Do We Really Need Hazard Prevention at the Expense of Safeguarding Death Dignity in COVID-19?

To date, little is known regarding the transmission risks of SARS-CoV-2 infection for subjects involved in handling, transporting, and examining deceased persons with known or suspected COVID-19 positivity at the time of death. This experimental study aims to define if and/or how long SARS-CoV-2 persists with replication capacity in the tissues of individuals who died with/from COVID-19, thereby generating infectious hazards. Sixteen patients who died with/from COVID-19 who underwent autopsy between April 2020 and April 2021 were included in this study. Based on PMI, all samples were subdivided into two groups: ‘short PMI’ group (eight subjects who were autopsied between 12 to 72 h after death); ‘long PMI’ (eight subjects who were autopsied between 24 to 78 days after death). All patients tested positive for RT-PCR at nasopharyngeal swab both before death and on samples collected during post-mortem investigation. Moreover, a lung specimen was collected and frozen at −80 °C in order to perform viral culture. The result was defined based on the cytopathic effect (subjective reading) combined with the positivity of the RT-PCR test (objective reading) in the supernatant. Only in one sample (PMI 12 h), virus vitality was demonstrated. This study, supported by a literature review, suggests that the risk of cadaveric infection in cases of a person who died from/with COVID-19 is extremely low in the first hours after death, becoming null after 12 h after death, confirming the World Health Organization (WHO) assumed in March 2020 and suggesting that the corpse of a subject who died from/with COVID-19 should be generally considered not infectious.

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

Revista Ciencias Biomédicas ◽

10.32997/rcb-2021-3238 ◽

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.

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Management of oncology patients receiving anti-cancer treatment in the COVID-19 pandemic

10.21203/rs.3.rs-28858/v1 ◽

2020 ◽

Author(s):

Esat Namal ◽

Nur Dinc ◽

Sezer Saglam ◽

Ali Vefa Ozturk ◽

Safiye Koculu ◽

...

Keyword(s):

Cancer Treatment ◽

World Health ◽

Rt Pcr ◽

Oncology Patients ◽

Rna Detection ◽

Recommended Treatment ◽

Anti Cancer ◽

The World ◽

Oropharyngeal Swab ◽

Health Organization

Abstract Background/Aim: Severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) has deeply affected life all over the World. The World Health Organization named this disease as COVID-19. The most important factor in the transmission of the disease is asymptomatic carriers. We’ve tested all oncology patients, that receive anti-cancer therapy, for COVİD-19 to prevent asymptomatic oncology patients from spreading infection and to make the decision to postpone chemotherapy in infected patients. Then, we analyzed the clinical and radiological findings of infected patients.Materials and Methods: Oncology patients who have indications of receiving anti-cancer treatment in the hospital were tested for COVID-19, two day prior to their treatment even if they were asymptomatic by collecting nasopharyngeal and oropharyngeal swab specimens for RT-PCR for viral RNA detection. Positive patients, underwent inspiratory phase of chest computed tomography (CT) examination. Infected patients were given the recommended treatment for COVID-19. Anti-cancer treatment of all patients that had positive PCR results was delayed for 14 days.Results: PCR test was positive in 28 of 312 patients that we tested, and the positivity rate was 8.9%. Three patients (10.7%) had symptoms; 2 of whom had dyspnea and cough, and 1 had headache, and 25 patients (89.3%) had no symptoms.Conclusion: In oncology patients, who are receiving anti-cancer treatment, we have to recognize the asymptomatic COVID-19 infection. We recommend testing for COVID-19 in oncology patients receiving chemotherapy, periodically or before each anti-cancer treatment, in order to continue their treatment without any problems and to prevent the risk of transmission.

