Analysis of Symptomology, Infectiveness, and Reinfections between Male and Female COVID-19 Patients: Evidence from Japanese Registry Data

Background: Hokkaido was the first Japanese prefecture to be affected by COVID-19. Since the beginning of the pandemic, the Japanese government has been publishing the information of each individual who was tested positive for the virus. Method: The current study analyzed the 1269 SARS-CoV-2 cases confirmed in Hokkaido in order to examine sex-based differences in symptomology and infectiveness, as well as the status of reinfections and the viral transmission networks. Results: The majority of asymptomatic patients were females and older. Females were 1.3-fold more likely to be asymptomatic (p < 0.001) while a decade of difference in age increased the likelihood of being asymptomatic by 1% (p < 0.001). The data contained information up to quaternary viral transmission. The transmission network revealed that, although asymptomatic patients are more likely to transmit the virus, the individuals infected by asymptomatic cases are likely to be asymptomatic (p < 0.001). Four distinct co-occurrences of symptoms were observed, including (i) fever/fatigue, (ii) pharyngitis/rhinitis, (iii) ageusia/anosmia, and (iv) nausea/vomiting/diarrhea. The presences of diarrhea (p = 0.05) as well as nausea/vomiting (p < 0.001) were predictive of developing dyspnea, i.e., severe disease. About 1% of the patients experienced reinfection. Conclusions: Sex and symptomatology appear to play important roles in determining the levels of viral transmission as well as disease severity.

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Karakter Jamur Ceratocystis sp. Penyebab Penyakit Busuk Batang pada Acacia decurrens dan Status Penyakitnya di Taman Nasional Gunung Merapi, Yogyakarta

Jurnal Ilmu Kehutanan ◽

10.22146/jik.10193 ◽

2016 ◽

Vol 9 (2) ◽

pp. 94

Author(s):

Sri Rahayu ◽

Handojo Hadi Nurjanto ◽

Rahman Gilang Pratama

Keyword(s):

Disease Severity ◽

Morphological Feature ◽

National Park ◽

Disease Incidence ◽

Severe Disease ◽

Stem Rot ◽

In Vitro Growth ◽

The Status ◽

Rot Disease

Acacia decurrens merupakan salah satu jenis tanaman yang tumbuh mendominasi kawasan Taman Nasional Gunung Merapi (TNGM), pasca erupsi Gunung Merapi tahun 2010. Sekitar 80% tegakan A. decurrens di kawasan tersebut menunjukkan gejala busuk batang akibat infeksi jamur Ceratocystis sp. yang umumnya dipicu oleh luka gerekan kumbang dari kelompok ambrosia. Penelitian bertujuan untuk : (1) mendeskripsikan karakter morfologi jamur Ceratocystis sp., serta kemampuannya beradaptasi pada beberapa jenis tanaman hutan, (2) mengevaluasi status penyakit busuk batang oleh jamur Ceratocystis sp. Karakter morfologi dan kemampuan adaptasinya pada inang akasia, melina, jabon, sengon, dan jati dilakukan di Laboratorium Perlindungan dan Kesehatan Hutan, Fakultas Kehutanan UGM. Survei untuk evaluasi status penyakit busuk batang dilakukan pada bulan Februari sampai Agustus 2014 di demplot restorasi pasca erupsi Merapi (luas 8,4 ha), dengan intensitas sampling 8%. Berdasarkan karakter morfologi, terdapat 2 isolat jamur Ceratocystis sp. yaitu asal lembah (L) dan dari bukit (B) dengan warna koloni krem, luas koloni 20-22 cm2 pada umur 14 hari, membentuk konidia menyerupai tong, dan silindris. Sifat lainnya yaitu memiliki kemampuan yang sama untuk tumbuh, mengkolonisasi, dan menginfeksi inang akasia, sengon, jabon, dan melina, tetapi tidak mampu tumbuh pada inang jati. Berdasarkan luas serangan, status penyakit busuk batang berkisar antara sangat umum sampai menyebar luas (luas serangan = 54-100%), dengan tingkat keparahan bekisar antara ringan sampai parah (intensitas penyakit = 15-67%).Kata kunci: Ceratocystis sp., Acacia decurrens, luas serangan, intensitas penyakit, Taman Nasional Gunung Merapi. Characteristic of stem rot diseases caused by Ceratocystis sp. on Acacia decurrens and its status in Gunung Merapi National Park, YogyakartaAbstractMount Merapi National Park (TNGM) has been dominated by Acacia decurrens after the eruption in 2010. Almost 80% of A. decurrens trees showed stem rot diseases caused by Ceratocystis sp. which may associate with stem wound induced by ambrosia beetle and other physical injuries. The research objective were (1) to characterize the morphological feature, in vitro growth, and ability to adapt, colonize as well as to infect akasia, jabon, sengon, melina and jati sedlings, (2) to evaluate the status of stem rot disease in TNGM demonstration plot. Laboratory work was conducted in order to study the morphological feature of the fungus, in vitro growth on PDA media, and to evaluate its compatibility to growth, colonize, and infect on 5th month seedling of akasia, sengon, jati, jabon and melina. Field monitorings were conducted from February to August 2014 at the restoration plot (8.4 ha) at 8% sampling intensity. Disease status was evaluated in order to ascertain the disease incidence and severity of stem rot disease at the demonstration plot area. Two Ceratocistys isolates found from the hill (B) and valley (L) had similar characteristics on morphologic features i.e. cream color, 20 to 22 cm2 colony size at 14 days growth in PDA media, having both cylindrical and barrel shaped conidia. The other characteristics of the Ceratocistys were an ability to growth, to colonize, and to infect akasia, sengon, melina and jabon, except on jati. The status of stem rot disease was ranged from highly common to widespread (disease incidence = 54%-100%) as the disease severity status was ranged from low to severe (disease severity = 15%-67%).

