, and the accuracy of radiologists reading was 58.17 %. Furthermore, the positive predictive value (PPV) was 41.76 %, and the negative predictive value (NPV) was 76.05%. Finally, the false positive rate (type-i error (alpha) was 45.49%, and the false-negative rate (type-ii error (beta) was 34.48% Our research findings show that CXRP imaging can detect COVID-19 infection in symptomatic patients and can be a valuable addition to RT-PCR testing. In an inpatient ED environment where availability of test kits, laboratory equipment, and laboratory personnel is compromised and risks delaying patient treatment and hospital workflow, serial CXRP could theoretically be used as an adjunct diagnostic function and monitoring in patients suspected of having COVID-19.

scholarly journals Clinical Presentation of Patients with Aseptic Meningitis, Factors Influencing Treatment and Hospitalization, and Consequences of Enterovirus Cerebrospinal Fluid Polymerase Chain Reaction Testing

2012 ◽  
Vol 23 (1) ◽  
pp. e1-e5 ◽  
Author(s):  
Glenn Patriquin ◽  
Jill Hatchette ◽  
Kevin Forward
Keyword(s):  
Polymerase Chain Reaction ◽  
Cerebrospinal Fluid ◽  
Neurological Symptoms ◽  
Chain Reaction ◽  
Positive Polymerase Chain Reaction ◽  
Recent Onset ◽  
Polymerase Chain ◽  
Enteroviral Meningitis ◽  
Test Result ◽  
Pcr Test

INTRODUCTION: Clinical and laboratory features of enteroviral meningitis may overlap with those of bacterial meningitis. In the present retrospective review, we compared features of enteroviral (EV)-positive and -negative patients to determine those that were most influential in admission, discharge and in anti-infective administration.METHODS: Data were analyzed from the records of 117 pediatric and adult patients who underwent cerebrospinal fluid (CSF) EV testing over a three-year period.RESULTS: The oldest EV-positive patient was 34 years of age and the occurrence of the disease was highly seasonal. EV-positive patients were more likely to report fever, rash, photophobia, short onset and exposure to an ill contact. A positive polymerase chain reaction (PCR) result was associated with relatively short hospitalization. Seizure and neurological symptoms were more strongly associated with a negative PCR test result. CSF characteristics did not discriminate well between patients with positive and negative PCR tests. Patients with imperfect Glasgow Coma Scores or with neurological symptoms were more likely to be admitted to hospital than those without. Fever and recent onset predicted determinants of anti-infective use.CONCLUSION: The present retrospective study confirms previous reports regarding seasonality and the young age of positive patients. Factors that indicate nonenteroviral etiology were appropriately also those that influenced hospitalization. Patients with EV meningitis were likely to be treated with empirical anti-infectives, and a substantial proportion continued to take antibiotics for more than 24 h after receiving the positive EV PCR test result.

scholarly journals Perioperative challenges in managing a patient with COVID-19 undergoing debridement for massive scalp myiasis

2021 ◽  
Vol 14 (2) ◽  
pp. e241189
Author(s):  
Shiu Yin Lo ◽  
Ming Kai Teah ◽  
Yan Zheng Ho ◽  
Tat Boon Yeap
Keyword(s):  
Real Time ◽  
Personal Protective Equipment ◽  
Real Time Pcr ◽  
Healthcare Workers ◽  
Patient Management ◽  
Cross Infection ◽  
Nasopharyngeal Swab ◽  
Protective Equipment ◽  
Test Result ◽  
Pcr Test

A young man presented to our centre needing an urgent debridement of his postcraniotomy wound due to massive myiasis during the COVID-19 pandemic in October 2020. Prior to the surgery, his nasopharyngeal swab real-time PCR test result was unknown. One day later, it returned as SARS-CoV-2 positive. All healthcare workers who were involved in the patient management avoided cross infection as they wore appropriate personal protective equipment. This article depicts the importance of adequate preparations when handling potentially infectious patients and the perioperative issues associated with it.

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