360. Evaluation of Cycle Threshold Values in Patients with Symptomatic COVID-19 Infection

Background One of the tests used to identify COVID-19 infections is the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcriptase quantitative polymerase chain reaction (RT-qPCR) test. There is a measure known as the cycle threshold (Ct) value, which provides an indirect measure of viral load. It has been proposed that the Ct value could help with clinical decisions regarding duration of isolation. We hypothesize that Ct values will correlate with symptom duration in a population of veterans with COVID-19 infection. Methods We reviewed the records of patients presenting to the emergency department (ED) or admitted to Audie L. Murphy VA Medical Center in San Antonio, Texas with positive SARS-CoV-2 PCR tests. We looked at patients who received multiple SARS-CoV-2 RT-qPCR tests. We compared date of onset of symptoms and cycle threshold values from their initial test to another test ordered after 7, 10, and 20 days from symptom onset. We recorded the Ct value for the N2 and E genes. Patients were classified into mild, severe and critical based on Center for Disease Control and Prevention (CDC) criteria. A Ct value of >30 as threshold for transmissible disease was used based on previously published studies. Results We identified 49 patients with more than two SARS-CoV-2 RT-qPCR tests. Patients with mild disease with tests less than or equal to ten days from symptom onset (n=10) had a mean Ct value 23.2 (±5.6) and 26.0 (±5.8) for the E and N2 genes. Patients with mild disease with tests greater than ten days from symptom onset (n=4) had mean Ct values of 26.0 (±6.5) and 27.8 (±6.8). When we stratified the patient population by disease severity, patients with severe and critical disease with tests less than ten days from symptom onset (n=24) had mean Ct values of 20.1 (±7.3) and 23.4 (±7.5). Patients with severe and critical disease greater than twenty days (n=6) had Ct values of 29.0 (±5.1) and 31.1 (±5.4). Conclusion We found that Ct values increased with longer symptom duration. We currently use the CDC criteria to discontinue isolation at ten days for mild disease and twenty days for severe and critical disease. The findings of this study suggest that our current practice for duration of isolation correlates with increasing Ct values near or above the threshold for transmissible disease. Disclosures All Authors: No reported disclosures

Acute kidney injury associated with COVID-19 infection: a case report

SARS-Cov2 infection is a highly transmissible disease associated with serious pulmonary disease. Renal involvement is frequent and associated with poor prognosis; however, mechanisms of kidney injury are not well established. We present a SARS-Cov2 patient with severe acute kidney injury. Kidney biopsy findings revealed a pattern of acute tubular necrosis with isometric vacuolization of the proximal tubule. The interstitium and glomeruli were normal. Electronic microscopy showed multiple viral-like particles in both the glomeruli and proximal tubule. This case study shows how SARS-Cov 2 infection can result in different kinds of kidney lesion.

Anti-Inflammatory Activity of Flavonoids: Potential Role against COVID-19

The Coronavirus Disease (COVID-19), caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), has spread all over the globe and emerged as one of the most threatening transmissible disease. The infection can cause an acute respiratory distress syndrome associated with a systemic immune response and inflammation. Up to now, there is no specific drugs available for its treatment. Flavonoids are important natural polyphenolic compounds widely distributed in the plant kingdom. It has been demonstrated the potential role of these metabolites in the modulation of signaling pathways particularly those related to inflammation and immunity. This review focuses on the anti-inflammatory activity of flavonoids and their effectiveness as possible therapeutic options to fight SARS-COV-2 infection.

Novel Coronavirus (2019-nCoV) pandemic: How Far or How Close is the Solution?

Novel coronavirus (2019-nCoV) is a transmissible disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease was first identified in December 2019 in the capital of China's Hubei province, Wuhan. It has spread globally, resulting in the ongoing 2019-20 coronavirus pandemic. The 2019-nCoV pandemic has evolved into a global health calamity bothering almost every country and territory in the world. Various countries are in different stages of the 2019-nCoV contagion. The virus has a positive-sense single-stranded RNA genome and a nucleocapsid of helical symmetry. The genome size (27 to 34 kb) of coronaviruses is the largest among all known RNA viruses. On January 22, 2020, 2019-nCoV has been proclaimed to be originated from wild bats and belonged to beta coronavirus that has Severe Acute Respiratory Syndrome Associated Coronavirus (SARS-CoV). This pandemic has taken a heavy toll in terms of loss in human life and the global economy. A few vaccines and medicines have been developed to combat the deadly pandemic to some extent. So far, medicines such as Remdesivir, Sofosbuvir, Lopinavir, and Ribavirin have been proposed as a possible remedy for novel coronavirus. Similarly, several combination drugs available in homeopathy, allopathy, and Ayurveda (herbal formulations) have been advocated either as immune booster or medicament against coronavirus. However, a permanent solution to this pandemic seems distant due to the re-occurrence of incidence and the ever-changing behavior of the virus and symptoms caused throughout the world.