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Review of the Microbiological Diagnostic Approaches of COVID-19

Frontiers in Public Health ◽

10.3389/fpubh.2021.592500 ◽

2021 ◽

Vol 9 ◽

Author(s):

Ada Melo-Vallès ◽

Clara Ballesté-Delpierre ◽

Jordi Vila

Keyword(s):

Diagnostic Tests ◽

Diagnostic Testing ◽

World Health ◽

Rt Pcr ◽

Exponential Increase ◽

Rapid Spread ◽

The World ◽

Diagnostic Approaches ◽

Health Organization ◽

Short Time

On March 12, the World Health Organization declared a pandemic following the exponential increase of SARS-CoV-2 cases. The rapid spread of the virus is due to both its high infectivity and the free circulation of unrecognized infectious cases. Thus, diagnostic testing is a key element to prevent further dissemination of the virus. Urged by WHO's call, laboratories worldwide have been working on nucleic acid tests protocols and immunoassays that became available, albeit poorly validated, within a comparatively short time. Since then, external studies evaluating these diagnostic tests have been published. The present study is a review of the COVID-19 diagnostic approaches, discussing both direct and indirect microbiological diagnoses. A compendium of the literature on commercial assays kits available to date is provided together with the conclusions drawn as well as RT-PCR protocols published by the WHO. Briefly, diagnostic accuracy varies according to time elapsed since symptom onset and evolves together with understanding of the COVID-19 disease. Taking into account all these variables will allow determining the most adequate diagnostic test to use and how to optimize diagnostic testing for COVID-19.

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Multisystem Inflammatory Syndrome in Infant with Negative SARS-CoV-2 RT-PCR and Antibodies

Osteopathic Family Physician ◽

10.33181/13036 ◽

2021 ◽

pp. 35-39

Author(s):

Hanna Sahhar ◽

Karly Derwitz ◽

Erica Rubin

Keyword(s):

Polymerase Chain Reaction ◽

Severe Acute Respiratory Syndrome ◽

Early Diagnosis ◽

World Health ◽

Rt Pcr ◽

Chain Reaction ◽

The World ◽

Polymerase Chain ◽

Health Organization ◽

Inflammatory Syndrome

Since the declaration of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in March 2020 by the World Health Organization (WHO), there has been an emergence of a new syndrome termed multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19. MIS-C is defined by the presence of fever, systemic inflammation and multiorgan dysfunction in association with SARS-CoV-2 infection or COVID-19 exposure. Knowledge of this syndrome’s presentation and pathophysiology is constantly evolving as more cases are reported in the literature. This case identifies a 3-month-old patient who tested negative for SARS-CoV-2 antigen, reverse transcriptase polymerase chain reaction (RT-PCR) and antibodies but qualified for MIS-C diagnosis. To the best of our knowledge and through extensive research at the time of diagnosing and reporting this condition to the healthcare authorities, we report the youngest pediatric patient with MIS-C diagnosis. We document this case to contribute to further understanding the variable manifestations of MIS-C and the importance of early diagnosis and treatment with intravenous immunoglobulin (IVIG).

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The US CDC RT-PCR probes for the Wuhan 2019-nCoV are non-specific for SARS - there is a better non-specific 500bp option (21852-22427) within the spike-protein

10.31219/osf.io/jsurx ◽

2020 ◽

Author(s):

Sandeep Chakraborty

Keyword(s):

Virulent Strain ◽

Spike Protein ◽

World Health ◽

Genomic Fragment ◽

Rt Pcr ◽

Inconclusive Result ◽

The Us ◽

The World ◽

Significant Homology ◽

Health Organization

The World Health Organization has declared the Wuhan coronavirus [1–3] outbreak a public health emer- gency on 30th Jan, 2020. An accurate detection of the Wuhan virus is imperative to avoid false positives, since 2019-nCoV [2,3] shares significant homology [4] with other species.On the 24th of Jan, the CDC has published a list of 3 probes (Fig 1) for detecting the 2019-nCoV. Detection of all three probes would give a positive result, while detection of one or two gives an ’inconclusive result’ (and obviously negative when none are found).All 3 probes will have significant homology in other strains (Table 1 and Fig 2 ) - specifically SARS (Severe Acute Respiratory Syndrome). A much more specific option is to look within a 500bp genomic fragment in the N-terminal of the spike protein (Accid:NC 045512.2 [2],21852-22427, SI.cdc:nCoVFULLSLICE.fa), which seems to the most perturbed in this virulent strain [5].It is also important to have a common repository for all countries to be following a similar protocol. Many papers do no provide what PCR was used to detect coronaviruses [6].

