scholarly journals Recurrence, Reactivation, or Inflammatory Rebound of SARS-CoV-2 Infection With Acute Vestibular Symptoms: A Case Report and Revision of Literature

2021 ◽  
Vol 15 ◽  
Author(s):  
Salvatore Zaffina ◽  
Paola Lanteri ◽  
Francesco Gilardi ◽  
Sergio Garbarino ◽  
Annapaola Santoro ◽  
...  
Keyword(s):  
Immunoglobulin M ◽  
Viral Reactivation ◽  
Nasopharyngeal Swab ◽  
Rt Pcr ◽  
Antibody Testing ◽  
Igg Antibody ◽  
First Case ◽  
Acute Vestibular Syndrome ◽  
Vestibular Symptoms ◽  
Pcr Test

A case of recurrent coronavirus disease 2019 (COVID-19) with neurovestibular symptoms was reported. In March 2020, a physician working in an Italian pediatric hospital had flu-like symptoms with anosmia and dysgeusia, and following a reverse transcription PCR (RT/PCR) test with a nasopharyngeal swab tested positive for SARS-CoV-2. After home quarantine, 21 days from the beginning of the symptoms, the patient tested negative in two subsequent swabs and was declared healed and readmitted to work. Serological testing showed a low level of immunoglobulin G (IgG) antibody title and absence of immunoglobulin M (IgM). However, 2 weeks later, before resuming work, the patient complained of acute vestibular syndrome, and the RT/PCR test with mucosal swab turned positive. On the basis of the literature examined and reviewed for recurrence cases and vestibular symptoms during COVID-19, to our knowledge this case is the first case of recurrence with vestibular impairment as a neurological symptom, and we defined it as probably a viral reactivation. The PCR retest positivity cannot differentiate re-infectivity, relapse, and dead-viral RNA detection. Serological antibody testing and viral genome sequencing could be always performed in recurrence cases.

scholarly journals Estimating the effectiveness of routine asymptomatic PCR testing at different frequencies for the detection of SARS-CoV-2 infections

2020 ◽  
Author(s):  
Joel Hellewell ◽  
Timothy W. Russell ◽  
Rupert Beale ◽  
Gavin Kelly ◽  
Catherine Houlihan ◽  
...  
Keyword(s):  
Vulnerable Populations ◽  
Research Unit ◽  
Asymptomatic Infection ◽  
Nasopharyngeal Swab ◽  
Rt Pcr ◽  
Symptomatic Infection ◽  
Testing Frequency ◽  
Peak Sensitivity ◽  
Pcr Test ◽  
Over Time

AbstractBackgroundRoutine asymptomatic testing using RT-PCR of people who interact with vulnerable populations, such as medical staff in hospitals or care workers in care homes, has been employed to help prevent outbreaks among vulnerable populations. Although the peak sensitivity of RT-PCR can be high, the probability of detecting an infection will vary throughout the course of an infection. The effectiveness of routine asymptomatic testing will therefore depend on testing frequency and how PCR detection varies over time.MethodsWe fitted a Bayesian statistical model to a dataset of twice weekly PCR tests of UK healthcare workers performed by self-administered nasopharyngeal swab, regardless of symptoms. We jointly estimated times of infection and the probability of a positive PCR test over time following infection, we then compared asymptomatic testing strategies by calculating the probability that a symptomatic infection is detected before symptom onset and the probability that an asymptomatic infection is detected within 7 days of infection.FindingsWe estimated that the probability that the PCR test detected infection peaked at 77% (54 - 88%) 4 days after infection, decreasing to 50% (38 - 65%) by 10 days after infection. Our results suggest a substantially higher probability of detecting infections 1–3 days after infection than previously published estimates. We estimated that testing every other day would detect 57% (33-76%) of symptomatic cases prior to onset and 94% (75-99%) of asymptomatic cases within 7 days if test results were returned within a day.InterpretationOur results suggest that routine asymptomatic testing can enable detection of a high proportion of infected individuals early in their infection, provided that the testing is frequent and the time from testing to notification of results is sufficiently fast.FundingWellcome Trust, National Institute for Health Research (NIHR) Health Protection Research Unit, Medical Research Council (UKRI)

scholarly journals Una presentación infrecuente de COVID-19, con diarrea como síntoma inicial, el primer caso diagnosticado en Cartagena, Colombia.

