scholarly journals New coronavirus infection (COVID-19) in children: clinical, laboratory and diagnostic aspects

2021 ◽  
Vol 20 (3) ◽  
pp. 23-28
Author(s):  
S. Yu. Nosyreva ◽  
A. S. Pankov ◽  
A. G. Korneev
Keyword(s):  
Clinical Laboratory ◽  
Clinical Manifestations ◽  
Epidemiological Data ◽  
Diagnostic Value ◽  
Sex Structure ◽  
Orenburg Region ◽  
Microbiological Laboratory ◽  
Examination Methods ◽  
Coronavirus Infection ◽  
Medical University

The study of a new coronavirus infection (COVID-19) in children is relevant and of interest for practical health care.Purpose: to identify the clinical and laboratory features of COVID-19 in the context of the six-month dynamics of the pandemic in children of the Orenburg region and to formulate recommendations for optimizing the diagnosis of this disease.Materials and methods. A retrospective analysis of 2661 results of detecting SARS-CoV-2 RNA (including 170 children) was carried out on the basis of the microbiological laboratory of the Orenburg State Medical University. Age and sex, structure of preliminary diagnoses, main clinical manifestations, frequency of testing and dynamics of the PCR threshold cycle in September 2020 and January 2021 were assessed.Results. The proportion of children examined in the Orenburg region from September 2020 to January 2021 increased from 4.6 ± 0.6% to 8.1 ± 0.7%. At the same time, the number of PCR + results also significantly increased from 5.0 ± 2.8% to 8.2 ± 2.6% (χ2 = 54.81; p = 0). The average age of children was 9—10 years old. The main reason for referral was pre-hospitalization screening not related to COVID-19. The proportion of PCR + results in this cohort was significantly lower in children than in adults. Among the clinically manifested forms in adults, the leading diagnosis was «pneumonia», and in children «ARVI». In childhood, a predominantly asymptomatic course of the disease was recorded. In children, unlike adults, PCR Ct values did not correlate with the severity and duration of the clinical manifestations of COVID-19.Conclusion. Due to the low diagnostic value of symptoms in children, it is more expedient to focus on epidemiological data and data from the results of laboratory examination methods. When interpreting the results of PCR diagnostics of COVID-19 for prognostic purposes, it is important to take into account the patient's age.

TUBERCULOSIS UNDER CONDITIONS OF NOVEL CORONAVIRUS INFECTION

2021 ◽  
Vol 100 (2) ◽  
pp. 153-157
Author(s):  
A.A. Starshinova ◽  
◽  
A.M. Malkova ◽  
A.Ya. Starshinova ◽  
V.E. Karev ◽  
...  
Keyword(s):  
Clinical Manifestations ◽  
Diagnostic Value ◽  
Skin Tests ◽  
High Incidence ◽  
Treatment Facilities ◽  
Coronavirus Infection ◽  
The One ◽  
Novel Coronavirus ◽  
Made In

Tuberculosis (TB) remains an important medical and social problem up to today. In recent years, great strides have been made in the fight against tuberculosis infection (TI) in reducing TB morbidity and mortality, especially in the Russian Federation. Emergence of new COVID-19 infection in the world has led to the need for long-term isolation of the population, on the one hand, and the need to resort to personal protective equipment, on the other. The spread of COVID-19 may have an impact on the increase in TB morbidity, despite the decrease in the incidence rate, which is related to objective difficulties in detecting TB and complexity of the structure of clinical manifestations of the disease against the background of coronavirus infection and severe complications after COVID-19. The use of immunosuppressive therapy in the treatment of COVID-19 may cause immunosuppression, which will affect the results of TI immunodiagnostics using skin tests. At the same time, IGRA tests can be useful in these conditions, since they are of great diagnostic value. Equally important is the reduction of patient visits to treatment facilities in the context of a pandemic or a high incidence of COVID-19.