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Knowledge and Awareness-based Survey of COVID-19 in the Eye Care Profession, Facts Sealed Myths. (Preprint)

10.2196/preprints.20422 ◽

2020 ◽

Author(s):

Sandip Das Sanyam ◽

Sanjay Sah ◽

Pankaj Chaudhary

Keyword(s):

World Health ◽

Disease Spread ◽

Confirmatory Test ◽

Rt Pcr ◽

Eye Care ◽

Qualitative Survey ◽

The World ◽

Mode Of Transmission ◽

Health Organization ◽

Analysis Of Knowledge

BACKGROUND Analysis of knowledge and awareness in the eye care profession is highly essential amid COVID-19 pandemic, myths have no place in medical research. OBJECTIVE To estimate the effect of myth in knowledge and awareness of eye care. METHODS A qualitative survey, designed by a focused group of researchers, to access the knowledge and awareness of COVID-19 in eye care practitioners. Questions were prepared and sent through an online link. Altogether, 25 questions (both open and closed-ended) were employed in the survey. The overall responses were coded with percentage calculation, and mythological facts were overruled if they persisted with appropriate justification. RESULTS Of the total delivered links, 51% (n=310) participated in the survey. Only 46% of the total participants were aware that COVID-19 is a disease and SARS-CoV-2 as the causative agent. The symptoms of COVID-19 were known to 94%, whereas only 54% were aware that everyone can get infected by SARS-CoV-2. Similarly, 49% of the participants had an idea about the mode of transmission of the disease and only 5% of the participants did not know the abbreviation of PPE. About 17% had no idea regarding RDT and 56% responded to RT-PCR as a confirmatory test for SARS-CoV-2. Almost 98% of participants recognized the WHO’s awareness message, but surprisingly 41% participants responded to another question felt that consumption of hot drinks kills the virus (is WHO’s awareness). Social distancing was key to restricting the disease spread; at the same time, about 41% had disagreement regarding PPE usage by eye care practitioners. CONCLUSIONS Eye care professionals seemed to be little behind the expected knowledge and awareness of COVID-19. One is recommended to follow the World Health Organization and National (Ministry of Health and Population, Nepal) guidelines for clinical practice and not to believe in baseless myths devoid of evidence.

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Head-to-head performance comparison of self-collected nasal versus professional-collected nasopharyngeal swab for a WHO-listed SARS-CoV-2 antigen-detecting rapid diagnostic test

Medical Microbiology and Immunology ◽

10.1007/s00430-021-00710-9 ◽

2021 ◽

Author(s):

Julian A. F. Klein ◽

◽

Lisa J. Krüger ◽

Frank Tobian ◽

Mary Gaeddert ◽

...

Keyword(s):