2021 ◽  
Vol 10 (1) ◽  
pp. 65-74
Author(s):  
Germán Enrique Arenas ◽  
Jesús De León Martínez ◽  
Marcela Negrete Vasquez ◽  
Mario Lora ◽  
Martín Carvajal ◽  
...  
Keyword(s):  
World Health ◽  
Nasopharyngeal Swab ◽  
Imaging Data ◽  
Rt Pcr ◽  
Global Pandemic ◽  
First Case ◽  
Initial Symptoms ◽  
The Common ◽  
Severity Of The Disease ◽  
Health Organization

Introduction: the Coronavirus disease 2019 (COVID-19) was declared as a global pandemic by the World Health Organization on March 11, 2020. The clinical presentation and severity of the disease has been described from its most typical symptoms, the common cold, pneumonia and respiratory distress syndrome, to the involvement of other organs and systems such such as the gastrointestinal, renal and cardiovascular. Case report: we describe the first case of COVID-19 diagnosed in Cartagena, Colombia, on March 11, 2020, and its uncommon clinic presentation, which was almost unknown at the time. An 85-year-old woman with week-long initial symptoms of nausea and occasional vomiting, with progression to diarrhea and a 38.5 oC fever during the last three days. The patient came from Oxford, UK, and she had been on a Caribbean cruise excursion since the end of February, 2020. Chest computed tomography showed ground glass opacities in both peripheral and central lung fields, multilobar and predominantly subpleural; without evidence of consolidation or pleural effusion. COVID-19 was confirmed three days after admission, when a RT-PCR molecular test performed on a nasopharyngeal swab sample tested positive for SARS-Cov-2 Conclusion: this first case of COVID-19 diagnosed in Cartagena occurred at a time when our health system was not prepared to face the pandemic. However, despite having manifested with a clinical that had not been described at the time, and thanks to the epidemiological, clinical and imaging data, the case could be adequately approached, diagnosed and treated according to the necessary and recommended measures at the time.

scholarly journals Use of Rapid COVID-19 Antibody Testing to Evaluate Relative Risk of Infection in Campus Versus Non-campus Residents at a Government Institution in Saudi Arabia: a Cohort Study

2021 ◽  
Author(s):  
Fawz S. AlHarthi ◽  
Mohammed AlFageeh ◽  
Abdulaziz AlMalik ◽  
Mohammed S. AlSuabeyl ◽  
Salam AlMustafa ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Pearson Correlation ◽  
Immunoglobulin M ◽  
Blood Type ◽  
World Health ◽  
Primary Study ◽  
Antibody Testing ◽  
Study Population ◽  
Government Institution ◽  
Pcr Test

Abstract Background: The World Health Organization confirmed in January 2020 that SARS-CoV-2 has become a pandemic infection. The first case in Saudi Arabia was reported on March 2, 2020. The Saudi Ministry of Health has authorized the use of anti-SARS-CoV-2 immunoglobulin M/immunoglobulin G (IgM/IgG) antibody testing, but serological test evaluations are still ongoing. Methods: The primary study aim was to determine whether living on a government institution campus, thus limiting contact with the general public, protects against SARS-CoV-2 infection. A study population of 763 employees of the King Abdulaziz City for Science and Technology (KACST) in Saudi Arabia and their family members were asked about their age, nationality, residency on or off the KACST campus, chronic conditions, previous COVID-19 symptoms, exposure to infected individuals, and COVID-19 PCR test results. After informed consent was obtained, the VivaDiagTM COVID-19 IgM/IgG Rapid Test was administered. Statistical analysis was conducted of Pearson correlation coefficients for, and generalized linear regression model fitting for predictive ability of, several independent variables versus IgG status. Results: While the study population was skewed towards male, Saudi nationality, and younger individuals, the age distribution was similar between on-campus residents and off-campus residents. Of the 763 study individuals 91.1% were non-campus residents and 8.9% were campus residents. Discussion: As expected, being IgG+ strongly positively correlated with having the COVID-19 symptom of loss of smell (r = 0.417052483). On-campus residency weakly or somewhat correlated with being IgG positive (IgG+; r = 0.187990064) or IgM positive (IgM+; r= 0.242302626), indicating that residing on campus actually increased the risk of SARS-CoV-2 infection. Consistent with this, residency status was highly statistically significantly predictive (p = 0.00002) of IgG status, second only to contact with a COVID19 infected individual (p = 0.00000), and living on campus increased the likelihood of being IgG+. Blood type (p = 0.01069), loss of sense of smell (p = 0.01079); hypertension (p = 0.01871), nationality (p = 0.02324), and PCR test status (p = 0.04243) also statistically significantly predicted IgG status.Conclusions: Contrary to the hypothesis, living on campus actually increased the risk of testing positive for IgG antibodies against SARS-CoV-2 infection.

