Torque Teno Virus in Nasopharyngeal Aspirate of Children With Respiratory Infections

Torque teno virus (TTV) is responsible for persistent infections and is considered a marker of immune function. The role of TTV as a facilitator of respiratory infections(RIs) is unknown. We aimed to estimate the prevalence of TTV in the nasopharyngeal aspirate (NPA) of hospitalized children with RIs and correlate them with outcomes and immune response. NPA was taken for testing 16 respiratory viruses by RT-polymerase chain reaction (PCR), TTV PCR, and immunological study.Sixty hospitalized children with an RI and 3 healthy control infants were included. A total of 51/60 patients had a positive common respiratory viral (CRV) identification. A total of 24/63 (38.1%) children were TTV+ and had other CRVs in 95.8% of cases vs 74.4% in TTV- (p=0.029). TTV+ patients tended to be older, have fever, and need PICU admission more often than TTV- patients. Abnormal chest X-ray was more frequent in the TTV+ patients, OR 2.6(95% CI:1.3-5.2).The genetic expression of filaggrin (involved in epithelial barrier integrity) was lower in TTV+ patients; however, levels of filaggrin in the NPA were increased.In summary, TTV infection is common in children with RI and could be associated with pneumonia, greater severity, and alteration in filaggrin gene expression and protein release.

Chest Radiography: A Review of 5 Year Findings in Peripheral Facilities in Jos, North -Central Nigeria

X-ray is a noninvasive imaging tool that utilizes a small dose of ionizing radiation to produce the image of the internal structure of the body which helps physicians diagnose and treat medical conditions. Chest x-ray is the most commonly performed diagnostic x-ray examination and carried out for a broad content of indications, including but not limited to cardiopulmonary diseases, follow up of known disease to assess progress and evaluation of symptoms that could relate to abdominopelvic pathology. Materials and Methods: A five (5) year retrospective review of the archive of chest radiographs referred from peripheral facilities in Jos between January, 2015 to December, 2020. The results were expressed as percentages and tests of significance were done using the chi-square. A P-value of < 0.05 was considered statistically significant. Findings: The study included 1039 (41.2%) females and 1482 (58.8%) male giving a male to female ratio of 1:1.4 with a mean age of 40.03± 20.38 years. Chest x-ray was normal in 68.9% of the subjects while 783 (31.1%) patients showed various abnormal findings. The common abnormal chest findings were chest infection(20.1%) and hypertensive heart disease (5.3%).Other findings include heart failure (1.5%), hypertension(1.5%),pleural effusion(1.0%) and pulmonary tuberculosis (0.6%).The least findings were lung metastasis and rib fracture following road traffic accidents constituting 0.1% each. The age groups 40-49 years and 50-59 years had the majority of the abnormal chest findings while age groups 10-19 years and 20-29 years had normal findings. This was statistically significant( p<0.005).

Clinical Characteristics of COVID-19 Infection

The typical clinical symptoms of the patients who suffered from the novel viral pneumonia were fever, cough, and myalgia or fatigue with abnormal chest CT, and the less common symptoms were sputum production, headache, hemoptysis, and diarrhea. This new infectious agent is more likely to affect older males to cause severe respiratory diseases. Major risk factors for severe illness and mortality from COVID-19 are age, comorbidities such as: heart disease, hypertension, prior stroke, diabetes, chronic lung disease, and chronic kidney disease and associated with adverse outcomes. Loss of taste and smell preceding the onset of respiratory symptoms has been reported.

Tuberculosis in Children in a Pediatric Hospital in Mexico

Tuberculosis (TB) remains a global problem and a diagnostic challenge, especially in pediatrics. The aim of this study was to describe the clinical, microbiological, radiological, and histopathological data of TB in children. A 7-year retrospective and descriptive cohort study that included 127 patients under 18 years of age with diagnosis of active TB was conducted from 2011 to 2018 in a pediatric hospital. Tuberculosis was microbiologically confirmed using Ziehl–Neelsen (ZN) staining, culture or polymerase chain reaction (PCR) in a total of 94 (74%) cases. Thirty-three cases were defined as probable TB based on tuberculin skin test result and epidemiological evaluation. The TB forms found were lymph node (39.3%), bone (15.7%), lung (13.6%), and meningeal TB (8.6%). The most common symptoms were fever (48.8%) and adenopathy (45.6%). History of contact was established in 34.6%. Positive ZN staining (sensitivity 30%) and culture (sensitivity 37%) were found in 29% and 37.7% of subjects, respectively. About 64.5% depicted abnormal chest X-ray. Xpert MTB/RIF® (PCR) was positive in 9.4% and biopsy was compatible in 52.7% of these samples. It is fundamental to have laboratory and epidemiological evaluation that support the diagnosis of the disease in children and thus, define its management; since, in most cases, early microbiologic confirmation is lacking.

Chinese experience in the management and control of COVID-19 epidemic

In December 2019, a new epidemic of coronavirus disease appeared (COVID–19), caused by SARS-CoV-2 (formerly 2019-nCoV). The first reported disease cases occurred in Wuhan, Hubei province, resulting in the third zoonotic event related to lethal human coronavirus. Initially, the incubation period is 1-14 days (mean 5-6 days) in most cases but can be as long as 24 days1,2. The most commonly seen characteristics of COVID-19 are fever, cough, tiredness, and abnormal chest computed tomography3,4. So far, bat is thought to be the origin of SARS-CoV-2, based on sequence homology of 96% between SARS-CoV-2 and Bat-CoV-RaTG135,6,7, but more impartial scientific investigations on the origin-tracing of the virus are required to elucidate the issue. Human-to-human transmission of SARS-CoV-2 occurs mainly via respiratory droplets1, direct contact1, asymptomatic transmission8,9 , and intrafamilial transmission3,4. At present, there are over 206 million cases of COVID-19 worldwide, with a 4.35 million death toll10. As of 12 August 2021, China had confirmed 94,260 cases with 4636 deaths (mortality rate 5%), and 87,740 recovered cases (93%)11. Other countries, even though they had much more time to prepare for the arrival of the virus, delayed their response and that meant lost control12. While the world is struggling to control COVID-19, China has been a good example of how to control the epidemic, and has shared information with other countries on the management and prevention of the disease. How was that possible?