Aplikasi System Repository Green Aceh untuk Menentukan Ramuan Obat Tradisional pada Penyakit Infeksi

Sistem Repository Green Aceh merupakan sistem informasi untuk menentukan jenis tumbuhan menjadi ramuan obat tradisional yang ada di aceh untuk pengobatan penyakit infeksi atau dikenal sebagai communicable disease atau transmissible disease yaitu penyakit yang nyata secara klinik mempunyai tanda-tanda atau gejala-gejala medis serta karakteristik penyakitnya. Sistem menentukan jenis tumbuhan untuk pengobatan penyakit infeksi (infectious disease) tersebut. Sistem memberikan pertanyaan berupa gejala-gejala yang harus dijawab oleh penderita, dari hasil proses tersebut sistem akan memberikan informasi penyakit apa yang dialami penderita guna mendapatkan tumbuhan apasaja yang sesuai untuk dijadikan ramuan alternative yang ada di aceh, Repository Green Aceh sangat bermanfaat untuk menyebar luaskan informasi tentang tumbuhan obat yang ada di provinsi aceh Pengembangan sistem repository ini tujuan untuk menyukseskan era industri 4.0 dan digitalisasi tumbuhan obat di aceh. Dengan sistem repository green aceh ini masyarakat bisa mendapatkan informasi mengenai tumbuhan yang bisa menjadi obat terhadap penyakit yang akan disembuhkan

Dynamic Analysis of a Population Competition Model with Disease in One Species and Group Defense in Another Species

In this paper, we study the dynamics of an ecoepidemic competition system where the individuals of one population gather together in herds with a defensive strategy, showing social behavior, while another predator population is subject to a transmissible disease and behaves individually. By analyzing the existence and stability of the equilibria of the system, we find that the relatively isolated population can be eradicated, or the population with group defense can live alone eventually under some constraints. Infected individuals end up in two possible situations. In the first case, the disease is eventually eliminated, meaning that only healthy and group-defense individuals in the system can survive. In the other case, the spread of the disease is controlled and eventually all three individuals can coexist. We also conduct a correlation analysis using competition parameter and recovery rate of disease as birfurcation parameters in order to study the transcritical bifurcation, saddle-node bifurcation and Hopf bifurcation. The long-term dynamics of the boundary and interior equilibria are demonstrated by numerical simulations.

Long Term Complications Associated with Covid-19 : A Review

The covid-19 has spread rapidly throughout the china and globally. This highly transmissible disease till date has infected around 17 million people worldwide. The infection spreads through the sputum or the droplets generated by the infected person by sneezing, coughing or talking. The droplets can settle down on the surfaces and floors or can remain in air where the viability of the virus varies from few minutes to several days. People can also get infected on coming in close proximity of the infected person. The patients experience mild to high fever, sore throat, headache, myalgia, tastelessness and shortness of breath along with pneumonia like symptoms in serious cases. A large number of asymptomatic cases were also reported making the detection difficult in early stages. The recovery rate as of now has reached to 78%, and fatality rates are low, still people are prone to various other long term symptoms after recovery which is a matter of concern. The researchers and scientists have found prominent effect on nervous system and other vital functions of the body, this article gives a brief review of such complications.

Hypoglycemic effect of p-hydroxycinnamic diesters extracted from carnauba wax powder (Copernicia Prunifera) in alloxan-induced diabetic animals

Diabetes is a chronic non-transmissible disease and the number of cases is increasing every year. Plants appear as an alternative therapy since ancient civilizations. Among the species that have promising pharmacological activities are carnauba (Copernicia prunifera (Miller) H. E. Moore). Carnauba wax powder consists of a mixture of heterogenic compounds, among them, p-hydroxycinnamic diesters (HCA). Therefore, this study aimed to investigate the hypoglycemic effect of HCA in alloxan-induced diabetic animals. Therefore, this study was performed with 50 female Swiss mice, distributed in 5 groups (n = 10). The animals of the negative and positive control groups were treated with water: healthy and diabetic mice, respectively; animals of the HCA groups 25 and 50 were diabetic animals and they were treated with the HCA solution at doses of 25 and 50 mg / Kg, respectively; and with metformin, standard drug, at the dose of 200 mg / kg. After 28 days of HCA treatment, a significant hypoglycemic effect was observed in animals treated with HCA at the lowest dose tested (25 mg / kg). In the present study, HCA shown to be a promising compound with good scientific applicability due to the reduction of glycemia of diabetic animals induced by alloxan.