scholarly journals Seroprevalence study of SARS-CoV-2 infection in General Practice in Ireland

BJGP Open ◽  
2021 ◽  
pp. BJGPO.2021.0038
Author(s):  
Michael Edmund O'Callaghan ◽  
Elizabeth Ryan ◽  
Cathal Walsh ◽  
Peter Hayes ◽  
Monica Casey ◽  
...  
Keyword(s):  
General Practice ◽  
Average Length ◽  
Point Of Care ◽  
Antibody Test ◽  
Igg Antibodies ◽  
Antibody Testing ◽  
Igg Antibody ◽  
Seroprevalence Study ◽  
History Of ◽  
Pcr Test

Background: SARS-CoV-2 antibody testing in community settings may help us better understand the immune response to this virus and therefore help guide public health efforts. Aim: Conduct a seroprevalence study of IgG antibodies in Irish GP clinics. Design and Setting: Participants were 172 staff and 799 patients of 15 general practices in the Midwest region of Ireland. Methods: This seroprevalence study utilised 2 manufacturers’ point-of-care (POC) SARS-CoV-2 IgM-IgG combined antibody tests, offered to patients and staff in general practice from mid-June to mid-July 2020. Results: Immunoglobulin G (IgG) seroprevalence was 12.6% in patients attending general practice and 11.1% in staff working in general practice, with administrative staff having the lowest seroprevalence at 2.5% and nursing staff having the highest at 17.6%. Previous symptoms suggestive of SARS-CoV-2 and history of a polymerase chain reaction (PCR) test were associated with higher seroprevalence. IgG antibodies were detected in approximately 80% of participants who had a previous PCR-confirmed infection. Average length of time between participants’ positive PCR test and positive IgG antibody test was 83 days. Conclusion: Patients and healthcare staff in general practice in Ireland had relatively high rates of IgG to SARS-CoV-2 compared to the national average at the time (1.7%). Four-fifths of participants with a history of confirmed COVID-19 disease still had detectable antibodies an average of 12 weeks post-infection. While not proof of immunity, SARS-CoV-2 POC testing can be used to estimate IgG seroprevalence in general practice settings.

scholarly journals Recurrence of COVID-19 related symptoms and viral detection in patient discharged after complete recovery and test negativization

2021 ◽  
Author(s):  
Chiara Vassallo ◽  
Francesca Pupo ◽  
Luca Marri ◽  
Chiara Schiavi ◽  
Francesca Giusti ◽  
...  
Keyword(s):  
Complete Recovery ◽  
Viral Reactivation ◽  
Nasopharyngeal Swab ◽  
Double Negative ◽  
The Novel ◽  
Lung Involvement ◽  
Rt Pcr ◽  
Pcr Assay ◽  
Virus Escape ◽  
Novel Coronavirus

Since the novel coronavirus disease 2019 (COVID-19) has declared pandemic, the possibility of recurrence of the disease after recovery has become a debated issue. We report a case of an 84-yearsold male patient who was admitted to our hospital for dyspnea and fever. Lab and clinical workout showed that he had COVID-19. After a full recovery of symptoms and a double negative nasopharyngeal swab of SARS-CoV-2 by RT-PCR assay, he was dismissed from the hospital. One month later, he developed again dyspnea and fever with lung involvement. Surprisingly, nasopharyngeal swab of SARS-CoV-2 was positive. Since he denied contacts with confirmed or suspected cases of COVID-19, he probably experienced a reactivation of a persistent infection. The failed eradication of the virus could depend on both virus’ escape mechanisms and dysfunctional immune response. Further studies are needed to confirm the hypothesis of viral reactivation and to identify signs of an incomplete clearance.

scholarly journals Corticosteroid injections during the COVID-19 pandemic

2020 ◽  
Vol 1 (9) ◽  
pp. 605-611 ◽  
Author(s):  
David McKean ◽  
Siok Li Chung ◽  
Rory Fairhead ◽  
Oliver Bannister ◽  
Malgorzata Magliano ◽  
...  
Keyword(s):  
Observational Study ◽  
Clinical Outcomes ◽  
Antibody Test ◽  
British Society ◽  
Rt Pcr ◽  
Antibody Testing ◽  
Igg Antibody ◽  
Thoracic Imaging ◽  
Polymerase Chain ◽  
Corticosteroid Injections