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Disease severity dictates SARS-CoV-2-specific neutralizing antibody responses in COVID-19

10.1101/2020.07.29.20164285 ◽

2020 ◽

Author(s):

Xiangyu Chen ◽

Zhiwei Pan ◽

Shuai Yue ◽

Fei Yu ◽

Junsong Zhang ◽

...

Keyword(s):

Disease Severity ◽

Severe Disease ◽

Neutralizing Antibody ◽

Antibody Responses ◽

Positive Correlation ◽

Asymptomatic Patients ◽

Neutralizing Capacity

COVID-19 patients exhibit differential disease severity after SARS-CoV-2 infection. It is currently unknown as to the correlation between the magnitude of neutralizing antibody (NAb) responses and the disease severity in COVID-19 patients. In a cohort of 59 recovered patients with disease severity including severe, moderate, mild and asymptomatic, we observed the positive correlation between serum neutralizing capacity and disease severity, in particular, the highest NAb capacity in sera from the patients with severe disease, while a lack of ability of asymptomatic patients to mount competent NAbs. Furthermore, the compositions of NAb subtypes were also different between recovered patients with severe symptoms and with mild-to-moderate symptoms. These results reveal the tremendous heterogeneity of SARS-CoV-2-specific NAb responses and their correlations to disease severity, highlighting the needs of future vaccination in COVID-19 patients recovered from asymptomatic or mild illness.

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Symptom and Age Homophilies in SARS-CoV-2 Transmission Networks during the First and Second Waves of the Pandemic in Japan

10.20944/preprints202104.0621.v1 ◽

2021 ◽

Author(s):

Ali Andalibi ◽

Naoru Koizumi ◽

Meng-hao Li ◽

Abu Bakkar Siddique

Keyword(s):

Graph Model ◽

Viral Transmission ◽

Registry Data ◽

Contact Tracing ◽

Pcr Analysis ◽

Transmission Networks ◽

Random Graph Model ◽

Healthcare Settings ◽

Exponential Random Graph ◽

The Government

Background Hokkaido is the northernmost, least populous, and coldest of the Japanese islands. It was the first prefecture to be affected by COVID-19, while Kanagawa is home to one of the most populous areas of Japan, namely the Tokyo metro area. The Japanese government responded early during the pandemic by identifying infected patients, contact tracing, and performing PCR analysis on anyone who was suspected of having been exposed to SARS-CoV-2. The government has also been publishing information about each individual who tested positive for the virus. Both Hokkaido and Kanagawa started recording COVID-19 cases in the winter of 2020 and have detailed records of thousands of patients, thus providing an invaluable resource for the transmission and behavior of the virus. Methods The current study analyzed the COVID-19 registry data from the Hokkaido and Kanagawa prefectures. The Hokkaido registry contained 1,269 cases (674 (53%) females and 595 (47%) males) recorded between February 14 and July 22, 2020. The Kanagawa registry had 3,123 cases (1,346 (43%) females and 1,777 (57%) males. The final data contained a total of 4,392 cases (2,020 (46%) females and 2,372 (54%) males). By leveraging the information on viral transmission paths available in the registry data, we performed exponential random graph model (ERGM) network analysis to examine demographic and symptomological homophilies of the SARS-CoV-2 viral transmission networks. Results We observed age, symptomatic, and asymptomatic homophilies in both prefectures. Furthermore, those patients who contracted the virus through secondary or tertiary contacts were more likely to be asymptomatic than those who contracted it from primary infection cases. The transmission networks showed that transmission occurred significantly in healthcare settings, as well as in families, although the size of the networks was small in the latter. Most of the transmissions stopped at the primary and secondary levels and no transmission beyond quaternary was observed. We also observed a higher level of asymptomatic transmission in Kanagawa than in Hokkaido. Conclusions Symptom homophilies are an important component of COVID-19 and suggest that nuanced genetic differences in the virus may affect its epithelial cell type range and can thus result in the diversity of symptoms seen in individuals infected by SARS-CoV-2. Moreover, environmental variables such as temperature and humidity may also be playing an important role in the overall pathogenesis of the virus.