High Viral Load ◽

Performance Comparison ◽

World Health ◽

Nasopharyngeal Swab ◽

Rapid Diagnostics ◽

Sample Collection ◽

Rt Pcr ◽

Percent Agreement ◽

Polymerase Chain ◽

Health Organization

AbstractIn 2020, the World Health Organization (WHO) recommended two SARS-CoV-2 lateral flow antigen-detecting rapid diagnostics tests (Ag-RDTs), both initially with nasopharyngeal (NP) sample collection. Independent head-to-head studies are necessary for SARS-CoV-2 Ag-RDT nasal sampling to demonstrate comparability of performance with nasopharyngeal (NP) sampling. We conducted a head-to-head comparison study of a supervised, self-collected nasal mid-turbinate (NMT) swab and a professional-collected NP swab, using the Panbio™ Ag-RDT (distributed by Abbott). We calculated positive and negative percent agreement between the sampling methods as well as sensitivity and specificity for both sampling techniques compared to the reference standard reverse transcription polymerase chain reaction (RT-PCR). A SARS-CoV-2 infection could be diagnosed by RT-PCR in 45 of 290 participants (15.5%). Comparing the NMT and NP sampling the positive percent agreement of the Ag-RDT was 88.1% (37/42 PCR positives detected; CI 75.0–94.8%). The negative percent agreement was 98.8% (245/248; CI 96.5–99.6%). The overall sensitivity of Panbio with NMT sampling was 84.4% (38/45; CI 71.2–92.3%) and 88.9% (40/45; CI 76.5–95.5%) with NP sampling. Specificity was 99.2% (243/245; CI 97.1–99.8%) for both, NP and NMT sampling. The sensitivity of the Panbio test in participants with high viral load (> 7 log10 SARS-CoV-2 RNA copies/mL) was 96.3% (CI 81.7–99.8%) for both, NMT and NP sampling. For the Panbio supervised NMT self-sampling yields comparable results to NP sampling. This suggests that nasal self-sampling could be used for to enable scaled-up population testing.Clinical Trial DRKS00021220.

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Performance Assessment of SARS-CoV-2 PCR Assays Developed by WHO Referral Laboratories

Journal of Clinical Medicine ◽

10.3390/jcm9061871 ◽

2020 ◽

Vol 9 (6) ◽

pp. 1871 ◽

Cited By ~ 9

Author(s):

Sibyle Etievant ◽

Antonin Bal ◽

Vanessa Escuret ◽

Karen Brengel-Pesce ◽

Maude Bouscambert ◽

...

Keyword(s):

United States ◽

Cell Culture ◽

World Health ◽

Diagnostic Assay ◽

Rt Pcr ◽

Molecular Approaches ◽

The World ◽

Pcr Assays ◽

Health Organization ◽

Culture Supernatants

A reliable diagnostic assay is crucial to early detect new COVID-19 cases and limit severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission. Since the onset of the COVID-19 pandemic, the World Health Organization has published several diagnostic molecular approaches developed by referral laboratories, including Charité (Germany), HKU (Hong Kong), China CDC (China), US CDC (United States), and Institut Pasteur, Paris (France). We aimed to compare the sensitivity and specificity of these different RT-PCR assays using SARS-CoV-2 cell culture supernatants and clinical respiratory samples. Overall, the different RT-PCR assays performed well for SARS-CoV-2 detection and were all specific except the N Charité (Germany), and N2 US CDC (United States) assays. RdRp Institut Pasteur (IP2, IP4), N China CDC, and N1 US CDC were found to be the most sensitive assays. The data presented herein are of prime importance to facilitate the equipment choice of diagnostic laboratories, as well as for the development of marketed tests.

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Concentration and detection of SARS coronavirus in sewage from Xiao Tang Shan hospital and the 309th Hospital of the Chinese People's Liberation Army

Water Science & Technology ◽

10.2166/wst.2005.0266 ◽

2005 ◽

Vol 52 (8) ◽

pp. 213-221 ◽

Cited By ~ 64

Author(s):

X.W. Wang ◽

J. Li ◽

T. Guo ◽

B. Zhen ◽

Q. Kong ◽

...