Aims To describe the incidence of adverse clinical outcomes related to COVID-19 infection following corticosteroid injections (CSI) during the COVID-19 pandemic. To describe the incidence of positive SARS-CoV-2 reverse transcriptase polymerase chain reaction (RT-PCR) testing, positive SARS-COV2 IgG antibody testing or positive imaging findings following CSI at our institution during the COVID-19 pandemic. Methods A retrospective observational study was undertaken of consecutive patients who had CSI in our local hospitals between 1 February and 30June 2020. Electronic patient medical records (EPR) and radiology information system (RIS) database were reviewed. SARS-CoV-2 RT-PCR testing, SARS-COV2 IgG antibody testing, radiological investigations, patient management, and clinical outcomes were recorded. Lung findings were categorized according to the British Society of Thoracic Imaging (BSTI) guidelines. Reference was made to the incidence of lab-confirmed COVID-19 cases in our region. Results Overall, 1,656 lab-confirmed COVID-19 cases were identified in our upper tier local authority (UTLA), a rate of 306.6 per 100,000, as of 30June 2020. A total of 504 CSI injections were performed on 443 patients between 1 February and 30June 2020. A total of 11 RT-PCR tests were performed on nine patients (2% of those who had CSI), all of which were negative for SARS-CoV-2 RNA, and five patients (1.1%) received an SARS-CoV-2 IgG antibody test, of which 2 (0.5%) were positive consistent with prior COVID-19 infection, however both patients were asymptomatic. Seven patients (1.6%) had radiological investigations for respiratory symptoms. One patient with indeterminate ground glass change was identified. Conclusion The incidence of positive COVID-19 infection following corticosteroid injections was very low in our cohort and no adverse clinical outcomes related to COVID-19 infection following CSI were identified. Our findings are consistent with CSI likely being low risk during the COVID-19 pandemic. The results of this small observational study are supportive of the current multi-society guidelines regarding the judicious use of CSI. Cite this article: Bone Joint Open 2020;1-9:605–611.

scholarly journals The value of anal swab RT-PCR for COVID-19 diagnosis in adult Indonesian patients

2021 ◽  
Vol 8 (1) ◽  
pp. e000590
Author(s):  
Murdani Abdullah ◽  
Dedy Gunawanjati Sudrajat ◽  
Virly Nanda Muzellina ◽  
Juferdy Kurniawan ◽  
Aulia Rizka ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Gastrointestinal Symptoms ◽  
High Specificity ◽  
Nasopharyngeal Swab ◽  
Rt Pcr ◽  
Severe Condition ◽  
Hospitalised Patients ◽  
Anal Swab ◽  
Low Sensitivity ◽  
Pcr Test

ObjectiveThis study will test the performance of the anal swab PCR test when compared with the nasopharyngeal swab PCR test as a diagnostic tool for COVID-19.DesignAn observational descriptive study which included hospitalised suspected, or probable cases of hopitalised COVID-19 patients, conducted in Dr. Cipto Mangunkusumo National Hospital, Ciputra Hospital, Mitra Keluarga Depok Hospital and Mitra Keluarga Kelapa Gading Hospital, Indonesia. Epidemiological, clinical, laboratory and radiology data were obtained. Nasopharyngeal and anal swabs specimens were collected for SARS-CoV-2 RNA detection.ResultsWe analysed 136 subjects as part of this study. The clinical spectrum of COVID-19 manifesation in this study was typical of hospitalised patients, with 25% classified as mild cases, 14.7% in severe condition and 12.5% of subjects classified as having acute respiratory distress syndrome. When compared with nasopharyngeal swab as the standard specimen for reverse transcription polymerase chain reaction (RT-PCR) detection of SARS-CoV-2 antigen, the sensitivity and specificity of the anal swab was 36.7% and 93.8%, respectively. The positive and negative predictive value were 97.8% and 16.5 %, respectively. The performance of the anal swab remained similar when only the subgroup of patients with gastrointestinal symptoms (n=92, 67.6%) was analysed (sensitivity 40% and specificity 91.7%). Out of all the subjects included in analysis, 67.6% had gastrointestinal symptoms. Similarly, 73.3% of patients in the anal swab-positive group had gastrointestinal symptoms. The two most common gastrointestinal symptoms in the subjects’ population were nausea and anorexia.ConclusionAnal swab specimen has low sensitivity (36.7%) but high specificity (93.8%) for detecting SARS-CoV-2 antigen by RT-PCR. Only one additional positive result was found by anal swab among the nasopharyngeal swab-negative group. Anal swab may not be needed as an additional test at the beginning of a patient’s diagnostic investigation and nasopharyngeal swab RT-PCR remains as the standard diagnostic test for COVID-19.

