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Introduction This study aimed to determine the prevalence of multidrug-resistant Gram-negative bacteria (GNB) from blood cultures in a tertiary-care hospital and the multiplex PCR assay's ability to detect resistance genes. Methods A total of 388 GNB isolates obtained from hospitalized patients between November 2019 and November 2021 were included in the study. Antimicrobial susceptibility testing was done by VITEK 2 system and broth microdilution method. Beta-lactamase-encoding genes were detected by multiplex PCR assays, BioFire-Blood Culture Identification 2 (BCID2) panel (bioMerieux, France). Extended-spectrum beta-lactamases (ESBLs) were detected phenotypically with VITEK AST-GN71 card (bioMerieux, France). The isolates of GNB were classified into multidrug-resistant, extensively-drug-resistant, and pandrug-resistant categories, and their prevalence and distribution in different wards, including coronavirus diseases 2019 (COVID-19) intensive care units (ICU), were calculated. Results Results revealed that all isolates of Acinetobacter baumannii and Pseudomonas aeruginosa were multidrug-resistant as well as 91.6% of Enterobacter cloacae, 80.6% of Proteus mirabilis, and 76.1% of Klebsiella pneumoniae, respectively. In fermentative bacteria, blaOXA-48-like (58.1%), blaNDM (16.1%), blaKPC (9.7%) and blaVIM (6.5%) genes were detected. More than half of Enterobacter cloacae (58.3%) and Klebsiella pneumoniae (53.7%) produced ESBLs. Among non-fermenters, the blaNDM gene was carried by 55% of Pseudomonas aeruginosa and 19.5% of Acinetobacter baumannii. In the COVID-19 ICU, Acinetobacter baumannii was the most common isolate (86.1%). Conclusions This study revealed high proportions of multidrug-resistant blood isolates and various underlying resistance genes in Gram-negative strains. The BCID2 panel seems to be helpful for the detection of the most prevalent resistance genes of fermentative bacteria.Copyright © GERMS 2022.
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OBJECTIVE: To analyze the role of nosocomial infection informatics surveillance system in the prevention and control of multidrug-resistant organisms(MDROs) infections. METHODS: The First Affiliated Hospital of Guangdong Pharmaceutical University was selected as the study subjects, which had adopted the nosocomial infection informatics surveillance system since Jan.2020. The period of Jan.to Dec.2020 were regarded as the study period, and Jan.to Dec.2019 were regarded as the control period. The situation of nosocomial infection and MDROs infections in the two periods were retrospectively analyzed. RESULTS: The incidence of nosocomial infections and underreporting of nosocomial infection cases in this hospital during the study period were 2.52%(1 325/52 624) and 1.74%(23/1 325), respectively, and the incidences of ventilator associated pneumonia(VAP), catheter related bloodstream infection(CRBSI), catheter related urinary tract infection(CAUTI)were 4.10(31/7 568), 2.11(14/6 634), and 2.50(25/9 993) respectively, which were lower than those during the control period(P< 0.05). The positive rate of pathogenic examination in the hospital during the study period was 77.95%(1 269/1 628), which was higher than that during the control period(P<0.05), the overall detection rate of MDROs was 15.77%(206/1 306), the detection rates of MDROs in Escherichia coli, Acinetobacter baumannii, Klebsiella pneumoniae, Staphylococcus epidermidis, Pseudomonas aeruginosa and Staphylococcus aureus were lower than those during the control period(P<0.05). CONCLUSION: The development and application of the informatics technology-based surveillance system of nosocomial infection could effectively reduce the incidence of nosocomial infections and device related infections, decrease the under-reporting of infection cases, and also reduce the detection rate of MDROs as well as the proportion of MDROs detected in common pathogenic species.
