scholarly journals Diagnostic SARS-CoV-2 Cycle Threshold Value Predicts Disease Severity, Survival, and Six-Month Sequelae in COVID-19 Symptomatic Patients

Viruses ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 281
Author(s):  
Mattia Trunfio ◽  
Francesco Venuti ◽  
Francesca Alladio ◽  
Bianca Maria Longo ◽  
Elisa Burdino ◽  
...  
Keyword(s):  
Disease Severity ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Predictive Marker ◽  
Threshold Value ◽  
Nasopharyngeal Swab ◽  
Cycle Threshold ◽  
Composite Scale ◽  
Group B ◽  
Novel Coronavirus

To date, there is no severe acute respiratory syndrome coronavirus 2-(SARS-CoV-2)-specific prognostic biomarker available. We assessed whether SARS-CoV-2 cycle threshold (Ct) value at diagnosis could predict novel CoronaVirus Disease 2019 (COVID-19) severity, clinical manifestations, and six-month sequelae. Hospitalized and outpatient cases were randomly sampled from the diagnoses of March 2020 and data collected at 6 months by interview and from the regional database for COVID-19 emergency. Patients were stratified according to their RNA-dependent-RNA-polymerase Ct in the nasopharyngeal swab at diagnosis as follows: Group A ≤ 20.0, 20.0 < group B ≤ 28.0, and Group C > 28.0. Disease severity was classified according to a composite scale evaluating hospital admission, worst oxygen support required, and survival. Two hundred patients were included, 27.5% in Groups A and B both, 45.0% in Group C; 90% of patients were symptomatic and 63.7% were hospitalized. The median time from COVID-19 onset to swab collection was five days. Lethality, disease severity, type, and number of signs and symptoms, as well as six-month sequelae distributed inversely among the groups with respect to SARS-CoV-2 Ct. After controlling for confounding, SARS-CoV-2 Ct at diagnosis was still associated with COVID-19-related death (p = 0.023), disease severity (p = 0.023), number of signs and symptoms (p < 0.01), and presence of six-month sequelae (p < 0.01). Early quantification of SARS-CoV-2 may be a useful predictive marker to inform differential strategies of clinical management and resource allocation.

scholarly journals Clinical and Laboratory Profiles of 75 Hospitalized Patients with Novel Coronavirus Disease 2019 in Hefei, China

2020 ◽  
Author(s):  
Zonghao Zhao ◽  
Jiajia Xie ◽  
Ming Yin ◽  
Yun Yang ◽  
Hongliang He ◽  
...  
Keyword(s):  
T Cell ◽  
Treatment Effectiveness ◽  
Antiviral Treatment ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
Nasopharyngeal Swab ◽  
The Novel ◽  
Reactive Protein ◽  
Cell Counts ◽  
Novel Coronavirus

AbstractThe outbreak of the novel coronavirus disease 2019 (COVID-19) infection began in December 2019 in Wuhan, and rapidly spread to many provinces in China. The number of cases has increased markedly in Anhui, but information on the clinical characteristics of patients is limited. We reported 75 patients with COVID-19 in the First Affiliated Hospital of USTC from Jan 21 to Feb 16, 2020, Hefei, Anhui Province, China. COVID-19 infection was confirmed by real-time RT-PCR of respiratory nasopharyngeal swab samples. Epidemiological, clinical and laboratory data were collected and analyzed. Of the 75 patients with COVID-19, 61 (81.33%) had a direct or indirect exposure history to Wuhan. Common symptoms at onset included fever (66 [88.0%] of 75 patients) and dry cough (62 [82.67%]). Of the patients without fever, cough could be the only or primary symptom. The most prominent laboratory abnormalities were lymphopenia, decreased percentage of lymphocytes (LYM%), decreased CD4+ and CD8+ T cell counts, elevated C-reactive protein (CRP) and lactate dehydrogenase (LDH). Patients with elevated interleukin 6 (IL-6) showed significant decreases in the LYM%, CD4+ and CD8+ T cell counts. Besides, the percentage of neutrophils, CRP, LDH and Procalcitonin levels increased significantly. We concluded that COVID-19 could cause different degrees of hematological abnormalities and damage of internal organs. Hematological profiles including LYM, LDH, CRP and IL-6 could be indicators of diseases severity and evaluation of treatment effectiveness. Antiviral treatment requires a comprehensive and supportive approach. Further targeted therapy should be determined based on individual clinical manifestations and laboratory indicators.