SARS-CoV-2 immunity and functional recovery of COVID-19 patients 1-year after infection

The long-term immunity and functional recovery after SARS-CoV-2 infection have implications in preventive measures and patient quality of life. Here we analyzed a prospective cohort of 121 recovered COVID-19 patients from Xiangyang, China at 1-year after diagnosis. Among them, chemiluminescence immunoassay-based screening showed 99% (95% CI, 98–100%) seroprevalence 10–12 months after infection, comparing to 0.8% (95% CI, 0.7–0.9%) in the general population. Total anti-receptor-binding domain (RBD) antibodies remained stable since discharge, while anti-RBD IgG and neutralization levels decreased over time. A predictive model estimates 17% (95% CI, 11–24%) and 87% (95% CI, 80–92%) participants were still 50% protected against detectable and severe re-infection of WT SARS-CoV-2, respectively, while neutralization levels against B.1.1.7 and B.1.351 variants were significantly reduced. All non-severe patients showed normal chest CT and 21% reported COVID-19-related symptoms. In contrast, 53% severe patients had abnormal chest CT, decreased pulmonary function or cardiac involvement and 79% were still symptomatic. Our findings suggest long-lasting immune protection after SARS-CoV-2 infection, while also highlight the risk of immune evasive variants and long-term consequences for COVID-19 survivors.

Data Augmentation using Auxiliary Classifier for Improved Detection of Covid 19

COVID-19 is a severe and potentially fatal respiratory infection called coronavirus 2 disease (SARS-Co-2). COVID-19 is easily detectable on an abnormal chest x-ray. Numerous extensive studies have been conducted due to the findings, demonstrating how precise the detection of coronas using X-rays within the chest is. To train a deep learning network, such as a convolutional neural network, a large amount of data is required. Due to the recent end of the pandemic, it is difficult to collect many Covid x-ray images in a short period. The purpose of this study is to demonstrate how X-ray imaging (CXR) is created using the Covid CNN model-based convolutional network. Additionally, we demonstrate that the performance of CNNs and various COVID-19 acquisition algorithms can be used to generate synthetic images from data extensions. Alone, with CNN distribution, an accuracy of 85 percent was achieved. The accuracy has been increased to 95% by adding artificial images generated from data. We anticipate that this approach will expedite the discovery of COVID-19 and result in radiological solid programs. We leverage transfer learning in this paper to reduce time complexity and achieve the highest accuracy.

The Relationship of Chest X-Ray in COVID-19 Patients and Disease Severity in Arifin Achmad General Hospital Riau

Introduction: Coronavirus Disease 2019 (COVID-19) pandemic is caused by SARS-CoV-2 which spreads rapidly throughout the world and causes clinical manifestations in various organs, especially in the lungs. Clinical symptoms arise from asymptomatic, mild, moderate, severe, and critical symptoms in patients with or without comorbid disease. Chest X-ray examination is one of the modalities in the management of COVID-19 which is cheap and easy to do.Methods: This study was performed by analyzing medical record data of confirmed COVID-19 patients from March to December 2020. This study aimed to examine the relationship between chest X-ray and the degree of disease severity.Results: The results showed that from the examined 542 total samples, the highest number was found in the age group of 40-49 years old (23.6%), women (53%), mild degree of COVID-19 (67.9%), normal chest X-ray (54.6%), predominance on the lower zone of the lung, peripheral and bilateral on abnormal chest X-ray, no comorbid (56.3%), hypertensive in comorbid disease (26.6%). There was a significant relationship between chest X-ray and comorbidity towards COVID-19 severity (p = 0.000).Conclusion:Chest X-ray can determine disease severity, therefore it can be used as the first modality for triage and treatment evaluation in COVID-19 patients.

Is It Feasible to Conduct Post-Tuberculosis Assessments at the End of Tuberculosis Treatment under Routine Programmatic Conditions in China?

There is growing evidence that a substantial proportion of people who complete anti-tuberculosis treatment experience significant morbidity and mortality which can negatively affect their quality of life. It is suggested that national tuberculosis programs conduct end-of-treatment assessments, but whether this is feasible is currently not known. We therefore assessed whether tuberculosis program staff could assess functional and general health status of patients at the end of treatment in five TB clinics in four provinces in China. There were 115 patients, aged 14–82 years, who completed anti-tuberculosis treatment and a post-TB assessment. There were 54 (47%) patients who continued to have symptoms, the commonest being cough, dyspnea and fatigue. Symptom continuation was significantly more common in the 22 patients with diabetes (p = 0.027) and the 12 patients previously treated for TB (p = 0.008). There were 12 (10%) current smokers, an abnormal chest X-ray was found in 106 (92%) patients and distance walked in the 6-min walking test (6MWT) ranged from 30–750 m (mean 452 ± 120); 24 (21%) patients walked less than 400 m. Time taken to perform the post-TB assessment, including the 6MWT, ranged from 8–45 min (mean 21 ± 8 min). In 98% of the completed questionnaires, health workers stated that conducting post-TB assessments was feasible and useful. This study shows that post-TB assessments can be conducted under routine programmatic conditions and that there is significant morbidity that needs to be addressed.