SARS-COV2 Virus in Tears and Conjunctival Secretions of COVID-19 Patients

2021 ◽  
Vol 37 (3) ◽  
Author(s):  
Ambreen Gull ◽  
M.Rafaaq Saleem ◽  
Fuad Ahmad Khan Niazi
Keyword(s):  
Severe Disease ◽  
Virus Transmission ◽  
Case Series ◽  
Polymerase Chain Reaction Analysis ◽  
High Viral Load ◽  
Viral Rna ◽  
Rt Pcr ◽  
Course Of Illness ◽  
Mild Disease ◽  
Therapeutic Services

Purpose:  To determine the presence of SARS-COV 2 viruses in tears and conjunctival secretions of patients with diagnosed COVID-19. Study Design:  Prospective interventional case series. Place and Duration of Study:  Rawalpindi Institute of Urology, Department of infectious diseases, Holy Family Hospital, Rawalpindi Medical University, from September 2020 to October 2020. Methods:  Samples of conjunctival and tear secretions were collected from 60 hospitalized patients of COVID-19 who were confirmed with nasopharyngeal swabs test. Disposable conjunctival swab sticks were used for sampling. Samples were taken within 3 days of admission. SARS-COV 2 virus evaluation in tears and conjunctival secretions was done by Qualitative RT-PCR (Reverse transcriptase polymerase chain reaction) analysis. Ocular features were documented. Regarding systemic course of illness, details were noted from their hospital records. Results:  Mean age of the patients was 56.63 ± 16.373 years. Out of 60 patients, 42 were males and 18 were females. Twenty two (36.6%) patients had mild disease and moderate and severe disease was present in 19 patients (31.6%) each. Six (10%) patients had positive conjunctival and tear secretions for SARS-COV 2 viral RNA. All patients with positive ocular secretions for viral RNA were in first week of course of disease and 3 patients had severe COVID 19 disease signifying high viral load.  Only one patient had conjunctivitis and ocular symptoms of redness and foreign body sensation. Conclusion:  There is likelihood of SARS-COV 2 virus transmission via ocular secretions as frequency of patients with SARS-COV 2 viral RNA detected in tears was 10% in current study therapeutic services. Key Words:  SARS-COV 2 Virus, COVID 19, Conjunctivitis, Qualitative RT-PCR, Ocular Manifestations

A Case Series of SARS-CoV-2 RT-PCR-Positive Hospitalized Infants 60 Days of Age or Younger From 2 New York City Pediatric Emergency Departments

2021 ◽  
Vol 60 (4-5) ◽  
pp. 247-251
Author(s):  
Ameer Hassoun ◽  
Nessy Dahan ◽  
Christopher Kelly
Keyword(s):  
New York ◽  
Case Reports ◽  
Severe Disease ◽  
Case Series ◽  
Pediatric Emergency ◽  
Rt Pcr ◽  
Vulnerable Group ◽  
Mild Disease ◽  
Young Infants ◽  
Novel Coronavirus

The emergence of novel coronavirus disease-2019 poses an unprecedented challenge to pediatricians. While the majority of children experience mild disease, initial case reports on young infants are conflicting. We present a case series of 8 hospitalized infants 60 days of age or younger with coronavirus disease-2019. A quarter of these patients had coinfections (viral or bacterial). None of these infants had severe disease. Continued vigilance in testing this vulnerable group of infants is warranted.

scholarly journals Premorbid Echocardiography And Risk of Hospitalization In COVID-19

2022 ◽  
Author(s):  
Harsh Goel ◽  
Kashyap Shah ◽  
Janish Kothari ◽  
Timothy Daly ◽  
Pooja Saraiya ◽  
...  
Keyword(s):  
Risk Factors ◽  
Left Atrial ◽  
Severe Disease ◽  
Vaccine Hesitancy ◽  
Hospital Death ◽  
Rt Pcr ◽  
Mild Disease ◽  
Global Pandemic ◽  
Artery Disease