Analysis of the clinical manifestations of cerebral stroke in patients with the novel coronavirus infection (COVID-19)

2020 ◽  
pp. 30-45
Author(s):  
Vladislav V. Andreev ◽  
Alexander Y. Podunov ◽  
Daniil S. Lapin ◽  
Zarema L. Gilyaeva ◽  
Ekaterina N. Nikiforova ◽  
...  
Keyword(s):  
Lung Tissue ◽  
Hemorrhagic Stroke ◽  
Clinical Laboratory ◽  
Clinical Manifestations ◽  
Community Acquired Pneumonia ◽  
Control Group ◽  
Cerebral Stroke ◽  
The Novel ◽  
Coronavirus Infection ◽  
Novel Coronavirus

Objective: To improve the diagnosis and treatment of acute cerebrovascular accident in patients with community-acquired pneumonia caused by the novel coronavirus infection (COVID-19). Materials and methods: For the first time, clinical manifestations of strokes in patients with diagnosed new coronavirus infection (COVID-19) were analyzed in 130 patients. The study was conducted in two groups. The main group consisted of 69,2 % (n = 90) with a clinical and instrumental diagnosis: novel coronavirus infection in combination with stroke. The control group (30,8 %; n = 40) included the cases of ischemic and hemorrhagic stroke without signs of SARS-CoV-2. In both groups, the severity of the disease and pathogenetic subtypes were compared, and the features of the laboratory biochemical data were studied. Statistical analysis of the outcomes was carried out taking into account the severity of brain and lung tissue damage. Results: In patients with cerebral stroke against the background of the new coronavirus infection (COVID-19), the prevalence of ischemic stroke cases (86,4 %) was noted for undetermined (41,4 %) and cardioembolic (35,7 %) pathogenetic subtypes (according to TOAST) with localization in the carotid basin (89,7 %). In hemorrhagic stroke, parenchymal hemorrhage was observed with a greater frequency (54,5 %). The severity of the diagnosed strokes according to the NIHSS scale was up to 13,16 (8,80) points with less severe brain damage — Glasgow coma scale (14,0 (12,0 15,0). In the group of the patients, a widespread lesion of the lung tissue was diagnosed in 82,2 % of cases. No significant increase in the incidence of clinically significant manifestations of systemic and organ hypercoagulation was established. Conclusions: In stroke patients with COVID-19, ischemic manifestations with undetermined and cardioembolic subtypes without age and gender features prevail, with no differences in the severity of the course and a large number of favorable outcomes. A high activity of inflammatory and infectious changes was established by clinical laboratory.

NEW CORONAVIRUS INFECTION AS TRIGGER FACTOR FOR MULTISYSTEM INFLAMMATORY SYNDROME IN CHILDREN: LITERATURE REVIEW AND ANALYSIS OF ORIGINAL DATA

2020 ◽  
Vol 99 (6) ◽  
pp. 127-134
Author(s):  
S.R. Rodionovskaya ◽  
◽  
L.N. Mazankova ◽  
I.M. Osmanov ◽  
E.R. Samitova ◽  
...  
Keyword(s):  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Epidemiological Data ◽  
Original Data ◽  
Trigger Factor ◽  
Laboratory Markers ◽  
Systemic Glucocorticoids ◽  
Coronavirus Infection ◽  
Characteristic Features ◽  
Inflammatory Syndrome

The article presents data on the epidemiology, pathogenesis, features of clinical manifestations and diagnosis of multisystem inflammatory syndrome in children (MIS-C) associated with a new coronavirus infection. Objective of the research: to identify clinical manifestations and results of laboratory and instrumental examination of pediatric patients with confirmed MIS-C caused by a new coronavirus infection, the most characteristic features of this pathology and to analyze the amount of therapy based on the assessment of epidemiological data. Results: median age – 8 years (6; 9,5), median duration of the disease at the time of hospitalization – 6 days (3; 6). A positive result of SARS-CoV-2 analysis in rhinopharyngeal swabs by PCR was in 3 patients, antibodies to SARS-CoV-2 by ELISA were detected in 10. Clinical manifestations included prolonged febrile fever in 11 patients, gastrointestinal symptoms of varying severity – in 10, polymorphic rash was noted in 7 cases, conjunctivitis/scleritis – in 7, edema of the eyelids, face, extremities – in 4. CNS lesion manifested itself with general cerebral and meningeal symptoms. All patients had an increase in the level of inflammation laboratory markers. In 2 children chest MSCT revealed characteristic changes for SARS-CoV-2, interpreted as CT 3–4. Therapy included intravenous immunoglobulin infusions, systemic glucocorticoids, antiviral and antibacterial drugs, anticoagulants; two patients received tocilizumab infusions.