COVID-19 Reinfection in a Healthcare Worker; Is There a Definitive Immunity Against SARS-CoV-2?

2021 ◽  
Author(s):  
Sayyed Reza Ahmadi ◽  
Saeideh Anvari Ardakani ◽  
Navid Kalani ◽  
Seyed Reza Habibzadeh ◽  
Elnaz Vafadar Moradi ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Healthcare Worker ◽  
Nasopharyngeal Swab ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Case Presentation ◽  
Long Period ◽  
Polymerase Chain ◽  
Pcr Test ◽  
First Admission

Introduction: While our knowledge is limited about COVID-19 immunity, recent cases of reinfection have raised concerns. Case presentation: Here, we report a case of COVID-19 reinfection after three months from recovery in a healthcare worker with negative IgM and IgG at the second infection and positive nasopharyngeal swab Reverse transcription polymerase chain reaction (RT-PCR) test despite being discharged with two negative RT-PCR tests at the first admission. Symptoms at first admission were fever, headache, sore throat, diarrhea, and vomiting and got changed to myalgia and anosmia. Conclusion: The strength of this case report is the long period (three months) between the infection and reinfection while other cases reported in literature were reinfected less than one month after their first infection.

scholarly journals COVID-19 infection in the palatine tonsil tissue and detritus: the detection of the virus compartment with RT-PCR

2021 ◽  
Vol 14 (2) ◽  
pp. e239108
Author(s):  
Hamsu Kadriyan ◽  
Bayu Tirta Dirja ◽  
Dewi Suryani ◽  
Didit Yudhanto
Keyword(s):  
Real Time ◽  
Real Time Pcr ◽  
Palatine Tonsil ◽  
Rdrp Gene ◽  
Nasopharyngeal Swab ◽  
Rt Pcr ◽  
Recurrent Tonsillitis ◽  
Igg Antibody ◽  
Tonsil Tissue

Two patients suffering from chronic recurrent tonsillitis were reported. The first patient was confirmed infected with COVID-19, 3 weeks prior to tonsillectomy. The detritus and tonsil specimen were further analysed through real-time PCR (RT-PCR) and revealed amplification of the fragment N and ORF1ab genes of SARS-CoV-2. The second patient had a negative IgM and positive IgG antibody for COVID-19; however, the nasopharyngeal swab indicated negative for SARS-CoV-2. Tonsillectomy was performed 2 weeks after the swab; the tonsil specimen was analysed through RT-PCR and revealed amplification of the N2 and RdRp gene of SARS-CoV-2. According to both results, the presence of the SARS-CoV-2 gene remains to be detected in tonsil and/or detritus after 2–3 weeks after recovery. Hence, it is suggested that it is necessary to use adequate protection when performing tonsillectomy on early recovered patients with COVID-19. Furthermore, tonsillectomy would be more advisable to be performed after the fourth week after recovery from COVID-19.

scholarly journals SARS-CoV-2 Detection in Fecal Sample from a Patient with Typical Findings of COVID-19 Pneumonia on CT but Negative to Multiple SARS-CoV-2 RT-PCR Tests on Oropharyngeal and Nasopharyngeal Swab Samples

Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 290
Author(s):  
Barbara Brogna ◽  
Carlo Brogna ◽  
Mauro Petrillo ◽  
Adriana Modestina Conte ◽  
Giulio Benincasa ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Clinical Symptoms ◽  
Nasopharyngeal Swab ◽  
Upper Respiratory Tract ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Negative Results ◽  
Upper Respiratory ◽  
Polymerase Chain ◽  
Pcr Test

Reverse transcriptase polymerase chain reaction (RT-PCR) negative results in the upper respiratory tract represent a major concern for the clinical management of coronavirus disease 2019 (COVID-19) patients. Herein, we report the case of a 43-years-old man with a strong clinical suspicion of COVID-19, who resulted in being negative to multiple severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RT-PCR tests performed on different oropharyngeal and nasopharyngeal swabs, despite serology having confirmed the presence of SARS-CoV-2 IgM. The patient underwent a chest computed tomography (CT) that showed typical imaging findings of COVID-19 pneumonia. The presence of viral SARS-CoV-2 was confirmed only by performing a SARS-CoV-2 RT-PCR test on stool. Performing of SARS-CoV-2 RT-PCR test on fecal samples can be a rapid and useful approach to confirm COVID-19 diagnosis in cases where there is an apparent discrepancy between COVID-19 clinical symptoms coupled with chest CT and SARS-CoV-2 RT-PCR tests’ results on samples from the upper respiratory tract.

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