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Distance Protection of Series Capacitor Compensated Lines: Practical Considerations, Industrial Status and Development

Electricity ◽

10.3390/electricity2020011 ◽

2021 ◽

Vol 2 (2) ◽

pp. 168-186

Author(s):

Md Tanbhir Hoq ◽

Nathaniel Taylor

Keyword(s):

Transmission Lines ◽

Transmission Network ◽

Distance Protection ◽

Academic Literature ◽

System Protection ◽

The Status ◽

In Series ◽

Insight Into ◽

Series Capacitor ◽

Current Inversion

The introduction of series capacitors in transmission lines causes problems in terms of reliability and the security of distance protection relays. As distance protection is widely used in the transmission network, the challenge of applying it to series compensated lines has been taken up by utilities and relay manufacturers in various ways. In the field of power system protection, developments are largely driven by relay manufacturers, and are often not published in the academic literature; the status and trend of the relay manufacturer’s development are better found in their product manuals and patent activity. Further insight into specific implementations by transmission utilities can be found from publications in industry-led forums and some academic journals. This article surveys the status and development of distance protection for series compensated lines, with a focus on industrial implementation and practical considerations. Factors that influence the protection of series compensated lines are presented. Implementation examples reported by utilities are summarized as examples of the different situations encountered and the methods used to deal with them. It is observed that many utilities use communication-aided protection in series compensated lines, and distance protection is used with reduced reach. Solutions described in relay manuals are presented to demonstrate the manufacturers’ approaches to problems associated with series capacitor protection. While there are methods to counter voltage inversion, current inversion seems to represent a more serious challenge. A patent overview indicates the trends in this domain to be moving towards time-domain-based faster protection methods.

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Serum C-Reactive Protein and Interleukin-6 Levels as Biomarkers for Disease Severity and Clinical Outcomes in Patients with Idiopathic Granulomatous Mastitis

Journal of Clinical Medicine ◽

10.3390/jcm10102077 ◽

2021 ◽

Vol 10 (10) ◽

pp. 2077

Author(s):

Yi-Min Huang ◽

Chiao Lo ◽

Chiao-Feng Cheng ◽

Cheng-Hsun Lu ◽

Song-Chou Hsieh ◽

...

Keyword(s):

Disease Severity ◽

Severe Disease ◽

Linear Regression Analysis ◽

Multiple Linear Regression Analysis ◽

Serum Biomarkers ◽

Healthy Controls ◽

Granulomatous Mastitis ◽

C Reactive Protein ◽

Idiopathic Granulomatous Mastitis ◽

Reactive Protein

Idiopathic granulomatous mastitis (IGM) is a rare inflammatory breast disease mimicking breast cancer. Limited research has been conducted on the application of serum biomarkers. This study aims to investigate the association of serum biomarkers with disease severity in patients with IGM. From November 2011 to March 2020, medical records of patients with IGM were reviewed. Serum cytokine levels were measured in patients and healthy controls between July 2018 and March 2020. A total of 41 patients with histologically proven IGM were found. Serum interleukin (IL)-6 level was significantly higher in patients with IGM (n = 11) than healthy controls (n = 7). Serum IL-6 and C-reactive protein (CRP) levels were significantly higher in patients with severe disease than mild and moderate disease. Serum IL-6 (Spearman’s ρ = 0.855; p < 0.001) and CRP (Spearman’s ρ = 0.838; p = 0.001) levels were associated with time to resolution. A higher serum CRP level was associated with a longer time to resolution (B = 0.322; p < 0.001) in multiple linear regression analysis. Serum IL-6 and CRP levels can be used as biomarkers for the evaluation of disease severity in IGM. IL-6 may play a crucial role in the immunopathology of IGM.