scholarly journals New COVID-19 coronavirus infection in the practice of a neonatologist and pediatrician

2020 ◽  
Vol 65 (3) ◽  
pp. 11-17
Author(s):  
A. L. Zaplatnikov ◽  
I. M. Osmanov ◽  
V. V. Gorev ◽  
A. V. Dmitriev ◽  
A. K. Mironova ◽  
...  
Keyword(s):  
Neonatal Period ◽  
Clinical Laboratory ◽  
Clinical Symptoms ◽  
Gastrointestinal Symptoms ◽  
Severe Pneumonia ◽  
Epidemiological Data ◽  
Medical Professional ◽  
Older Children ◽  
Strict Adherence ◽  
Coronavirus Infection

The article analyses the data published from January 2020 to April 25, 2020 in the print media or available on the official websites of peer-reviewed medical sources (pre print), international and national medical professional communities, and state regulatory authorities dedicated to the epidemiological and clinical laboratory features of the new coronavirus infection in newborns, infants and older children. The authors have concluded that currently there are no convincing data on vertical transmission of infection. At the same time, they have found that there is a risk of horizontal infection of a newborn child; therefore, there is the need for strict adherence to the recommended algorithms for monitoring children in the neonatal period born by the women with positive or presumably positive COVID-19 (Coronavirus disease 2019) status. The authors note that due to the limited quantity of observation cases, all existing recommendations are temporary and may be revised. The newborns from mothers with COVID-19 demonstrate the variability of clinical picture from asymptomatic course to severe respiratory failure. In the post-neonatal period children have asymptomatic or mild course of a new coronavirus infection. The authors note that some children with an asymptomatic course of the disease have pneumonia detectable during X-ray examination. Children with the manifest forms of COVID-19 do not have specific clinical symptoms; both children and adults have fever, cough and other catarrhal symptoms; tachypia, tachycardia and gastrointestinal symptoms are much less common. It has been found that children with COVID-19, unlike adults, are unlikely to develop severe pneumonia, as well as conditions requiring intensive care and mechanical ventilation. Changes in laboratory parameters in children also do not have a consistent pattern and they are less pronounced than in adults. The epidemiological data indicate that children are one of the main sources of the ongoing spread of infection in the human population. The authors present the first-ever data on the cases of 45 infants born from the mothers with positive COVID-19 status in Moscow.

THE CLINICAL, LABORATORY MANIFESTATIONS AND HISTOPATHOLOGY IN NEPHROTIC PATIENTS WITH LUPUS NEPHRITIS

2018 ◽  
pp. 52-58
Author(s):  
Le Thuan Nguyen ◽  
Bui Bao Hoang
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Clinical Laboratory ◽  
Activity Index ◽  
Clinical Manifestations ◽  
Systemic Lupus ◽  
Cross Sectional ◽  
Organ Systems ◽  
Tubulointerstitial Lesions

Introduction: Systemic lupus erythematosus (SLE) is an autoimmune disease involving multiple organ systems. The kidney appears to be the most commonly affected organ, especially nephrotic is a serious kidney injury. The clinical, laboratory manifestations and histopathology are very useful for diagnosis, provide the means of predicting prognosis and guiding therapy in nephrotic patients with lupus nephritis. Methods: Descriptive cross-sectional study of nephrotic patients with lupus treated in the Department of Nephrology Trung Vuong Hospital and Cho Ray Hospital between May/2014 and May/2017. Renal histopathological lesions were classified according to International Society of Nephrology/Renal Pathology Society - ISN/RPS ’s 2003. The clinical, laboratory manifestations and histopathological features were described. Results: Of 32 LN with nephritic range proteinuria cases studied, 93.7% were women. The 3 most common clinical manifestations were edema (93.8%), hypertension (96.8%) and pallor (68.9%), musculoskeletal manifestions (46.9%), malar rash (40.6%). There was significant rise in laboratory and immunological manifestions with hematuria (78.1%), Hb < 12g/dL (93.5%), increased Cholesterol (100%), and Triglycerid (87.5%), Creatinine > 1.4 mg/dL (87.5%), increased BUN 71.9%, ANA (+) 93.8%, Anti Ds DNA(+) 96.9%, low C3: 96.9%, low C4: 84.4%. The most various and severe features were noted in class IV with active tubulointerstitial lesions and high activity index. Conclusion: Lupus nephritis with nephrotic range proteinuria has the more severity of histopathological feature and the more severity of the more systemic organ involvements and laboratory disorders were noted. Key words: Systemic lupus, erythematosus (SLE) lupus nepphritis, clinical