scholarly journals Is Novel Coronavirus Novel: Covid-19, A Pandemic or An Endemic?

2020 ◽  
Author(s):  
Sangam Banerjee
Keyword(s):  
Disease Progression ◽  
Herd Immunity ◽  
Threshold Value ◽  
Acquired Immunity ◽  
Test Results ◽  
Serological Survey ◽  
Previous Infection ◽  
Group A ◽  
Group B ◽  
Novel Coronavirus

We have analysed the death and recovery rate of Covid-19 disease progression. From the analysis, we have argued that the pandemic is over in certain countries (labelled as group-A) and for other countries (labelled as group-B) the disease appears to remain as endemic. Taking into account the serological survey (sero-survey) test results obtained by certain groups and comparing it with herd immunity threshold value one can infer that the low number of infection for group-B is either due to acquired immunity by some previous infection by other coronavirus or due to innate immunity towards this infection. This effect is stronger for group-B to slow the progress of the disease to such an extent resulting in flattening of the disease progression curve compared to group-A.

scholarly journals A recent review on 2019 novel coronavirus outbreak

2020 ◽  
Vol 10 (1) ◽  
pp. 140
Author(s):  
Bipin Shaji ◽  
Abisri Suresh ◽  
Nimitha Vasanth ◽  
Sharon Mary Stanly
Keyword(s):  
Rna Virus ◽  
Clinical Manifestations ◽  
Nucleic Acid Amplification ◽  
Personal Hygiene ◽  
Diagnostic Tools ◽  
Nasopharyngeal Swab ◽  
Blood Oxygen Saturation ◽  
Fraction Of Inspired Oxygen ◽  
Novel Coronavirus ◽  
Tract Infections

SARS-CoV2, a single-stranded RNA virus that can cause a wide array of clinical manifestations ranging from mild to severe (respiratory failure). The spread of SARS-CoV2 has now become uncontrollable leading to a pandemic. The infection is usually transmitting through cough droplets and sneeze. The main clinical manifestations of the disease are similar to common respiratory tract infections and may become fatal after the development of symptoms such as severe dyspnea, low PaO2/FiO2 (fraction of inspired oxygen) ratio, and severe decline in blood oxygen saturation. Current diagnostic tools employed at the moment include time-consuming NAAT (nucleic acid amplification test). Recent investigations and researches are aimed at rapid serological testing. Real-time reverse transcription-polymerase chain reaction (rRT- PCR) is the standard method of testing, using respiratory samples obtained by the nasopharyngeal swab. Medications such as darunavir, ribavirin, remdesivir, interferon, and lopinavir/ritonavir combination therapy were used for the management of the infection. Social distancing, use of protective masks, isolation of the infected persons and maintaining personal hygiene helps in the prevention of the disease.

scholarly journals Comparative clinical study of Nasya Karma and Shirodhara with Prapaundarikadi Taila in Ardhavabhedaka w.s.r. to Migraine

2020 ◽  
Vol 5 (05) ◽  
pp. 46-58
Author(s):  
Navyashree M S ◽  
Rashmi R
Keyword(s):  
Marked Improvement ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Treatment Modalities ◽  
Age Group ◽  
Unilateral Headache ◽  
Comparative Clinical Study ◽  
Group A ◽  
Group B ◽  
Cardinal Feature