Abstract Background: COVID-19 has caused an unprecedented global pandemic, with cardiovascular risk factors predicting outcomes. We investigated whether baseline trans-thoracic echocardiography could refine risk beyond clinical risk factors. Methods: Symptomatic COVID-19 positive (RT-PCR) adults across St Luke’s University Health Network between March 1st-October 31st 2021, with trans-thoracic echocardiography (TTE) within 15-180 days preceding COVID-19 positivity were selected. Demographic/clinical/echocardiographic variables were extracted from patients’ EHR and compared between groups stratified by disease severity. Logistic regression was used to identify independent predictors of hospitalization. Results: 192 patients were included. 87 (45.3%) required hospitalization, 34 (17.7%) suffered severe disease (need for ICU care/mechanical ventilation/in-hospital death). Age, co-morbidities, and several echocardiographic abnormalities were more prevalent in moderate-severe versus mild disease. On multivariate analysis, age (OR 1.039, 95% CI 1.011-1.067), coronary artery disease (OR 4.184, 95% CI 1.451-12.063), COPD (OR 6.886, 95% CI 1.396-33.959) and left atrial (LA) diameter ≥4.0cm (OR 2.379, 95% CI 1.031-5.493) predicted need for hospitalization. Model showed excellent discrimination (ROC AUC 0.809, 95% CI 0.746-0.873). Conclusion: Baseline LA enlargement independently predicts risk of hospitalization in COVID-19. When available, baseline LA enlargement could identify patients for 1) closer outpatient follow-up, and 2) counseling vaccine-hesitancy.

scholarly journals Performance characteristics of a rapid SARS-CoV-2 antigen detection assay at a public plaza testing site in San Francisco

2020 ◽  
Author(s):  
Genay Pilarowski ◽  
Paul Lebel ◽  
Sara Sunshine ◽  
Jamin Liu ◽  
Emily Crawford ◽  
...  
Keyword(s):  
Viral Load ◽  
San Francisco ◽  
High Viral Load ◽  
Performance Characteristics ◽  
Viral Rna ◽  
Antigen Test ◽  
Rt Pcr ◽  
Detection Assay ◽  
Community Transmission ◽  
Testing Site

ABSTRACTWe evaluated the performance of the Abbott BinaxNOW™ Covid-19 rapid antigen test to detect virus among persons, regardless of symptoms, at a public plaza site of ongoing community transmission. Titration with cultured clinical SARS-CoV-2 yielded a human observable threshold between 1.6×104-4.3×104 viral RNA copies (cycle threshold (Ct) of 30.3-28.8 in this assay). Among 878 subjects tested, 3% (26/878) were positive by RT-PCR, of which 15/26 had a Ct<30, indicating high viral load. 40% (6/15) of Ct<30 were asymptomatic. Using this Ct<30 threshold for Binax-CoV2 evaluation, the sensitivity of the Binax-CoV2 was 93.3% (14/15), 95% CI: 68.1-99.8%, and the specificity was 99.9% (855/856), 95% CI: 99.4-99.9%.

scholarly journals Role of high-dose exposure in transmission hot zones as a driver of SARS-CoV-2 dynamics

2021 ◽  
Vol 18 (176) ◽  
Author(s):  
Dominik Wodarz ◽  
Natalia L. Komarova ◽  
Luis M. Schang
Keyword(s):  
Severe Disease ◽  
Virus Transmission ◽  
Epidemiological Data ◽  
High Dose ◽  
Infected People ◽  
Targeted Interventions ◽  
Mild Disease ◽  
Successful Infection ◽  
Hot Zone ◽  
Infection Spread

Epidemiological data about SARS-CoV-2 spread indicate that the virus is not transmitted uniformly in the population. The transmission tends to be more effective in select settings that involve exposure to relatively high viral dose, such as in crowded indoor settings, assisted living facilities, prisons or food processing plants. To explore the effect on infection dynamics, we describe a new mathematical model where transmission can occur (i) in the community at large, characterized by low-dose exposure and mostly mild disease, and (ii) in so-called transmission hot zones, characterized by high-dose exposure that can be associated with more severe disease. The model yields different types of epidemiological dynamics, depending on the relative importance of hot zone and community transmission. Interesting dynamics occur if the rate of virus release/deposition from severely infected people is larger than that of mildly infected individuals. Under this assumption, we find that successful infection spread can hinge upon high-dose hot zone transmission, yet the majority of infections are predicted to occur in the community at large with mild disease. In this regime, residual hot zone transmission can account for continued virus spread during community lockdowns, and the suppression of hot zones after community interventions are relaxed can cause a prolonged lack of infection resurgence following the reopening of society. This gives rise to the notion that targeted interventions specifically reducing virus transmission in the hot zones have the potential to suppress overall infection spread, including in the community at large. Epidemiological trends in the USA and Europe are interpreted in light of this model.

