Within-Host and Between-Host Evolution in SARS-CoV-2—New Variant’s Source

Some of the newly emerging corona viral variants show high numbers of mutations. This is unexpected for a virus with a low mutation rate due to an inherent proof-reading system. Could such a variant arise under very special conditions occurring in a host where the virus replicates and mutates in a rather unlimited fashion, such as in immune compromised patients? The virus was shown to replicate in an immunosuppressed cancer patient for more than 105 days and might be a source of new variants. These patients are asymptomatic and the virus may therefore escape detection and attention and be high-risk. Similarly, HIV-infected individuals may be immunocompromised and support coronavirus replication with increased mutation rates. The patients may promote “within-host evolution”. Some of the viruses present in such a highly mutagenic swarm or quasispecies within one patient may become founders and cause a pandemic by further “between-host evolution”. B.1.1.7 with 23 mutations may be such a case. Immunosuppressed patients can be identified and treated by the synthetic antibody cocktails as passive immunization and kept under control. Immunosuppressed patients can be easily identified and supervised by healthcare workers—once they become aware of the risk—to avoid new variants with pandemic potential.

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Evaluation of a home-based 7-day infection control strategy for healthcare workers following high-risk exposure to severe acute respiratory coronavirus virus 2 (SARS-CoV-2): A cohort study

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.1389 ◽

2020 ◽

pp. 1-4

Author(s):

Carla Benea ◽

Laura Rendon ◽

Jesse Papenburg ◽

Charles Frenette ◽

Ahmed Imacoudene ◽

...

Keyword(s):

High Risk ◽

Infection Control ◽

Control Strategy ◽

Healthcare Workers ◽

Control Strategies ◽

Risk Exposure ◽

Nasopharyngeal Swab ◽

Home Based ◽

Respiratory Coronavirus ◽

Second Wave

Abstract Objective: Evidence-based infection control strategies are needed for healthcare workers (HCWs) following high-risk exposure to severe acute respiratory coronavirus virus 2 (SARS-CoV-2). In this study, we evaluated the negative predictive value (NPV) of a home-based 7-day infection control strategy. Methods: HCWs advised by their infection control or occupational health officer to self-isolate due to a high-risk SARS-CoV-2 exposure were enrolled between May and October 2020. The strategy consisted of symptom-triggered nasopharyngeal SARS-CoV-2 RNA testing from day 0 to day 7 after exposure and standardized home-based nasopharyngeal swab and saliva testing on day 7. The NPV of this strategy was calculated for (1) clinical coronavirus disease 2019 (COVID-19) diagnosis from day 8–14 after exposure, and for (2) asymptomatic SARS-CoV-2 detected by standardized nasopharyngeal swab and saliva specimens collected at days 9, 10, and 14 after exposure. Interim results are reported in the context of a second wave threatening this essential workforce. Results: Among 30 HCWs enrolled, the mean age was 31 years (SD, ±9), and 24 (80%) were female. Moreover, 3 were diagnosed with COVID-19 by day 14 after exposure (secondary attack rate, 10.0%), and all cases were detected using the 7-day infection control strategy: the NPV for subsequent clinical COVID-19 or asymptomatic SARS-CoV-2 detection by day 14 was 100.0% (95% CI, 93.1%–100.0%). Conclusions: Among HCWs with high-risk exposure to SARS-CoV-2, a home-based 7-day infection control strategy may have a high NPV for subsequent COVID-19 and asymptomatic SARS-CoV-2 detection. Ongoing data collection and data sharing are needed to improve the precision of the estimated NPV, and here we report interim results to inform infection control strategies in light of a second wave threatening this essential workforce.

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Understanding the awareness, perception and practices of community healthcare workers for high risk antenatal cases: A survey conducted in India

Clinical Epidemiology and Global Health ◽

10.1016/j.cegh.2021.100710 ◽

2021 ◽

pp. 100710

Author(s):

Archita Ghosh ◽

Sayantani Ghosh ◽

Joy Dutta ◽

Rashmi Sinha ◽

Jayanta Mukherjee ◽

...

Keyword(s):

High Risk ◽

Healthcare Workers ◽

Community Healthcare ◽

Community Healthcare Workers

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SARS-CoV-2 Seroprevalence in Healthcare Workers in Germany: A Follow-Up Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18094540 ◽

2021 ◽

Vol 18 (9) ◽

pp. 4540

Author(s):

Johannes Korth ◽

Benjamin Wilde ◽

Sebastian Dolff ◽

Jasmin Frisch ◽

Michael Jahn ◽

...