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Many zoonotic diseases are found in wild animals and present a serious risk to human health, in particularly the virus carried by birds flying freely around the world is hard to control. There are three main bird migration routes which cover the most areas of China. It is important to investigate and fully understand the types of avian transmitted diseases in key areas on the bird migration routines and its impacts on both birds and human health. However, no literature is available in how about the risk of virus carried by migrating birds, and how to predict and reduce this risk of virus spreading to human being so far. In this paper, we first reviewed the main pathogen types carried by birds, including coronaviruses, influenza viruses, parasites, Newcastle disease virus (NDV), etc., and then discussed the spread risk of avian viruses to human being and animals in key areas of biosafety prevention. We also analyzed and discussed the risk of cross-spread of diseases among different bird species in nature reserves located on bird migration routes which provide sufficient food sources for migratory birds and attract numerous birds. Diseases transmitted by wild birds pose a serious threat to poultry farms, where high density of poultry may become avian influenza virus (AIV) reservoirs, cause a risk of avian influenza outbreaks. Airports are mostly built in suburban areas or remote areas with good ecological environment. There are important transit places for bird migration and densely populated areas, which have serious risk of disease transmission. Finally, this paper puts forward the following prevention suggestions from three aspects. First, establish and improve the monitoring and prediction mechanism of migratory birds, and use laser technology to prevent contact between wild birds and poultry. Second, examine and identify virus types carried by birds in their habitats and carry out vaccination. Third, protect the ecological environment of bird habitat, and keep wild birds in their natural habitat, so as to reduce the contact between wild birds and human and poultry, and thus reduce the risk of virus transmission.
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The COVID-19 pandemic has become a partisan issue rather than an independent public health issue in the US. This study examined the behavioural consequences of motivated reasoning and framing by investigating the impacts of COVID-19 news exposure and news frames, as apparent through a Latent Dirichlet topic modelling analysis of local news coverage, on state-level preventive behaviours as understood through a nationally representative survey. Findings suggested that the media effects on various preventive behaviours differed. The overall exposure rate to all COVID-19 news articles increased mask-wearing but did not significantly impact other preventive behaviours. Four news frames significantly increased avoiding contact or avoiding public or crowded places. However, news articles discussing anxiety and stay at home order triggered resistance and countereffects and led to risky behaviours. ‘Solid Republican' state residents were less likely to avoid contact, avoid public or crowded places, and wear masks. However, partisan leanings did not interfere with the impact of differing local COVID-19 news frames on reported preventive behaviours. Plus, statements regarding pre-existing trust in Trump did not correlate with reported preventive behaviour. Attention to effect sizes revealed that news exposure and news frames could have a bigger impact on health behaviours than motivated reasoning.
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Diabetes mellitus is prevalent worldwide and affects 1 in 10 adults. Despite the successful development of glucose-lowering drugs, such as glucagon-like peptide-1 (GLP-1) receptor agonists and sodium-glucose cotransporter-2 inhibitors recently, the proportion of patients achieving satisfactory glucose control has not risen as expected. The heterogeneity of diabetes determines that a one-size-fits-all strategy is not suitable for people with diabetes. Diabetes is undoubtedly more heterogeneous than the conventional subclassification, such as type 1, type 2, monogenic and gestational diabetes. The recent progress in genetics and epigenetics of diabetes has gradually unveiled the mechanisms underlying the heterogeneity of diabetes, and cluster analysis has shown promising results in the substratification of type 2 diabetes, which accounts for 95% of diabetic patients. More recently, the rapid development of sophisticated glucose monitoring and artificial intelligence technologies further enabled comprehensive consideration of the complex individual genetic and clinical information and might ultimately realize a precision diagnosis and treatment in diabetics.