DIAGNOSTIC VALUE OF SPECIFIC ANTIBODY SYNTHESIS IN BRAIN OF PATIENTS WITH NEUROINFECTIONS

2019 ◽  
Vol 72 (8) ◽  
pp. 1437-1441
Author(s):  
Pavel Dyachenko ◽  
Igor Filchakov ◽  
Anatoly Dyachenko ◽  
Victoria Kurhanskaya
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Clinical Manifestations ◽  
Diagnostic Value ◽  
Diagnostic Challenge ◽  
Specific Antibodies ◽  
Intrathecal Synthesis ◽  
Varicella Zoster ◽  
Mrz Reaction ◽  
Wide Range

Introduction: Viral encephalitis accounts for 40-70% of all cases worldwide, central nervous system infections pose a diagnostic challenge because clinical manifestations are not typically pathognomonic for specific pathogens, and a wide range of agents can be causative. The aim: To assess the diagnostic value of intrathecal synthesis of specific antibodies in patients with inflammatory lesions of the central nervous system. Materials and methods: Within the framework of the study, two groups of 90 people in each were formed from the patients with neuroinfections admitted to our Center. Intrathecal synthesis (ITS) of total (unspecific) IgG in members of one of group (group of compare) was determined. Brain synthesis of specific antibodies (Ab) to some neurotropic pathogens (herpes simplex virus 1/2, cytomegalovirus, Epstein-Barr virus, varicella zoster virus, rubella virus, Borrelies) was studied in the second group of patients (group of interest). There were no statistically significant differences between groups by gender and age. Encephalitis and encephalomyelitis prevailed among patients of both groups Results: ITS of total IgG was established in 30 (33.3 ± 6.1 %) patients of the first group with IgG index more than 0.6 indicating on inflammatory process in CNS and no marked changes of CSF. ITS of specific Ab was determined in 23 of 90 (25.6 ± 4.6 %) patients included into group of interest. In more than half of cases Ab to several infectious agents were detected simultaneously. ITS of various specificity, in particular, to measles and rubella viruses, and VZV, known as MRZ-reaction, is characteristic of some autoimmune lesions of CNS, multiple sclerosis first of all. In fact, further research of 5 patients with MRZ-reaction confirmed their autoimmune failure of CNS. Detection of ITS in the CSF samples didn’t depend on concentration of specific Ab in serum and CSF and wasn’t followed by HEB dysfunctions which were observed with the same frequency in patients with or without ITS (13.0 % and 13.6 % respectively). Conclusion: Specific Ab synthesis to several neurotropic pathogens in the CSF of significant part of examined patients was established. Thus, diagnostic value of ITS of specific immunoglobulins seems to be limited to cases in which autoimmune damage of the CNS is suspected.

Influence of the Acetylation Type on the Incidence of Isoniazid-Induced Hepatotoxicity in Patients with Newly Diagnosed Pulmonary Tuberculosis

2020 ◽  
Vol 65 (7-8) ◽  
pp. 31-36
Author(s):  
N. M. Krasnova ◽  
N. E. Evdokimova ◽  
A. A. Egorova ◽  
O. I. Filippova ◽  
E. A. Alekseeva ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Clinical Laboratory ◽  
Clinical Manifestations ◽  
Normal Activity ◽  
Slow Acetylators ◽  
Nucleotide Polymorphisms ◽  
Newly Diagnosed ◽  
Single Nucleotide ◽  
Tuberculosis Chemotherapy ◽  
Genetically Determined