Keyword(s):

High Risk ◽

Healthcare Workers ◽

Risk Group ◽

Close Contact ◽

Virus Transmission ◽

High Risk Group ◽

Low Risk ◽

University Hospital ◽

Intermediate Risk ◽

Igg Antibody

SARS-CoV-2 is a worldwide challenge for the medical sector. Healthcare workers (HCW) are a cohort vulnerable to SARS-CoV-2 infection due to frequent and close contact with COVID-19 patients. However, they are also well trained and equipped with protective gear. The SARS-CoV-2 IgG antibody status was assessed at three different time points in 450 HCW of the University Hospital Essen in Germany. HCW were stratified according to contact frequencies with COVID-19 patients in (I) a high-risk group with daily contacts with known COVID-19 patients (n = 338), (II) an intermediate-risk group with daily contacts with non-COVID-19 patients (n = 78), and (III) a low-risk group without patient contacts (n = 34). The overall seroprevalence increased from 2.2% in March–May to 4.0% in June–July to 5.1% in October–December. The SARS-CoV-2 IgG detection rate was not significantly different between the high-risk group (1.8%; 3.8%; 5.5%), the intermediate-risk group (5.1%; 6.3%; 6.1%), and the low-risk group (0%, 0%, 0%). The overall SARS-CoV-2 seroprevalence remained low in HCW in western Germany one year after the outbreak of COVID-19 in Germany, and hygiene standards seemed to be effective in preventing patient-to-staff virus transmission.

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Point prevalence survey to evaluate the seropositivity for coronavirus disease 2019 (COVID-19) among high-risk healthcare workers

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.1370 ◽

2020 ◽

pp. 1-6

Author(s):

Norihiro Yogo ◽

Kristina L. Greenwood ◽

Leslie Thompson ◽

Pamela J. Wells ◽

Stephen Munday ◽

...

Keyword(s):

High Risk ◽

Healthcare Workers ◽

Point Prevalence ◽

Prevalence Survey ◽

Unit Type ◽

Point Prevalence Survey ◽

Positive Antibody ◽

Respiratory Coronavirus ◽

Antibody Tests

Abstract Among 1,770 healthcare workers serving in high-risk care areas for coronavirus disease 2019 (COVID-19), 39 (2.2%) were seropositive. Exposure to severe acute respiratory coronavirus virus 2 (SARS-CoV-2) in the community was associated with being seropositive. Job or unit type and percentage of time working with COVID-19 patients were not associated with positive antibody tests.

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Innovative Draping Method to Mitigate Aerosolization During Coronavirus Pandemic

Nepal Medical Journal ◽

10.37080/nmj.136 ◽

2020 ◽

Vol 3 (2) ◽

pp. 73-76

Author(s):

Kripa Dongol ◽

Yogesh Neupane ◽

Dipesh Shakya

Keyword(s):

Viral Load ◽

High Risk ◽

Operating Room ◽

Healthcare Workers ◽

Operative Procedure ◽

High Viral Load ◽

Upper Airways ◽

Self Confidence ◽

Additional Form

Otolaryngologists are at high risk of acquiring coronavirus because most of the procedures are aerosol generating and we have to deal with upper airways which contain high viral load. The objective of this study is to elaborate the draping technique which diminishes aerosol in the operating room. Use of a framework and a drape with customized hand insertion ports help to contain the aerosol generated during the operative procedure. The draping technique acts as an additional form of protection from aerosol along with an increase in self-confidence to the healthcare workers during this pandemic.

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The impact of SARS-CoV-2 transmission fear and COVID-19 pandemic on the mental health of patients with primary immunodeficiency disorders, severe asthma, and other high-risk groups (Preprint)

10.2196/preprints.24853 ◽

2020 ◽

Author(s):

Fatih Çölkesen ◽

Oguzhan Kilincel ◽

Mehmet Sozen ◽

Eray Yıldız ◽

Sengul Beyaz ◽

...

Keyword(s):

Mental Health ◽

High Risk ◽

Severe Asthma ◽

Primary Immunodeficiency ◽

Healthcare Workers ◽

Depression Scale ◽

High Risk Group ◽

Primary Immunodeficiency Disorder ◽

Significant Difference ◽

The Impact

BACKGROUND The adverse effects of COVID-19 pandemic on the mental health of high-risk group patients for morbidity and mortality and its impact on public health in the long term have not been clearly determined. OBJECTIVE To determine the level of COVID-19 related transmission fear and anxiety in healthcare workers and patients with primary immunodeficiency disorder (PID), severe asthma, and the ones with other comorbidities. METHODS The healthcare workers and patients with PID, severe asthma (all patients receiving biological agent treatment), malignancy, cardiovascular disease, hypertension (90% of patients receiving ACEI or ARB therapy), diabetes mellitus (42 % of patients receiving DPP-4 inhibitor therapy) were included in the study. A total of 560 participants, 80 individuals in each group, were provided. The hospital anxiety and depression scale ( HADS ) and Fear of illness and virus evaluation (FIVE ) scales were applied to the groups with face to face interview methods. RESULTS The mean age was 49.30 years and 306 (55 %) were female. The FIVE Scale and HADS-A scale scores of health care workers were significantly higher than other groups' scores (p = 0.001 and 0.006). The second-highest scores belonged to patients with PID. There was no significant difference between the groups for the HADS-D score (p=0.07). The lowest score in all scales was observed in patients with hypertension. CONCLUSIONS This study demonstrated that in the pandemic process, patients with primary immunodeficiency, asthma patients, and other comorbid patients, especially healthcare workers, should be referred to the centers for the detection and treatment of mental health conditions.

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