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Background: The outbreak of coronavirus disease 2019 (COVID-19) was declared by the World Health Organization (WHO) as a COVID-19 pandemic on March 11, 2020. Therefore, the availability of vaccines will help develop immunity and protect people from this pandemic. The present systematic study examined knowledge, attitudes, and willingness of adolescents towards COVID-19 vaccine in Bangkok, Thailand. Objectives: The objective of the study was to evaluate the knowledge, attitudes, and willingness toward COVID-19 vaccine of key stage 4A-5 students at Satit Prasarnmit International Programme in Bangkok towards COVID-19 vaccine. Materials and Methods: The study was conducted using an online questionnaire. A total of 136 students participated. Knowledge, attitudes, and willingness of adolescents toward the COVID-19 vaccine were assessed. Differences between outcomes and socio-demographic characteristics of participants were analyzed through independent t-tests and the ANOVA. The level of willingness to vaccinate against COVID-19 was analyzed by a generalized linear model. Results: Students revealed moderate knowledge about COVID-19, correctly answering 11.08 out of 15 points (SD = 1.74), a low level of attitudes toward COVID-19 vaccine 8.49 out of 15 points (SD = 2.51), and low level of willingness to vaccinate against COVID-19 vaccine 2.29 out of 5 points (SD = 1.26), in total of 35 points (28 questions). There are statistically significant positive correlations shown between attitude towards COVID-19 vaccine and the level of willingness to vaccinate against COVID-19 vaccine (I2 = 0.384, P < 0.01%). Conclusion: This study revealed students in Satit Prasarnmit International Programme had moderate knowledge towards COVID-19, negative attitudes toward COVID-19 vaccine and low willingness to vaccinate against COVID-19. Furthermore, it indicates that there is a casual relationship between attitudes toward COVID-19 vaccine and the willingness of individuals to be vaccinated against COVID-19 vaccine. Thus, attitude toward COVID-19 vaccine acts as a major predictive factor toward the willingness to vaccinate against COVID-19 vaccine. Therefore, to increase peopleA's willingness to be vaccinated against COVID-19 vaccine, it is necessary to increase peopleA's attitude toward COVID-19 vaccine.
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Background: Coronavirus disease 2019 (COVID-19) has affected all aspects of life globally and becomes a major threat to public health around the world. One of the most important actions that need to be taken to stop the pandemic is vaccinations. Managing the COVID-19 pandemic in the long-term, vaccine hesitancy and negative attitudes toward vaccines are major barriers. Objectives: This study aimed to investigate undergraduate students' knowledge, risk perceptions, and attitudes toward COVID-19 vaccinations among undergraduate students in Chiang Mai University, Thailand. Materials and Methods: The study was conducted using a questionnaire. A total of 280 students participated. COVID-19 related knowledge, risk perception, and attitude toward COVID-19 vaccines were assessed. Statistical test using SPSS statistics to analyze differences between intention to be vaccinated and socio-demographic was done using exact P-value, Pearson's Chi-square test, and Binary Logistic Regression. Results: Students revealed a moderate level of COVID-19 related knowledge. A moderate level of risk perception of getting COVID-19 has the highest number of students who want to get vaccinated (n = 76, 51.0%). Intention to get vaccinated was 53% (n = 148). The analysis of a binary logistic regression indicated that the monthly household income of students had a statistically significant effect on the intention to get vaccinated. Level of monthly household income predicted the deposition of intention to get vaccinated of students (Exp [B] = 0.773, P < 0.001). Most students had no intention to be vaccinated against COVID-19 due to concerns on side effects and efficacy of the current availability of COVID-19 vaccine in Thailand. Therefore, to increase more acceptance of COVID-19 vaccination among students, more choices of COVID-19 vaccine with high efficacy should be provided. Conclusion: Government should take firm and faster action for the unavailability of vaccines in Thailand to decrease vaccine hesitancy rate and give Thai citizens more choices of vaccine brands with higher levels of vaccine efficacy. Side effects from vaccines are one of the reasons for increase in vaccine hesitancy. Therefore, if Thai people can choose a higher efficacy vaccine, the news about vaccine side effects will be lower. Government should start educating and letting people know about side effects and whether the side effects are life threatening or not.
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Renal patients are particularly vulnerable to infection in part because they are relatively, or significantly, immunocompromised, undergo numerous invasive procedures and typically have frequent contact with healthcare institutions putting them at much higher risk of nosocomial infections. In addition, they are typically exposed to multiple antibiotics, which may select out resistant organisms or damage protective microbiomes. The Covid-19 pandemic has brought the life and death importance of infection control to every renal unit and forced a, perhaps overdue, appreciation of the issues and responsibilities associated with nosocomial infections. In addition, our patients are disproportionately impacted by the growing emergence of antimicrobial resistance. This chapter reviews the key aspects of nosocomial infections in renal patients and the important elements of infection control and antibiotic stewardship that can protect our patients. © Springer Nature Switzerland AG 2014, 2022.