scholarly journals Performance characteristics of a rapid SARS-CoV-2 antigen detection assay at a public plaza testing site in San Francisco

2021 ◽  
Author(s):  
Genay Pilarowski ◽  
Paul Lebel ◽  
Sara Sunshine ◽  
Jamin Liu ◽  
Emily Crawford ◽  
...  
Keyword(s):  
Viral Load ◽  
San Francisco ◽  
High Viral Load ◽  
Performance Characteristics ◽  
Viral Rna ◽  
Antigen Test ◽  
Rt Pcr ◽  
Detection Assay ◽  
Community Transmission ◽  
Testing Site

Abstract We evaluated the performance of the Abbott BinaxNOW TM Covid-19 rapid antigen test (Binax-CoV2) to detect virus among persons, regardless of symptoms, at a public plaza site of ongoing community transmission. Titration with cultured SARS-CoV-2 yielded a human observable threshold between 1.6x10 4-4.3x10 4 viral RNA copies (cycle threshold (Ct) of 30.3-28.8). Among 878 subjects tested, 3% (26/878) were positive by RT-PCR, of which 15/26 had Ct&lt;30, indicating high viral load. 40% (6/15) of Ct&lt;30 were asymptomatic. Using this Ct&lt;30 threshold for Binax-CoV2 evaluation, the sensitivity of Binax-CoV2 was 93.3% (14/15), 95% CI: 68.1-99.8%, and the specificity was 99.9% (855/856), 95% CI: 99.4-99.9%.

scholarly journals Urinary viral shedding of COVID-19 and its clinical associations: A Systematic Review and Meta-analysis of Observational Studies

2020 ◽  
Author(s):  
Amir H Kashi ◽  
Jean de la Rosette ◽  
Erfan Amini ◽  
Hamidreza Abdi ◽  
Morteza Fallah-karkan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Sample Size ◽  
Case Reports ◽  
Meta Analysis ◽  
Severe Disease ◽  
Disease Onset ◽  
Case Series ◽  
Adult Patients ◽  
Mild Disease ◽  
Viral Shedding

Objectives: To review the current literature on the presence of COVID-19 virus in the urine of infected patients and to explore the clinical features that can predict the presence of COVID-19 in urine. Materials and Methods: A systematic review of published literature between 30th December 2019 and 21st June 2020 was conducted on Pubmed, Google Scholar, Ovid, Scopus, and ISI web of science. Studies investigating urinary viral shedding of COVID-19 in infected patients were included. Two reviewers selected relative studies and performed quality assessment of individual studies. Meta-analysis was performed on the pooled case reports and cohort with a sample size of >= 9. Results: Thirty-nine studies were finally included in the systematic review; 12 case reports, 26 case series, and one cohort study. Urinary samples from 533 patients were investigated. Fourteen studies reported the presence of COVID19 in the urinary samples from 24 patients. The crude overall rate of COVID-19 detection in urinary samples was 4.5%. Considering case series and cohorts with a sample size of >= 9, the estimated viral shedding frequency was 1.18 % (CI 95%: 0.14 - 2.87) in the metaanalysis. In adult patients, urinary shedding of COVID-19 was commonly detected in patients with moderate to severe disease (16 adult patients with moderate or severe disease versus two adult patients with mild disease). In children, urinary viral shedding of COVID-19 was reported in 4 children who all suffered from mild disease. Urinary viral shedding of COVID-19 was detected from day 1 to day 52 after disease onset. The pathogenicity of virus isolated from urine has been demonstrated in cell culture media in one study while another study failed to reveal replication of isolated viral RNA in cell cultures. Urinary symptoms were not attributed to urinary viral shedding. Conclusions: While COVID-19 is rarely detected in urine of infected individuals, infection transmission through urine still remains possible. In adult patients, infected urine is more likely in the presence of moderate or severe disease. Therefore, caution should be exerted when dealing with COVID-19 infected patients during medical interventions like endoscopy and urethral catheterization.

scholarly journals Implications in the quantitation of SARS-CoV2 copies in concurrent nasopharyngeal swabs, whole mouth fluid and respiratory droplets