Background: Ardhavabhedaka is a type of Shiroroga with the cardinal feature of unilateral headache, which if left untreated leads to complications like blindness and hearing loss. This disease can be correlated to Migraine head-ache based on the clinical manifestations. Nasya Karma and Shirodhara are the prime treatment modalities for Shirorogas. Objectives: To evaluate the effects of Nasyakarma and Shirodhara in the management of Ardhavabhedhaka. Material and Methods: Patients presenting with the classical features of Ardhavabhedaka and between the age group of 18 to 60 years irrespective of sex were selected and allotted in Group A and B with 20 patients in each group. Group A was administered with Nasya with Prapaundarikadi Taila and Group B with Shirodhara with Prapaundarikadi Taila for 7 days. Result: Data was tabulated and analyzed using Student t-test, paired proportion test, which showed marked improvement in patients with Ardhavabhedaka in both the groups. Nasya and Shirodhara with Prapaundarikadi Taila is proved effective in all patients. According to percentage wise relief in the symptoms of Ardhavabhedaka in Group A and B, Group A showed comparatively better relief. Conclusion: On the basis of the results of this study, it can be clearly concluded that Nasya performed with Prapaundarikadi Taila provided significant relief in the signs and symptoms of Ardhavabhedaka than Shirodhara performed with Prapaundarikadi Taila.

scholarly journals Human genetic factors associated with susceptibility to SARS-CoV-2 infection and COVID-19 disease severity

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Cleo Anastassopoulou ◽  
Zoi Gkizarioti ◽  
George P. Patrinos ◽  
Athanasios Tsakris
Keyword(s):  
Disease Severity ◽  
Genetic Factors ◽  
Current Knowledge ◽  
Wide Spectrum ◽  
Clinical Manifestations ◽  
Severe Pneumonia ◽  
Cell Surface Receptor ◽  
Main Body ◽  
Susceptibility To Infection ◽  
Novel Coronavirus

Abstract Background The emergence of the novel coronavirus in Wuhan, Hubei Province, China, in December 2019 marked the synchronization of the world to a peculiar clock that is counting infected cases and deaths instead of hours and minutes. The pandemic, highly transmissible severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has indeed caused considerable morbidity and mortality and drastically changed our everyday lives. As we continue to become acquainted with the seventh coronavirus known to infect our species, a number of its characteristics keep surprising us. Among those is the wide spectrum of clinical manifestations of the resulting coronavirus disease 2019 (COVID-19), which ranges from asymptomatic or mildly symptomatic infections to severe pneumonia, respiratory failure, and death. Main body Data, now from patient populations, are beginning to accumulate on human genetic factors that may contribute to the observed diversified disease severity. Therefore, we deemed it prudent to review the associations between specific human genetic variants and clinical disease severity or susceptibility to infection that have been reported in the literature to date (at the time of writing this article in early August 2020 with updates in mid-September). With this work, we hope (i) to assist the fast-paced biomedical research efforts to combat the virus by critically summarizing current knowledge on the potential role of host genetics, and (ii) to help guide current genetics and genomics research towards candidate gene variants that warrant further investigation in larger studies. We found that determinants of differing severity of COVID-19 predominantly include components of the immune response to the virus, while determinants of differing susceptibility to SARS-CoV-2 mostly entail genes related to the initial stages of infection (i.e., binding of the cell surface receptor and entry). Conclusion Elucidating the genetic determinants of COVID-19 severity and susceptibility to SARS-CoV-2 infection would allow for the stratification of individuals according to risk so that those at high risk would be prioritized for immunization, for example, if or when safe and effective vaccines are developed. Our enhanced understanding of the underlying biological mechanisms could also guide personalized therapeutics. Such knowledge is already beginning to provide clues that help explain, at least in part, current epidemiologic observations regarding the typically more severe or benign disease course in older males and children, respectively.

scholarly journals An Update of Coronavirus Disease 2019 (COVID-19): An Essential Brief for Clinicians