Introduction. Liver damage can be a dangerous side effect of using isoniazid. Individual susceptibility to isoniazid in humans is dependent on the presence of N-acetyltransferase 2 allelic variants in genome. It was imperative to assess the effect of genetically determined isoniazid acetylation rate in terms of risk of developing isoniazid-induced hepatotoxicity, as well as prevention of potential hepatopathy, and improvement of tuberculosis chemotherapy safety. Aim. To study the effect of acetylation type on the incidence of isoniazid hepatotoxicity in residents of the Sakha Republic (Yakutia) with newly diagnosed pulmonary tuberculosis. Methods. The study included 112 patients with newly diagnosed pulmonary tuberculosis. Genotyping was performed using real-time polymerase chain reaction. The following single nucleotide polymorphisms were studied: rs1801280, rs1799930, rs1799931, rs1799929, rs1208, rs1041983. Hepatotoxicity was determined based on the results of clinical laboratory monitoring and using the criteria developed by the European Association for the Study of the Liver (2019). Results. Hepatotoxic reactions developed more often in slow acetylators (43.2%), compared to fast acetylators (20.7%) and intermediate acetylators (10.9%); p=0.002. Serum alanine aminotransferase activity was 5 or more times above the upper limit of normal activity in 37.8% of slow acetylators, and in 8.7% of intermediate acetylators; p=0.001. Clinical manifestations of isoniazid hepatotoxicity were observed more often in slow acetylators (29.7%), than in fast acetylators (3.4%); p=0.000. Conclusion. Slow acetylation type ought to be considered an important risk factor for developing isoniazid hepatotoxicity in patients with pulmonary tuberculosis.

scholarly journals Defining Kawasaki disease and pediatric inflammatory multisystem syndrome-temporally associated to SARS-CoV-2 infection during SARS-CoV-2 epidemic in Italy: results from a national, multicenter survey

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Marco Cattalini ◽  
◽  
Sara Della Paolera ◽  
Fiammetta Zunica ◽  
Claudia Bracaglia ◽  
...  
Keyword(s):  
Kawasaki Disease ◽  
Clinical Laboratory ◽  
Troponin T ◽  
Inflammatory Diseases ◽  
Age At Onset ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
Chi Square ◽  
Pediatric Society ◽  
Multicenter Survey

Abstract Background There is mounting evidence on the existence of a Pediatric Inflammatory Multisystem Syndrome-temporally associated to SARS-CoV-2 infection (PIMS-TS), sharing similarities with Kawasaki Disease (KD). The main outcome of the study were to better characterize the clinical features and the treatment response of PIMS-TS and to explore its relationship with KD determining whether KD and PIMS are two distinct entities. Methods The Rheumatology Study Group of the Italian Pediatric Society launched a survey to enroll patients diagnosed with KD (Kawasaki Disease Group – KDG) or KD-like (Kawacovid Group - KCG) disease between February 1st 2020, and May 31st 2020. Demographic, clinical, laboratory data, treatment information, and patients’ outcome were collected in an online anonymized database (RedCAP®). Relationship between clinical presentation and SARS-CoV-2 infection was also taken into account. Moreover, clinical characteristics of KDG during SARS-CoV-2 epidemic (KDG-CoV2) were compared to Kawasaki Disease patients (KDG-Historical) seen in three different Italian tertiary pediatric hospitals (Institute for Maternal and Child Health, IRCCS “Burlo Garofolo”, Trieste; AOU Meyer, Florence; IRCCS Istituto Giannina Gaslini, Genoa) from January 1st 2000 to December 31st 2019. Chi square test or exact Fisher test and non-parametric Wilcoxon Mann-Whitney test were used to study differences between two groups. Results One-hundred-forty-nine cases were enrolled, (96 KDG and 53 KCG). KCG children were significantly older and presented more frequently from gastrointestinal and respiratory involvement. Cardiac involvement was more common in KCG, with 60,4% of patients with myocarditis. 37,8% of patients among KCG presented hypotension/non-cardiogenic shock. Coronary artery abnormalities (CAA) were more common in the KDG. The risk of ICU admission were higher in KCG. Lymphopenia, higher CRP levels, elevated ferritin and troponin-T characterized KCG. KDG received more frequently immunoglobulins (IVIG) and acetylsalicylic acid (ASA) (81,3% vs 66%; p = 0.04 and 71,9% vs 43,4%; p = 0.001 respectively) as KCG more often received glucocorticoids (56,6% vs 14,6%; p < 0.0001). SARS-CoV-2 assay more often resulted positive in KCG than in KDG (75,5% vs 20%; p < 0.0001). Short-term follow data showed minor complications. Comparing KDG with a KD-Historical Italian cohort (598 patients), no statistical difference was found in terms of clinical manifestations and laboratory data. Conclusion Our study suggests that SARS-CoV-2 infection might determine two distinct inflammatory diseases in children: KD and PIMS-TS. Older age at onset and clinical peculiarities like the occurrence of myocarditis characterize this multi-inflammatory syndrome. Our patients had an optimal response to treatments and a good outcome, with few complications and no deaths.