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Este artigo aborda conflitos socioambientais decorrentes da construção de complexos portuários no estado do Pará a partir de três parâmetros de análise: ameaças às comunidades tradicionais, agentes envolvidos e formas de resistências daquelas comunidades. Em função da pandemia do novo coronavírus (SARS-COV-2), os procedimentos metodológicos foram redefinidos, utilizando-se da técnica de Revisão Sistemática de Literatura (RSL) agregada à pesquisa documental, observação in loco e entrevistas realizadas na comunidade de Guajará de Beja, município de Abaetetuba, um dos lócus da pesquisa. Da aplicação do Protocolo de Pesquisa (PP) da RSL resultaram dez estudos selecionados, os quais, após análise agregada aos demais procedimentos metodológicos, indicaram que as disputas por recursos naturais/locacionais, em especial para instalação de complexos portuários no estado do Pará, têm produzido conflitos socioambientais entre agentes econômicos, agentes públicos e comunidades tradicionais na Amazônia paraense.Alternate :This article addresses socio-environmental conflicts arising from the construction of port complexes in the state of Pará from 03 (communities) parameters of analysis - threats to traditional communities, agents involved and forms of complex resistance. Due to the new coronavirus (SARS-COV-2) pandemic, the methodological procedures were redefined, using the Systematic Literature Review (RSL) technique combined with documentary research, on-site observation and interviews carried out in the community of Guajará de research Beja, municipality of Abaetetuba, one of the locus of the research. The application of the RSL Research Protocol/PP resulted in 10 (ten) selected studies which, after being added to the other methodological procedures, indicating that as natural/locational resources, especially for the analysis of port complexes in the state of Pará, companies socio-environmental producers between local agents for audiences and traditional communities in the Amazon.
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Background: Coronavirus disease 2019 (COVID-19) is an epidemic that has greatly affected the daily life of people around the world. This epidemic, in addition to affecting lives, also affects other matters such as the economy or government administration that need to find ways to reduce the epidemic rate. That is to provide adequate quality vaccines for the people of the country. Finally, the government finds measures to stop the spread of COVID-19. Objectives: This study aimed to assess an acceptance to be vaccinated against COVID-19. Materials and Methods: Intention to be vaccinated against COVID-19 was measured with a question A"When a vaccine for COVID-19 is ready for you, will you get vaccinated?A" Response options were A"yes, A" A"not sureA" and A"no.A" Participants who responded A"not sureA" or A"noA" were asked to provide a reason. Results: A total of 400 responses were received. Overall, 38.5% (n = 154) of participants intended to get vaccinated, 29.5% (n = 117) were unsure, and 32.25% (n = 129) were not planning to get vaccinated. Factors that are independently related to vaccine hesitancy (A"not sureA" or A"yesA" response) include being male, risk perception of getting COVID-19, confidence in the government in handling the pandemic. Conclusion: A total of 400 participants, in the study, 38.5% (n = 154) of participants intended to get vaccinated, 29.5% (n = 117) were unsure, and 32.25% (n = 129) were not planning to get vaccinated. Male participants had a higher chance to refuse to vaccinate more than female 2.69 times. Predictive factors for COVID-19 vaccination were risk perception of contracting COVID-19 and lack of confidence in the government handling the pandemic of COVID-19.
