Relevance of TMPRSS2, CD163/CD206, and CD33 in clinical severity stratification of COVID-19.

Background: Approximately 13.8% and 6.1% of coronavirus disease 2019 (COVID-19) patients require hospitalization and sometimes intensive care unit (ICU) admission, respectively. There is no biomarker to predict which of these patients will develop an aggressive stage that we could improve their quality of life and healthcare management. Our main goal is to include new markers for the classification of COVID-19 patients. Methods: Two tubes of peripheral blood were collected from a total of 66 (n = 34 mild and n = 32 severe) samples (mean age 52 years). Cytometry analysis was performed using a 15-parameter panel included in the Maxpar® Human Monocyte/Macrophage Phenotyping Panel Kit. Cytometry by time-of-flight mass spectrometry (CyTOF) panel was performed in combination with genetic analysis using TaqMan® probes for ACE2 (rs2285666), MX1 (rs469390), and TMPRSS2 (rs2070788) variants. GemStone™ and OMIQ software were used for cytometry analysis. Results: The frequency of CD163+/CD206- population of transitional monocytes (T-Mo) was decreased in the mild group compared to that of the severe one, while T-Mo CD163-/CD206- were increased in the mild group compared to that of the severe one. In addition, we also found differences in CD11b expression in CD14dim monocytes in the severe group, with decreased levels in the female group (p = 0.0412). When comparing mild and severe disease, we also found that CD45- [p = 0.014; odds ratio (OR) = 0.286, 95% CI 0.104-0.787] and CD14dim/CD33+ (p = 0.014; OR = 0.286, 95% CI 0.104-0.787) monocytes were the best options as biomarkers to discriminate between these patient groups. CD33 was also indicated as a good biomarker for patient stratification by the analysis of GemStone™ software. Among genetic markers, we found that G carriers of TMPRSS2 (rs2070788) have an increased risk (p = 0.02; OR = 3.37, 95% CI 1.18-9.60) of severe COVID-19 compared to those with A/A genotype. This strength is further increased when combined with CD45-, T-Mo CD163+/CD206-, and C14dim/CD33+. Conclusions: Here, we report the interesting role of TMPRSS2, CD45-, CD163/CD206, and CD33 in COVID-19 aggressiveness. This strength is reinforced for aggressiveness biomarkers when TMPRSS2 and CD45-, TMPRSS2 and CD163/CD206, and TMPRSS2 and CD14dim/CD33+ are combined.

A facility and community-based assessment of scabies in rural Malawi.

BACKGROUND: Scabies is a neglected tropical disease of the skin, causing severe itching, stigmatizing skin lesions and systemic complications. Since 2015, the DerMalawi project provide an integrated skin diseases clinics and Tele-dermatology care in Malawi. Clinic based data suggested a progressive increase in scabies cases observed. To better identify and treat individuals with scabies in the region, we shifted from a clinic-based model to a community based outreach programme. METHODOLOGY/PRINCIPAL FINDINGS: From May 2015, DerMalawi project provide integrated skin diseases and Tele-dermatological care in the Nkhotakota and Salima health districts in Malawi. Demographic and clinical data of all patients personally attended are recorded. Due to a progressive increase in the number of cases of scabies the project shifted to a community-based outreach programme. For the community outreach activities, we conducted three visits between 2018 to 2019 and undertook screening in schools and villages of Alinafe Hospital catchment area. Treatment was offered for all the cases and school or household contacts. Scabies increased from 2.9% to 39.2% of all cases seen by the DerMalawi project at clinics between 2015 to 2018. During the community-based activities approximately 50% of the population was assessed in each of three visits. The prevalence of scabies was similar in the first two rounds, 15.4% (2392) at the first visit and 17.2% at the second visit. The prevalence of scabies appeared to be lower (2.4%) at the third visit. The prevalence of impetigo appeared unchanged and was 6.7% at the first visit and 5.2% at the final visit. CONCLUSIONS/SIGNIFICANCE: Prevalence of scabies in our setting was very high suggesting that scabies is a major public health problem in parts of Malawi. Further work is required to more accurately assess the burden of disease and develop appropriate public health strategies for its control.