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Use of monoclonal antibody therapy for nosocomial SARS-CoV-2 infection in patients at high risk for severe COVID-19: experience from a tertiary-care hospital in Germany

Infection ◽

10.1007/s15010-021-01657-y ◽

2021 ◽

Author(s):

Johanna Koehler ◽

Barbara Ritzer ◽

Simon Weidlich ◽

Friedemann Gebhardt ◽

Chlodwig Kirchhoff ◽

...

Keyword(s):

High Risk ◽

Tertiary Care Hospital ◽

Severe Disease ◽

Treatment Options ◽

Tertiary Care ◽

Antibody Therapy ◽

Additional Treatment ◽

Care Hospital ◽

Cross Sectional ◽

Asymptomatic Patients

AbstractAdditional treatment options for coronavirus disease (COVID-19) are urgently needed, particularly for populations at high risk of severe disease. This cross-sectional, retrospective study characterized the outcomes of 43 patients with nosocomial severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection with and without treatment using monoclonal SARS-CoV-2 spike antibodies (bamlanivimab or casirivimab/imdevimab). Our results indicate that treatment with monoclonal antibodies results in a significant decrease in disease progression and mortality when used for asymptomatic patients with early SARS-CoV-2 infection.

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COVID-19 in an Asymptomatic Renal Transplant Recipient Employed in the Health Care Setting: A Case Report

International Journal of Angiology ◽

10.1055/s-0041-1725183 ◽

2021 ◽

Author(s):

Harsha Adnani ◽

Akshay Khatri ◽

Nirav Agrawal ◽

Ernesto Molmenti ◽

Madhu Bhaskaran

Keyword(s):

Health Care ◽

Renal Transplant ◽

Transplant Recipient ◽

Renal Transplant Recipient ◽

Clinical Symptoms ◽

Severe Disease ◽

Care Facility ◽

Health Care Facility ◽

Asymptomatic Patients

AbstractDuring the ongoing pandemic, there have been varying presentations of coronavirus disease 2019 (COVID-19) infection, with the concern that patients who are immunosuppressed (due to underlying medical conditions and/or therapies) are at higher risk of severe disease. We report the case of an elderly renal transplant recipient working in a long-term health care facility who was being monitored by weekly surveillance testing and tested positive for COVID-19 by polymerase chain reaction (PCR) testing, despite having no clinical symptoms. He recovered with supportive care, despite being on multiple long-term immunosuppressant drugs and having multiple comorbidities. Additionally, it was found that he did not mount an antibody response, when he tested negative by serologic testing. Through this case, we wish to highlight the unique clinical scenario of asymptomatic patients who may have an underwhelming immune response to COVID-19, but may nevertheless be an important source of dissemination. We further discuss the probable mechanism of such asymptomatic presentations in immunosuppressed patients, while reinforcing the importance of self-isolation of COVID-19 patients (particularly in asymptomatic health care workers).

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Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio and Their Role as Predictors of Disease Severity of Coronavirus Disease 2019 (COVID-19)

Journal of Laboratory Physicians ◽

10.1055/s-0041-1723057 ◽

2021 ◽

Author(s):

Rohit Jain ◽

Arun Gopal ◽

Basant Kumar Pathak ◽

Sourya Sourabh Mohakuda ◽

TVSVGK Tilak ◽

...

Keyword(s):

Disease Severity ◽

Complete Blood Count ◽

Wide Spectrum ◽

Statistical Significance ◽

Severe Disease ◽

Neutrophil To Lymphocyte Ratio ◽

Screening Tools ◽

Platelet To Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Time Of Admission

Abstract Context Due to the wide spectrum of clinical illness in coronavirus disease 2019 (COVID-19) patients, it is important to stratify patients into severe and nonsevere categories. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been evaluated rapidly by a few studies worldwide for its association with severe disease, but practically none have been conducted in the Indian population. This study was undertaken to examine the role of NLR and PLR in predicting severe disease in Indian patients. Objectives The objective was to study the association of NLR and PLR observed at the time of admission with maximum disease severity during hospitalization and to study their role in predicting disease severity. Material and Methods A total of 229 COVID-19 patients were admitted at the center during the study period. After applying inclusion and exclusion criteria, 191 patients were included in the study. The demographic, clinical, and laboratory (complete blood count, NLR, and PLR) data of all patients were obtained at the time of admission. Maximum disease severity of all patients was assessed during hospitalization. Statistical Analysis Chi-square and Mann–Whitney U tests were used to assess statistical significance. Receiver operating characteristic curve (ROC) was plotted for NLR and PLR to estimate the cutoff values and sensitivity and specificity using Youden’s index for predicting severe disease. Logistic regression analysis was used to estimate the odds ratios (OR) and 95% confidence intervals. Results Mean NLR and PLR were significantly higher in severe patients (NLR = 7.41; PLR = 204) compared with nonsevere patients (NLR = 3.30; PLR = 121). ROC analysis showed that NLR, in comparison to PLR, had a higher area under the curve (AUC) of 0.779, with a larger OR of 1.237 and cutoff of 4.1, and showed 69% sensitivity and 78% specificity in predicting severe disease. Cut off for PLR was 115.3, which showed 79% sensitivity and 62% specificity in predicting severe disease. Conclusion NLR and PLR, both showing acceptable AUCs, can be used as screening tools to predict disease severity. However, NLR was a better predictor of disease severity.