2021 ◽  
Author(s):  
Afshin Zare ◽  
Seyyede Fateme Sadati-Seyyed-Mahalle ◽  
Amirhossein Mokhtari ◽  
Nima Pakdel ◽  
Zeinab Hamidi ◽  
...  
Keyword(s):  
Neurological Diseases ◽  
Clinical Manifestations ◽  
Severe Pneumonia ◽  
Unknown Origin ◽  
Signs And Symptoms ◽  
Host Cells ◽  
Healthy Human ◽  
Angiotensin Converting Enzyme 2 ◽  
Number Of Patients ◽  
Novel Coronavirus

During 2019, the number of patients suffering from cough, fever and reduction of WBC&rsquo;s count increased. At the beginning, this mysterious illness was called &ldquo;fever with unknown origin&rdquo;. At the present time, the cause of this pneumonia is known as the 2019 novel coronavirus (2019-nCoV) or the severe acute respiratory syndrome corona virus 2 (SARS-CoV-2). The SARS-CoV-2 is one member of great family of coronaviruses. Coronaviruses can cause different kind of illnesses including respiratory, enteric, hepatic, and neurological diseases in animals like cat and bat. Coronaviruses are enveloped positive-stranded RNA viruses. The SARS-CoV-2 has some particular structures for binding to host cells, reproducing itself in cells and damaging human cells. The SARS-CoV-2 can bind angiotensin-converting enzyme 2 (ACE‐2) receptors and cause various difficulties for human. The SARS-CoV-2 can cause either not-serious issues like fever and cough or serious concerns such as multi-organ failure. Source(s) of SARS-CoV-2 is under debate. Malayan pangolin and bat are the most suspicious candidate for being sources of the SARS-CoV-2. The SARS-CoV-2 can be transmitted by various ways such as transmitting from infected human to healthy human and can make severe pneumonia, which can lead to death. The SARS-CoV-2 can infect different kind of people with different ages, races, and social and economic levels. The SARS‐CoV‐2 infection can cause various sorts of clinical manifestations like cough and fever and intensity of signs and symptoms depends on sufferer conditions. Clinicians use all of available documents and tests like laboratory, histopathological and radiological findings for diagnosing new cases and curing patients with high accuracy. At the present time, there is no particular way for treating SARS-CoV-2 infection; neither antiviral drugs nor palliative agents. It seems that the best way for standing against the SARS-CoV-2 infection is preventing from it by social distancing and vaccination. This review tries to prepare an essential brief update about SARS-CoV-2 infection for clinicians.

scholarly journals Epidemiological and Clinical Characteristics of COVID-19: A Retrospective Multi-Center Study in Pakistan

2021 ◽  
Vol 9 ◽  
Author(s):  
Mehmood Ahmad ◽  
Bilal Mahmood Beg ◽  
Arfa Majeed ◽  
Sadaf Areej ◽  
Sualeha Riffat ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Clinical Aspects ◽  
Chi Square ◽  
Chi Square Test ◽  
History Of ◽  
Novel Coronavirus ◽  
Multi Center Study ◽  
Center Study

The emergence of a pathogen responsible for a mysterious respiratory disease was identified in China and later called a novel coronavirus. This disease was named COVID-19. The present study seeks to determine the epidemiological and clinical characteristics of COVID-19 in Pakistan. This report will exhibit a linkage between epidemiology and clinical aspects which in turn can be helpful to prevent the transmission of the virus in Pakistan. A retrospective, multiple center study was performed by collecting the data from patients' with their demographics, epidemiological status, history of co-morbid conditions, and clinical manifestations of the disease. The data was collected from 31 public-sector and 2 private hospitals across Pakistan by on-field healthcare workers. A Chi-square test was applied to assess the relationship between categorical data entries. A total of 194 medical records were examined. The median age of these patients was found to be 34 years. A total of 53.6% active cases were present including 41.2% males and 12.4% females till the end of the study. Adults accounted for most of the cases (94.3%) of COVID-19. Fever (86.60%), cough (85.05%), fatigue (36.60%), dyspnea (24.74%), and gastrointestinal discomfort (10.31%) were among the most frequently reported signs and symptoms by the patients. However, 4.12% of the total patient population remained asymptomatic. The median duration of hospital stay was found to be 14 (0–19) days. The earliest source of the spread of the virus may be linked to the foreigners traveling to Pakistan. Spread among men was more as compared to women. A few cases were found to be positive, due to the direct contact with pets or livestock. Hypertension (7.73%), diabetes (4.64%), cardiovascular conditions (2.58%) were the most common co-morbidities. The percentage mortality was 2.50% with the highest mortality among elders.