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Background: Since patients admitted to the intensive care unit have a compromised im-mune system and are more prone to infection than other patients, timely diagnosis and treatment of corneal ulcers among this group of patients can prevent vision loss. Therefore, it is necessary to treat eye infections and corneal ulcers promptly and economize prohibitive costs. Objective(s): Appropriate treatment with the most effective antibiotic before the answer is available to prevent corneal ulcer complications and blindness. Method(s): This study was conducted from November 2019 to November 2020 and after approval by the ethics committee of Hamedan University of Medical Sciences with the code of ethics: IR.UMSHA.REC.1398.716. First, the corneal secretions of 121 patients admitted to the intensive care unit of Sina Hospital are prepared by an ophthalmologist (after anesthetizing the cornea with tetra-caine drops and sterile swabs) and culture in four growth mediums (blood agar, chocolate agar, thio-glycolate, and EMB). Microbial cultures are examined after 48 hours and a fungal culture is examined one week later. Disc diffusions are placed in positive microbial cultures. Antibiotic susceptibility or resistance of the antibiogram was recorded. Other demographic data, including patients' age and sex, are extracted from ICU files. Also, test results and patient identifications are recorded in a checklist designed for this purpose. Result(s): Of all the antibiotics used against common bacteria, vancomycin (84%), colistin (80.43%), cefazolin (80%), and levofloxacin (60%) had the highest sensitivity and gentamicin (93.75%), ceftazidime (86.42%) Erythromycin (85%) had the highest resistance against isolated bacteria. Conclusion(s): The data obtained from this study showed that the most common microorganisms in the age group under the age of 30 years were Acinetobacter Baumannii, in the group of 30-60 years old was Klebsiella pneumonia, and age group over 61 years old was Staphylococcus aureus, and the most sensitive antibiotics in the age group under 30 years were vancomycin and levofloxacin and the age group30-60 were colistin and vancomycin and in the age group over 61 years were vancomycin and cefazolin.Copyright © 2023 Bentham Science Publishers.
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In 2020, anti-Asian racism re-emerged during the coronavirus pandemic in Germany and elsewhere, manifesting in media narratives, and evoking different forms of violence and exclusion, especially in public space. Racialisation as an everyday process creates "counter-frames” by racialised groups. They are constructed in relation to institutionalised interpellation as "the other.” Building on Feagin's concept of "white framing” and "counter-framing” and Löw's concept of space, this paper discusses the effects of racialisation, coping and anti-racist resistance strategies as developed by the Asian diaspora. Social change regarding racism will be analysed through Foroutan's concept of "postmigrant society.” We based this study on a convenience sample of people with Asian heritage which we conducted in 2020 in Germany. In addition, we included a diary study for which a subset has been sampled. We argue that the pandemic influenced the formation of counter-frames against anti-Asian racism in the specific context of Berlin. © The Author(s) 2023.
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Background/Objectives: Corticosteroids are widely used for the treatment of coronavirus disease (COVID)-19 caused by SARS-CoV- 2 as they attenuate the immune response with their antiinflammatory properties. Genetic polymorphisms of glucocorticoid receptor, metabolizing enzymes or transporters may affect treatment response to dexamethasone. The aim of this study was to evaluate the association of polymorphisms in glucocorticoid pathway with disease severity and duration of dexamethasone treatment in COVID-19 patients. Method(s): Our study included 107 hospitalized COVID-19 patients treated with dexamethasone. We isolated DNA from peripheral blood and genotyped all samples for polymorphisms in NR3C1 (rs6198, rs33388), CYP3A4 (rs35599367), CYP3A5 (rs776746), GSTP1 (rs1695, rs1138272), GSTM1/GSTT1 deletions and ABCB1 (1045642, rs1128503, rs2032582 Fisher's and Mann- Whitney tests were used in statistical analysis. Result(s): The median (min-max) age of the included patients was 62 (26-85) years, 69.2 % were male and 30.8 % female and they had moderate (1.9 %), severe (83 %) or critical (15.1 %) disease. NR3C1 rs6198 polymorphism was associated with more severe disease in additive genetic model (P = 0.022). NR3C1 rs6198, ABCB1 rs1045642 and ABCB1 rs1128503 polymorphisms were associated with a shorter duration of dexamethasone treatment in additive (P = 0.048, P = 0.047 and P = 0.024, respectively) and dominant genetic models (P = 0.015, P = 0.048 and P = 0.020, respectively), while carriers of the polymorphic CYP3A4 rs35599367 allele required longer treatment with dexamethasone (P = 0.033). Other polymorphisms were not associated with disease severity or dexamethasone treatment duration. Conclusion(s): Genetic variability of glucocorticoid pathway genes was associated with the duration of dexamethasone treatment of COVID-19 patients.
