Anterior ischemic optic neuropathy as a rare manifestation of COVID-19: a case report

Aim: A variety of manifestations in different organs could be associated with severe COVID-19; for example, ocular manifestations. Case report: A 52-year-old male complaining of sudden onset unilateral painless vision loss in the right eye for 1 month (started just 1 week after COVID-19 remission) came to the ophthalmology clinic. On further evaluations, he was diagnosed with anterior ischemic optic neuropathy (AION). Considering his past history and the result of evaluations, the hypothesis of association between AION and COVID-19 was proposed. Results & discussion: Ocular and neurologic manifestations of COVID-19 are more likely to happen in patients with more severe conditions. Complications occur secondary to two basic mechanisms including severe inflammatory response and hypercoagulable state. Conclusion: Our findings indicated that non-arteritic AION is another manifestation of microangiopathic/thrombotic events which may occur in the course of COVID-19.

The virome of bronchoalveolar lavage fluid from patients with fever of unknown origin

Background: Viral metagenomics, a high-throughput sequencing combined with virus sequence-independent amplification by random PCR, allows for unbiased detection of virtually any viruses present in samples. Materials & methods: In order to investigate the virome of bronchoalveolar lavage fluid from patients with fever of unknown origin, 58 samples collected from diseased patients were characterized and compared. Results: Some representatives of Anelloviridae were identified, we found the torque teno virus (TTV) accounts for the majority of virus communities and were more prevalent in the specimens of febrile patients. Phylogenetic analysis suggested that these anellovirus isolates were close to the previous TTV available in GenBank®. Conclusion: All these data indicate that the human anellovirus species TTV may associated with fever of unknown origin.

Real-world evidence of sofosbuvir/velpatasvir as an effective and simple hepatitis C virus treatment and elimination tool in homeless populations

Background: People experiencing homelessness are disproportionately affected by hepatitis C virus (HCV) and can face specific barriers to care. Simple treatment algorithms could increase linkage to care in this population. Methods: This retrospective real-world analysis pooling data from 15 clinical cohorts evaluated effectiveness of a once-daily sofosbuvir/velpatasvir (SOF/VEL) regimen in HCV-infected people experiencing homelessness. The primary outcome was sustained virological response (SVR) in the effectiveness population (patients with confirmed SVR status). Secondary outcomes included reasons for not achieving SVR, adherence and time between diagnosis and SOF/VEL treatment start. Results: Of 153 patients treated with SOF/VEL for 12 weeks without ribavirin, SVR was 100% in the effectiveness population (n = 122), irrespective of various baseline factors including active injecting drug use and presence of mental health disorders. Conclusion: HCV-infected people experiencing homelessness can successfully be treated with SOF/VEL. SOF/VEL enables implementation of simple treatment algorithms and can support test-and-treat strategies through rapid treatment starts and minimal monitoring.

A systematic review and meta-analysis of the sensitivity of antibody tests for the laboratory confirmation of COVID-19

Aim: The aim of this study was to investigate the utility of serological tests for the diagnosis of COVID-19 during the first week of symptom onset in patients confirmed with the real-time RT-PCR. Materials & methods: A systematic review and meta-analysis of 58 publications were performed using data obtained from Academic Search Ultimate, Africa-wide, Scopus, Web of Science and MEDLINE. Results: We found that the highest pooled sensitivities were obtained with ELISA IgM-IgG and chemiluminescence immunoassay IgM tests. Conclusion: Serological tests have low sensitivity within the first week of symptom onset and cannot replace nucleic acid amplification tests. However, serological assays can be used to support nucleic acid amplification tests.

The seroepidemiology and risk factors of West Nile virus infection in blood donors of Fars province, southwest of Iran

Aim: To evaluate the frequency of West Nile virus (WNV) in blood donors of the blood transfusion center of Fars province, Iran. Materials & methods: A total of 337 participants referred for blood donation to Fars blood centers were included. The presence of anti-WNV antibodies was analyzed using the WNV IgG ELISA kit. Results: Out of all participants, 76 (22.6%) were positive for anti-WNV IgG antibodies. Our results also showed that the frequency of WNV was associated with the age, educational level, job and city of residency of participants (p < 0.05). Conclusion: The results indicated the high frequency of WNV seropositivity among blood donors in southwest Iran. Accordingly, there is an urgent need to establish an integrated surveillance system for monitoring WNV infection in Iran.

Performance of six SARS-CoV-2 RNA detection systems in symptomatic and asymptomatic pediatric and maternal patients

Aim: This study evaluated the real-world performance of six test systems for detection of SARS-CoV-2 in 138 pediatric and 110 adult maternal patients. Materials & methods: Nasopharyngeal swabs were tested directly using the Aptima™ SARS-CoV-2 (Aptima) and Simplexa™ COVID-19 Direct (Simplexa), and with Altona RealStar® RT-PCR and CDC RT-PCR with nucleic acid extracted on the Roche® MagNA Pure 96 (Altona-MP96) or bioMérieux EMAG® (Altona-EMAG). Results/Conclusion: Overall percent-positive and percent-negative agreements among the six test systems were, respectively: Aptima: 94.8 and 100%; Altona-MP96: 96.5 and 99.3%; CDC-MP96: 100 and 99.3%; Altona-EMAG: 86.1 and 100%; CDC-EMAG: 98.2 and 100%; Simplexa: 87 and 99.2%. The six test systems showed agreement ranging from 92.7 (κ = 0.85) to 98.8% (κ = 0.98).

Myocarditis and COVID-19 mRNA vaccines: a mechanistic hypothesis involving dsRNA

While tolerance to COVID-19 vaccination is considered satisfactory, a phenomenon of myocarditis, although rare, is becoming a safety concern in mRNA COVID-19 vaccination. The presence of low residual levels of double-strand RNA (dsRNA) has been reported in mRNA COVID-19 vaccine preparations. dsRNA is a known inducer of immune-inflammatory reactions. dsRNA present in vaccine nanoparticles may be suspected to be at the origin of the still unexplained cases of myocarditis.