scholarly journals Abnormal interhemispheric functional connectivity in patients with strabismic amblyopia: a resting-state fMRI study using voxel-mirrored homotopic connectivity

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shuang Zhang ◽  
Gui-Ping Gao ◽  
Wen-Qing Shi ◽  
Biao Li ◽  
Qi Lin ◽  
...  
Keyword(s):  
Functional Connectivity ◽  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Brain Activity ◽  
Characteristic Curve ◽  
Clinical Manifestations ◽  
Resting State Fmri ◽  
Diagnostic Value ◽  
Functional Connections ◽  
Receiver Operating

Abstract Background Previous studies have demonstrated that strabismus amblyopia can result in markedly brain function alterations. However, the differences in spontaneous brain activities of strabismus amblyopia (SA) patients still remain unclear. Therefore, the current study intended to employthe voxel-mirrored homotopic connectivity (VMHC) method to investigate the intrinsic brain activity changes in SA patients. Purpose To investigate the changes in cerebral hemispheric functional connections in patients with SA and their relationship with clinical manifestations using the VMHC method. Material and methods In the present study, a total of 17 patients with SA (eight males and nine females) and 17 age- and weight-matched healthy control (HC) groups were enrolled. Based on the VMHC method, all subjects were examined by functional magnetic resonance imaging. The functional interaction between cerebral hemispheres was directly evaluated. The Pearson’s correlation test was used to analyze the clinical features of patients with SA. In addition, their mean VMHC signal values and the receiver operating characteristic curve were used to distinguish patients with SA and HC groups. Results Compared with HC group, patients with SA had higher VMHC values in bilateral cingulum ant, caudate, hippocampus, and cerebellum crus 1. Moreover, the VMHC values of some regions were positively correlated with some clinical manifestations. In addition, receiver operating characteristic curves presented higher diagnostic value in these areas. Conclusion SA subjects showed abnormal brain interhemispheric functional connectivity in visual pathways, which might give some instructive information for understanding the neurological mechanisms of SA patients.

scholarly journals Making a Difference: Adaptation of the Clinical Laboratory in Response to the Rapidly Evolving COVID-19 Pandemic

2021 ◽  
Vol 8 ◽  
pp. 237428952110239
Author(s):  
Nikhil S. Sahajpal ◽  
Ashis K. Mondal ◽  
Sudha Ananth ◽  
Allan Njau ◽  
Sadanand Fulzele ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Clinical Manifestations ◽  
Nasopharyngeal Swab ◽  
Next Generation Sequencing Technology ◽  
Making A Difference ◽  
Scale Population ◽  
Wide Scale ◽  
Pooling Strategy ◽  
Polymerase Chain ◽  
Phylogenetic Evolution

The COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2, led to unprecedented demands assigned to clinical diagnostic laboratories worldwide, forcing them to make significant changes to their regular workflow as they adapted to new diagnostic tests and sample volumes. Herein, we summarize the modifications/adaptation the laboratory had to exercise to cope with rapidly evolving situations in the current pandemic. In the first phase of the pandemic, the laboratory validated 2 reverse transcription polymerase chain reaction–based assays to test ∼1000 samples/day and rapidly modified procedures and validated various preanalytical and analytical steps to overcome the supply chain constraints that would have otherwise derailed testing efforts. Further, the pooling strategy was validated for wide-scale population screening using nasopharyngeal swab samples and saliva samples. The translational research arm of the laboratory pursued several initiatives to understand the variable clinical manifestations that this virus presented in the population. The phylogenetic evolution of the virus was investigated using next-generation sequencing technology. The laboratory has initiated the formation of a consortium that includes groups investigating genomes at the level of large structural variants, using genome optical mapping via this collaborative global effort. This article summarizes our journey as the laboratory has sought to adapt and continue to positively contribute to the unprecedented demands and challenges of this rapidly evolving pandemic.

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