Keyword(s):

Cell Culture ◽

Nucleic Acid ◽

World Health ◽

Laboratory Studies ◽

Rt Pcr ◽

People's Liberation Army ◽

The World ◽

People’S Liberation Army ◽

Health Organization ◽

Close Contacts

A worldwide outbreak of severe acute respiratory syndrome (SARS) had been reported. Over 8439 SARS cases and 812 SARS-related deaths were reported to the World Health Organization from 32 countries around the world up to 5 July 2003. The mechanism of transmission of SARS-CoV has been limited only to close contacts with patients. Attention was focused on possible transmission by the sewage system because laboratory studies showed that patients excreted coronavirus RNA in their stools in Amoy Gardens in Hong Kong. To explore whether the stool of SARS patients or the sewage containing the stool of patients would transmit SARS-CoV or not, we used a style of electropositive filter media particle to concentrate the SARS-CoV from the sewage of two hospitals receiving SARS patients in Beijing, as well as cell culture, semi-nested RT–PCR and sequencing of genes to detect and identify the viruses from sewage. There was no live SARS-CoV detected in the sewage in these assays. The nucleic acid of SARS-CoV was found in the sewage before disinfection from both hospitals by PCR. After disinfection, SARS-CoV RNA could be detected from some samples from the 309th Hospital of the Chinese People's Liberation Army, but not from Xiao Tang Shan Hospital after disinfection. In this study, we found that the virus can survive for 14 days in sewage at 4°C, 2 days at 20°C, and its RNA can be detected for 8 days though the virus had been inactivated. In conclusion, this study demonstrates that the RNA of SARS-CoV could be detected from the concentrates of sewage of both hospitals receiving SARS patients before disinfection and occasionally after disinfection though there was no live SARS-CoV; thus much attention should be paid to the treatment of stools of patients and the sewage of hospitals receiving SARS patients.

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Head-to-head performance comparison of self-collected nasal versus professional-collected nasopharyngeal swab for a WHO-listed SARS-CoV-2 antigen-detecting rapid diagnostic test

10.1101/2021.03.17.21253076 ◽

2021 ◽

Author(s):

Julian A.F. Klein ◽

Lisa J. Kr&uumlger ◽

Frank Tobian ◽

Mary Gaeddert ◽

Federica Lainati ◽

...

Keyword(s):

Scale Up ◽

High Viral Load ◽

Performance Comparison ◽

World Health ◽

Nasopharyngeal Swab ◽

Rapid Diagnostics ◽

Sample Collection ◽

Rt Pcr ◽

Percent Agreement ◽

Health Organization

Background: In 2020, the World Health Organization (WHO) recommended two SARS-CoV-2 lateral flow antigen detecting rapid diagnostics tests (Ag-RDTs), both initially with nasopharyngeal (NP) sample collection. Independent head-to-head studies demonstrated for SARS-CoV-2 Ag-RDTs nasal sampling to be a comparable and reliable alternative for nasopharyngeal (NP) sampling. Methods: We conducted a head-to-head comparison study of a supervised, self-collected nasal mid-turbinate (NMT) swab and a professional-collected NP swab, using the Panbio Ag-RDT (the second WHO-listed SARS-CoV-2 Ag-RDT, distributed by Abbott). We calculated positive and negative percent agreement and, compared to the reference standard reverse transcription polymerase chain reaction (RT-PCR), sensitivity and specificity for both sampling techniques. Results: A SARS-CoV-2 infection could be diagnosed by RT-PCR in 45 of 290 participants (15.5%). Comparing the NMT and NP sampling the positive percent agreement of the Ag-RDT was 88.1% (37/42 PCR positives detected; CI 75.0% - 94.8%). The negative percent agreement was 98.8% (245/248; CI 96.5% - 99.6%). The overall sensitivity of Panbio with NMT sampling was 84.4% (38/45; CI 71.2% - 92.3%) and 88.9% (40/45; CI 76.5% - 95.5%) with NP sampling. Specificity was 99.2% (243/245; CI 97.1% - 99.8%) for both, NP and NMT sampling. The sensitivity of the Panbio test in participants with high viral load (> 7 log10 SARS-CoV-2 RNA copies/mL) was 96.3% (CI 81.7% - 99.8%) for both, NMT and NP sampling. Conclusion: For the Panbio Ag-RDT supervised NMT self-sampling yields to results comparable to NP sampling. This suggests that nasal self-sampling could be used for scale-up population testing.

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