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The respiratory pump that provides pulmonary ventilation includes the respiratory center, peripheral nervous system, chest and respiratory muscles. The aim of this study was to evaluate the activity of the respiratory center and the respiratory muscles strength after COVID-19 (COronaVIrus Disease 2019). Methods. The observational retrospective cross-sectional study included 74 post-COVID-19 patients (56 (76%) men, median age - 48 years). Spirometry, body plethysmography, measurement of lung diffusing capacity (DLCO), maximal inspiratory and expiratory pressures (MIP and MEP), and airway occlusion pressure after 0.1 sec (P0.1) were performed. In addition, dyspnea was assessed in 31 patients using the mMRC scale and muscle strength was assessed in 27 of those patients using MRC Weakness scale. Results. The median time from the COVID-19 onset to pulmonary function tests (PFTs) was 120 days. The total sample was divided into 2 subgroups: 1 - P0.1 <= 0.15 kPa (norm), 2 - > 0.15 kPa. The lung volumes, airway resistance, MIP, and MEP were within normal values in most patients, whereas DLCO was reduced in 59% of cases in both the total sample and the subgroups. Mild dyspnea and a slight decrease in muscle strength were also detected. Statistically significant differences between the subgroups were found in the lung volumes (lower) and airway resistance (higher) in subgroup 2. Correlation analysis revealed moderate negative correlations between P0.1 and ventilation parameters. Conclusion. Measurement of P0.1 is a simple and non-invasive method for assessing pulmonary function. In our study, an increase in P0.1 was detected in 45% of post-COVID-19 cases, possibly due to impaired pulmonary mechanics despite the preserved pulmonary ventilation as well as normal MIP and MEP values.Copyright © Savushkina O.I. et al., 2023.
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Objective: The present study aimed to assess the attitude and perception of Kabul city's residents toward COVID-19 vaccines hesitancy and acceptance. Methods: Applying a cross-sectional study design, the data was collected from 665 participants in Kabul city using a predesigned validated questionnaire. For statistical analysis, Spearman correlation, chi-square, and logistic regression techniques were used. Results: Although the vaccine availability was limited for the public during the survey period, 70.5% of the participants were willing to receive COVID-19 vaccines. Meanwhile, 49.2% participants were concerned about the COVID-19 vaccines side effects. The presence of positive COVID-19 cases among family members and friends (OR: 2.7), presence of fears during COVID-19 pandemic (OR: 4.4) and beliefs that vaccine has important and vital role in people's protection against COVID-19 (OR: 5.3), increase the likelihood of vaccine acceptance among the participants. On the other hand, participant's mistrust of the safety of COVID-19 vaccines (OR: 0.21) and disbelief on ministry of public health "MoPH" advice about COVID-19 vaccine safety and efficiency (OR: 0.27) decrease the odds of COVID-19 vaccine acceptance among the respondents. In addition, a strong correlation was found between vaccine attitude and vaccine acceptance scales (Spearman p=0.52, p<0.001). Conclusion: Although majority of the participants were willing to receive the COVID-19 vaccines, due to high level of participant's concerns about COVID-19 vaccines-related side effects, a great proportion of the respondents were hesitate to receive the COVID-19 vaccines. Accordingly, public awareness about COVID-19 vaccines must be increased to counteract incorrect and misleading propaganda about vaccination and immunization.