2021 ◽  
Author(s):  
Priya Kannian ◽  
Bagavad Gita Jayaraman ◽  
Swarna Alamelu ◽  
Chandra Lavanya ◽  
Nagalingeswaran Kumarasamy ◽  
...  
Keyword(s):  
Disease Severity ◽  
Severe Disease ◽  
Cross Sectional Study ◽  
Nasopharyngeal Swab ◽  
Rt Pcr ◽  
Cross Sectional ◽  
Virus Shedding ◽  
Mild Disease ◽  
Copy Numbers ◽  
Respiratory Droplets

AbstractImportanceThe nasopharyngeal swab (NPS) is considered the ideal diagnostic specimen for Covid-19, while WMF is recently promoted due to collection simplicity and importance in disease transmission. There is limited knowledge on the relative viral load in these samples – NPS, whole mouth fluid (WMF) and respiratory droplets (RD; another important source in transmission), on how the loads vary with disease severity and on how much virus is shed.ObjectiveTo quantify and compare SARS-CoV2 copies in the NPS, WMF and RD samples, and correlate with disease severity.DesignCross sectional study.SettingTertiary care multi-speciality hospital with limited resources in a low-to-middle income country.ParticipantsEighty suspected COVID-19 patients were recruited from the COVID-19 out-patient clinic and hospital isolation wards.InterventionConcurrent NPS, WMF and RD samples were collected from all the recruited patients and tested for SARS-CoV2 copies by quantitative reverse transcriptase-polymerase chain reaction (RT-PCR).Main outcomes and measuresThe main outcome was COVID-19 measured by SARS-CoV2 quantitative RT-PCR in NPS samples. COVID-19 disease severity was determined according to NIH criteria. Virus shedding was defined as the presence of SARS-CoV2 copies in the WMF and RD samples.ResultsSARS-CoV2 was detected in 55/80 (69%) of the NPS samples. Of these 55, WMF and RD samples were positive in 44 (80%) and 17 (31%), respectively. The concordance of WMF with NPS was 84% (p=0.02). SARS-CoV2 copy numbers were comparable in the NPS (median: 8.74×10^5) and WMF (median: 3.07×10^4), but lower in RD samples (median: 3.60×10^2). Patients with mild disease had higher copies in the NPS (median: 3.46×10^6), while patients with severe disease had higher copies in the WMF (median: 1.34×10^6) and RD samples (median: 4.29×10^4). The 25-75% interquartile range of NPS SARS-CoV2 copies was significantly higher in the WMF (p=0.0001) and RD (p=0.01) positive patients.Conclusion and relevanceSARS-CoV2 copies are highest in NPS samples. WMF is a reliable surrogate sample for diagnosis. High copy numbers in the NPS imply initial virological phase and higher risk of virus shedding via WMF and RD.Key pointsQuestionHow the numbers of SARS-CoV2 copies in nasopharyngeal swab (NPS) samples might reflectvirus shedding from the whole upper aerodigestive tract and indicatedisease severity?FindingsIn this cross-sectional study involving 80 suspected COVID-19 patients, the data indicate higher SARS-CoV2 copies in NPS samples of patients with mild disease,and in the whole mouth fluid (WMF) and respiratory droplet (RD) samples of patients with severe disease. Patients with higher SARS-CoV2 copies in the NPS shed the virus in the WMF and RD samples at statistically higher levels.MeaningHigh SARS-CoV2 copies in NPS samples imply initial virological phase withhigh levels of shedding through both WMF and RD.

scholarly journals Characteristic of COVID-19 infection in pediatric patients: early findings from two Italian Pediatric Research Networks

2020 ◽  
Vol 179 (8) ◽  
pp. 1315-1323 ◽  
Author(s):  
Niccolò Parri ◽  
◽  
Anna Maria Magistà ◽  
Federico Marchetti ◽  
Barbara Cantoni ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Severe Disease ◽  
Case Series ◽  
High Rate ◽  
Respiratory Support ◽  
Hospital Level ◽  
Mild Disease ◽  
Moderate Disease ◽  
Increased Risk