A Study on Frozen Shoulder and its clinical management through Nasaapana and Nasya

2016 ◽  
Vol 1 (1) ◽  
Author(s):  
Praveenkumar H. Bagali ◽  
A. S. Prashanth
Keyword(s):  
Medical Science ◽  
Frozen Shoulder ◽  
Signs And Symptoms ◽  
Treatment Modalities ◽  
Animal Kingdom ◽  
Shoulder Joints ◽  
Group A ◽  
Group B

The unique position of man as a master mechanic of the animal kingdom is because of skilled movements of his hands and when this shoulder joints get obstructed, we call it as Apabahuka (Frozen shoulder), we do not find satisfactory management in modern medical science. Various effective treatment modalities have been mentioned which reverse the pathogenesis, Shodhana is advised initially followed by Shamana therapies. In the present study 30 patients were selected incidentally and placed randomly into two groups A and B, with 15 subjects in each group. Group A received Amapachana with Panchakola Churna, Jambeera Pinda Sweda and Nasya Karma. Group B received Amapachana with Panchakola Churna, Jambeera pinda Sweda and Nasaapana. In both the groups two months follow up was done. Both groups showed significant improvement in the signs and symptoms of Apabahuka as well as the activities of daily livings, thereby improving the quality of life of the patients. Nasya Karma and Nasaapana provided highly significant results in all the symptoms of Apabahuka. In the present study as per the clinical data, Nasaapana is found to be more effective than Nasya Karma.

scholarly journals SARS-CoV-2 Is Not Detected in the Cerebrospinal Fluid of Encephalopathic COVID-19 Patients

2020 ◽  
Vol 11 ◽  
Author(s):  
Dimitris G. Placantonakis ◽  
Maria Aguero-Rosenfeld ◽  
Abdallah Flaifel ◽  
John Colavito ◽  
Kenneth Inglima ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Viral Entry ◽  
Cell Types ◽  
Host Cells ◽  
Nasopharyngeal Swab ◽  
Rt Pcr ◽  
Neurologic Sequelae ◽  
Show Evidence ◽  
Novel Coronavirus ◽  
Transmembrane Serine Protease

Neurologic manifestations of the novel coronavirus SARS-CoV-2 infection have received wide attention, but the mechanisms remain uncertain. Here, we describe computational data from public domain RNA-seq datasets and cerebrospinal fluid data from adult patients with severe COVID-19 pneumonia that suggest that SARS-CoV-2 infection of the central nervous system is unlikely. We found that the mRNAs encoding the ACE2 receptor and the TMPRSS2 transmembrane serine protease, both of which are required for viral entry into host cells, are minimally expressed in the major cell types of the brain. In addition, CSF samples from 13 adult encephalopathic COVID-19 patients diagnosed with the viral infection via nasopharyngeal swab RT-PCR did not show evidence for the virus. This particular finding is robust for two reasons. First, the RT-PCR diagnostic was validated for CSF studies using stringent criteria; and second, 61% of these patients had CSF testing within 1 week of a positive nasopharyngeal diagnostic test. We propose that neurologic sequelae of COVID-19 are not due to SARS-CoV-2 meningoencephalitis and that other etiologies are more likely mechanisms.

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