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Background: COVID-19 or coronavirus disease 2019 has rapidly affected all aspects of life around and becomes a major threat to public health around the world. One of the most important actions that need to be taken to stop the pandemic is vaccinations. Managing the COVID-19 pandemic in the long term, unwillingness to receive vaccinations and negative attitudes toward vaccines are major barriers. Objectives: This study aimed to investigate community knowledge, risk perceptions, and attitudes toward COVID-19 vaccinations among high school students in Chonburi, Thailand. Materials and Methods: The study was conducted using a questionnaire. A total of 303 students participated. COVID-19-related knowledge, risk perception, and attitude toward COVID-19 vaccines were assessed. Independent t-test and ANOVA were used to analyze differences between outcomes and sociodemographic. Attitudes toward vaccination were analyzed by a generalized linear model. Results: Students revealed a moderate level of COVID-19-related knowledge, correctly answering 7.09 (SD = 1.56) questions in a total of 10, a moderate level of risk perception of getting COVID-19, average score was 9.7 (SD = 3.03) of 12, and attitude toward vaccine against, the average scores at 3.02 (SD = 1.64), questions in a total of 21. Conclusion: This study revealed a moderate level of knowledge about COVID-19, risk perception, and attitude against COVID-19 vaccination among high school students at Princess Chulabhorn Science School, Chonburi, Thailand. Moreover, it reinforces that there is no relation between those factors and the attitude for accepting COVID-19 vaccines. However, the reasons behind the attitude against the COVID-19 vaccination were efficacy of vaccines. News about the side effects of the vaccines, such as chest pain, muscle pain, dizziness, fatigue, breathing problems, numbness, and facial tics, was widespread among people and brought more attitudes against COVID-19 vaccination. Considering precisely, increasing efficacy of the vaccine will lead to higher vaccine acceptance. Therefore, to control the pandemic in the long term, providing high vaccine efficacy will be one of the recommended solutions.
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Severe acute respiratory syndrome coronavirus (SARS-CoV-2), the causative agent of the current COVID-19 pandemic, has evolved to have a wide range of hosts, including non-human primates, wild and domestic animals. Determining the susceptibility of different animal species to SARS-CoV-2 infection and the role of animals in the epidemiology of the disease will be critical to designing appropriate human and veterinary public health responses to this pandemic. A better understanding of the susceptibility of animal species to SARS-CoV-2 may help clarify transmission mechanisms and identify potential reservoirs and sources of infection that are important for both animal and human health. The current pandemic produced by SARS CoV-2 and its variants represents an example of the unique concept of health (One Health) in which humans and animals are components of the same epidemiological chain. In this paper, only the natural infections found in different animals species will be reviewed, according to literature data, regarding the species of affected animals, the transmission patterns (human-animal, animal-human), clinical aspects, diagnosis confirmation and a brief presentation of the prevention possibilities through vaccination.
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Aim: To evaluate the prevalence of new diabetes in secondary care during the second wave of the Covid-19 pandemic. Method(s): Data were collected prospectively for patients presenting to the hospital with new diagnosis of diabetes from December 2020 to May 2021. It included demographics, risk factors, presenting glucose, other investigations and treatment. Result(s): In the six-month study period, 31 patients were diagnosed with new diabetes. Thus far, approximately 13 patients have been identified to have type 1 diabetes and the average age was 37 years. Everyone was discharged with insulin except one patient. Prior to the pandemic in the year 2019, only 17 patients were diagnosed with diabetes in the hospital. Conclusion(s): The lockdown led to a reduction in physical activity and varied diet which may have contributed to weight gain;worsening insulin resistance. It is plausible that severe acute respiratory syndrome coronavirus 2 (SARS-CoV- 2) could trigger autoimmune type 1 diabetes or accelerate its presentation. Together with a hesitancy for patients to seek medical attention and reduced access to face-to- face primary care consultations, this may have contributed to the increased presentation of diabetes-related emergencies and reduction in symptomatic hyperglycaemia. Various studies found patients with pre-existing diabetes have a worse outcome if they develop Covid-19. Overall, during the pandemic, physical and mental health worsened, pre-disposing to medical conditions and impacting self-management of health and disease. We predict the increase in new diagnoses of diabetes in secondary care is multifactorial due to the effects of the pandemic rather than Covid-19 infection solely.