Abstract Detailed data on clinical presentations and outcomes of children with COVID-19 in Europe are still lacking. In this descriptive study, we report on 130 children with confirmed COVID-19 diagnosed by 28 centers (mostly hospitals), in 10 regions in Italy, during the first months of the pandemic. Among these, 67 (51.5%) had a relative with COVID-19 while 34 (26.2%) had comorbidities, with the most frequent being respiratory, cardiac, or neuromuscular chronic diseases. Overall, 98 (75.4%) had an asymptomatic or mild disease, 11 (8.5%) had moderate disease, 11 (8.5%) had a severe disease, and 9 (6.9%) had a critical presentation with infants below 6 months having significantly increased risk of critical disease severity (OR 5.6, 95% CI 1.3 to 29.1). Seventy-five (57.7%) children were hospitalized, 15 (11.5%) needed some respiratory support, and nine (6.9%) were treated in an intensive care unit. All recovered. Conclusion:This descriptive case series of children with COVID-19, mostly encompassing of cases enrolled at hospital level, suggest that COVID-19 may have a non-negligible rate of severe presentations in selected pediatric populations with a relatively high rates of comorbidities. More studies are needed to further understand the presentation and outcomes of children with COVID-19 in children with special needs. What is Known:• There is limited evidence on the clinical presentation and outcomes of children with COVID-19 in Europe, and almost no evidence on characteristics and risk factors of severe cases. What is New:• Among a case series of 130 children, mostly diagnosed at hospital level, and with a relatively high rate (26.2%) of comorbidities, about three-quarter had an asymptomatic or mild disease.• However, 57.7% were hospitalized, 11.5% needed some respiratory support, and 6.9% were treated in an intensive care unit.

scholarly journals Familial aggregation of COVID-19 severity suggests a genetic component to host infection response

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Alexandre R Vieira ◽  
Keyword(s):  
Familial Aggregation ◽  
Severe Disease ◽  
Case Series ◽  
Genetic Component ◽  
Mild Disease ◽  
Individual Host ◽  
Disease Pattern ◽  
Infection Response ◽  
Severity Of The Disease ◽  
Host Infection

Familial aggregation of COVID-19 cases suggest transmission occurs by contact but can also be evidence of a genetic component to the disease presentation. The goal of this work was to evaluate the disease pattern in families that many individuals have been affected by the disease. A case series analysis of six families that had many individuals affected by COVID-19 and the pattern of the severity of the disease is reported. Families were from two densely populated cities in Brazil. Participants included family members of six unrelated families, with some individuals that showed signs of COVID-19. The exposure was SARS-CoV-2 in the same household. The main outcomes and measures were disease affection and severity, including mortality. From the six families, two had mild cases only, whereas the other four families showed severe disease and death in the same sibship. The two families that had mild disease could be followed for six months and one showed reinfection after six months. This cases series suggest that disease severity aggregates in families, which suggests a genetic component for individual host response to SARS-CoV-2 infection.

scholarly journals Dynamic alterations in monocyte numbers, subset frequencies and activation markers in acute and convalescent COVID-19 individuals

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Anuradha Rajamanickam ◽  
Nathella Pavan Kumar ◽  
Arul Nancy Pandiarajan ◽  
Nandhini Selvaraj ◽  
Saravanan Munisankar ◽  
...  
Keyword(s):  
Plasma Levels ◽  
Severe Disease ◽  
Rt Pcr ◽  
Activation Markers ◽  
Mild Disease ◽  
Comprehensive Examination ◽  
The Absolute ◽  
And Function ◽  
Classical Monocytes ◽  
Activation Status

AbstractMonocytes are thought to play an important role in host defence and pathogenesis of COVID-19. However, a comprehensive examination of monocyte numbers and function has not been performed longitudinally in acute and convalescent COVID-19. We examined the absolute counts of monocytes, the frequency of monocyte subsets, the plasma levels of monocyte activation markers using flowcytometry and ELISA in seven groups of COVID-19 individuals, classified based on days since RT-PCR confirmation of SARS-CoV2 infection. Our data shows that the absolute counts of total monocytes and the frequencies of intermediate and non-classical monocytes increases from Days 15–30 to Days 61–90 and plateau thereafter. In contrast, the frequency of classical monocytes decreases from Days 15–30 till Days 121–150. The plasma levels of sCD14, CRP, sCD163 and sTissue Factor (sTF)—all decrease from Days 15–30 till Days 151–180. COVID-19 patients with severe disease exhibit higher levels of monocyte counts and higher frequencies of classical monocytes and lower frequencies of intermediate and non-classical monocytes and elevated plasma levels of sCD14, CRP, sCD163 and sTF in comparison with mild disease. Thus, our study provides evidence of dynamic alterations in monocyte counts, subset frequencies and activation status in acute and convalescent COVID-19 individuals.

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