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Clinical Stratification of Pregnant COVID-19 Patients based on Severity: A Single Academic Center Experience

American Journal of Perinatology ◽

10.1055/s-0041-1723761 ◽

2021 ◽

Vol 38 (05) ◽

pp. 515-522

Author(s):

Marissa Berry ◽

Amanda Wang ◽

Shannon M. Clark ◽

Hassan M. Harirah ◽

Sangeeta Jain ◽

...

Keyword(s):

Pregnant Women ◽

Disease Severity ◽

Gestational Age ◽

Laboratory Data ◽

Population Characteristics ◽

Neonatal Outcomes ◽

P Value ◽

Asymptomatic Patients ◽

Increased Risk ◽

Maternal And Neonatal Outcomes

Objective This study aimed to describe baseline characteristics of a cohort of pregnant women infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and determine if these correlate with disease severity and perinatal outcomes. Study Design This was a retrospective cohort trial conducted at the University of Texas Medical Branch Galveston, Texas. All pregnant women presented to our medical center, who were screened and tested positive for SARS-CoV-2 virus, were included. We stratified our study population in three groups: asymptomatic, symptomatic not requiring oxygen therapy, and patients requiring oxygen support to maintain oxygen saturation >94%. Relevant population characteristics, laboratory data, and maternal and neonatal outcomes were abstracted. A p-value <0.05 was considered statistically significant. Results Between March and July 2020, 91 women tested positive for SARS-CoV-2 upon admission to our labor and delivery unit. Among these, 61.5% were asymptomatic, 34.1% were symptomatic, and 4.4% required oxygen support. Our population was mainly Hispanic (80.2%), multiparous (76.9%), obese (70.3%), and with a median age of 27 years. Median gestational age at symptom onset or diagnosis was 36 weeks. Significant differences were found between gestational age and disease severity. Maternal characteristics including age, body mass index (BMI), and presence of comorbid conditions did not appear to influence severity of SARS-CoV-2 infection. Significant laboratory findings associated with increasing disease severity included decreasing hemoglobin and white blood cell count, lymphopenia, and increasing levels of inflammatory markers including CRP, ferritin, and procalcitonin. Maternal and neonatal outcomes did not differ among groups. No SARS-CoV-2 was detected by polymerase chain reaction testing in neonates of mothers with COVID-19. Conclusion Pregnant patients with COVID-19 infection are predominantly asymptomatic. Patients appear to be at increased risk for more severe infection requiring oxygen support later in pregnancy. Key Points

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CD169/SIGLEC1 is expressed on circulating monocytes in COVID-19 and expression levels are associated with disease severity

Infection ◽

10.1007/s15010-021-01606-9 ◽

2021 ◽

Author(s):

Jan-Moritz Doehn ◽

Christoph Tabeling ◽

Robert Biesen ◽

Jacopo Saccomanno ◽

Elena Madlung ◽

...

Keyword(s):

Severe Acute Respiratory Syndrome ◽

Disease Severity ◽

Clinical Studies ◽

Viral Infections ◽

Severe Disease ◽

Type I Interferons ◽

Type I ◽

Interferon Signaling ◽

Expression Levels

AbstractCoronavirus disease 2019 (COVID-19) is caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Type I interferons are important in the defense of viral infections. Recently, neutralizing IgG auto-antibodies against type I interferons were found in patients with severe COVID-19 infection. Here, we analyzed expression of CD169/SIGLEC1, a well described downstream molecule in interferon signaling, and found increased monocytic CD169/SIGLEC1 expression levels in patients with mild, acute COVID-19, compared to patients with severe disease. We recommend further clinical studies to evaluate the value of CD169/SIGLEC1 expression in patients with COVID-19 with or without auto-antibodies against type I interferons.

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