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BackgroundAnti-MDA5 antibody-positive dermatomyositis (anti-MDA5+DM) is a rare autoimmune disease associated with a high mortality rate due to rapid-progressive interstitial lung disease (RP-ILD), particularly in East Asia[1]. MDA5, acts as a cytoplasmic sensor of viral RNA, thus activating antiviral responses including the type I interferon (IFN) signaling pathway[2]. The involvement of type 1 IFN in the pathogenesis of MDA5+DM has been proposed based on the significantly elevated expression of its downstream stimulated genes(ISG) in muscle, skin, lung, and peripheral blood[3;4]. Janus kinase inhibitor, which targets the IFN pathway, combined with glucocorticoid could improve the survival of early-stage MDA5+DM-ILD patients[5]. In clinical practice, there is still an urgent demand for sensitive biomarkers to facilitate clinical risk assessment and precise treatment.ObjectivesThis study aimed to investigate the clinical significance of interferon score, especially IFN-I score, in patients with anti-MDA5+DM.MethodsDifferent subtypes of idiopathic inflammatory myopathy, including anti-MDA5+DM(n=61), anti-MDA5-DM(n=20), antisynthetase syndrome(ASS,n=22),polymyositis(PM,n=6) and immune-mediated necrotizing myopathy(IMNM,n=9), and 58 healthy controls were enrolled.. A multiplex quantitative real-time PCR(RT-qPCR) assay using four TaqMan probes was utilized to evaluate two type I ISGs (IFI44, MX1, which are used for IFN-I score), one type II ISG (IRF1), and one housekeeping gene (HRPT1). Clinical features and disease activity index were compared between high and low IFN-I score groups in 61 anti-MDA5+DM patients. The association between laboratory findings and the predictive value of baseline IFN-I score level for mortality was analyzed.ResultsThe IFN scores were significantly higher in patients with anti-MDA5+DM than in HC (Figure 1A). The IFN-I score correlated positively with serum IFN α(r = 0.335, P =0.008), ferritin (r = 0.302, P = 0.018), and Myositis Disease Activity Assessment Visual Analogue Scale (MYOACT) score(r=0.426, P=0.001). Compared with patients with low IFN-I scores, patients with high IFN-I scores showed increased MYOACT score, CRP, AST, ferritin, and the percentages of plasma cells (PC%) but decreased lymphocyte count, natural killer cell count, and monocyte count. The 3-month survival rate was significantly lower in patients with IFN-I score > 4.9 than in those with IFN-I score ≤ 4.9(72.9% vs. 100%, P=0.044)(Figure 1B).ConclusionIFN score, especially IFN-I score, detected by multiplex RT-qPCR, can be a valuable biomarker for monitoring disease activity and predicting mortality in anti-MDA5+DM patients.References[1]I.E. Lundberg, M. Fujimoto, J. Vencovsky, R. Aggarwal, M. Holmqvist, L. Christopher-Stine, A.L. Mammen, and F.W. Miller, Idiopathic inflammatory myopathies. Nat Rev Dis Primers 7 (2021) 86.[2]G. Liu, J.H. Lee, Z.M. Parker, D. Acharya, J.J. Chiang, M. van Gent, W. Riedl, M.E. Davis-Gardner, E. Wies, C. Chiang, and M.U. Gack, ISG15-dependent activation of the sensor MDA5 is antagonized by the SARS-CoV-2 papain-like protease to evade host innate immunity. Nat Microbiol 6 (2021) 467-478.[3]G.M. Moneta, D. Pires Marafon, E. Marasco, S. Rosina, M. Verardo, C. Fiorillo, C. Minetti, L. Bracci-Laudiero, A. Ravelli, F. De Benedetti, and R. Nicolai, Muscle Expression of Type I and Type II Interferons Is Increased in Juvenile Dermatomyositis and Related to Clinical and Histologic Features. Arthritis Rheumatol 71 (2019) 1011-1021.[4]Y. Ye, Z. Chen, S. Jiang, F. Jia, T. Li, X. Lu, J. Xue, X. Lian, J. Ma, P. Hao, L. Lu, S. Ye, N. Shen, C. Bao, Q. Fu, and X. Zhang, Single-cell profiling reveals distinct adaptive immune hallmarks in MDA5+ dermatomyositis with therapeutic implications. Nat Commun 13 (2022) 6458.[5]Z. Chen, X. Wang, and S. Ye, Tofacitinib in Amyopathic Dermatomyositis–Associated Interstitial Lung Disease. New England Journal of Medicine 381 (2019) 291-293.AcknowledgementsThis work was supported by the National Natural Science Foundation of China [81974251], and Shanghai Hospital Develop ent Center, Joint Research of New Advanced Technology Project [SHDC12018106]Disclosure of InterestsNone Declared.