Severe colon ischemia in patients with severe coronavirus-19 (COVID-19)

COVID-19 is associated with severe coagulopathy. We present three cases of colonic ischemia that can be attributed to the hypercoagulable state related with SARS-CoV2 and disseminated intravascular coagulation. Three males aged 76, 68 and 56 with respiratory distress presented episodes of rectal bleeding, abdominal distension and signs of peritoneal irritation. Endoscopy (case 1) and computed tomography angiography revealed colonic ischemia. One patient (case 2) in which a computed tomography (CT) scan showed perforation of the gangrenous cecum underwent surgery. D-dimer levels were markedly increased (2,170, 2,100 and 7,360 ng/ml) in all three patients. All three patients died shortly after diagnosis

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Occurrence of pharmaceutical, recreational and psychotropic drug residues in surface water on the northern Antarctic Peninsula region.

Human presence in the Antarctic is increasing due to research activities and the rise in tourism. These activities contribute a number of potentially hazardous substances. The aim of this study is to conduct the first characterisation of the pharmaceuticals and recreational drugs present in the northern Antarctic Peninsula region, and to assess the potential environmental risk they pose to the environment. The study consisted of a single sampling of ten water samples from different sources, including streams, ponds, glacier drains, and a wastewater discharge into the sea. Twenty-five selected pharmaceuticals and 21 recreational drugs were analysed. The highest concentrations were found for the analgesics acetaminophen (48.74 µg L-1), diclofenac (15.09 µg L-1) and ibuprofen (10.05 µg L-1), and for the stimulant caffeine (71.33 µg L-1). All these substances were detected in waters that were discharged directly into the ocean without any prior purification processes. The hazard quotient (HQ) values for ibuprofen, diclofenac and acetaminophen were far in excess of 10 at several sampling points. The concentrations of each substance measured and used as measured environmental concentration values for the HQ calculations are based on a one-time sampling. The Toxic Unit values indicate that analgesics and anti-inflammatories are the therapeutic group responsible for the highest toxic burden. This study is the first to analyse a wide range of substances and to determine the presence of pharmaceuticals and psychotropic drugs in the Antarctic Peninsula region. We believe it can serve as a starting point to focus attention on the need for continued environmental monitoring of these substances in the water cycle, especially in protected regions such as the Antarctic. This will determine whether pharmaceuticals and recreational drugs are hazardous to the environment and, if so, can be used as the basis for risk-assessment studies to prioritise the exposure to risk.

Fármacos psicoactivos en las cuencas de Galicia / Psychoactive pharmaceutical residues in the watersheds of Galicia (Spain)

Objetivo Monitorizar la presencia de 14 fármacos psicoactivos pertenecientes a tres grupos terapéuticos en la cuenca de Galicia. Método Se seleccionaron cinco estaciones depuradoras de aguas residuales en las principales ciudades de Galicia. Se escogieron trece compuestos farmacéuticos psicoactivos y un metabolito. Asimismo, se tomaron muestras de aguas del grifo de espacios públicos y privados en las ciudades seleccionadas. Resultados En todas las muestras de agua analizadas, las mayores concentraciones han correspondido al grupo de los ansiolíticos, y especialmente el lorazepam ha aparecido en altas concentraciones en las muestras de aguas de río y del grifo. Conclusiones Esta investigación demuestra la presencia de fármacos psicoactivos en las cuencas de Galicia y la reversión de los metabolitos a sus compuestos parentales. Asimismo, muestra la necesidad de incrementar la monitorización ambiental de las cuencas y de mejorar los procesos de tratamiento de las aguas residuales y potables para eliminar estos fármacos (AU)

Objective To monitor the presence of pharmaceutical residues of 14 psychoactive drugs belonging to three therapeutic groups in the watersheds of Galicia (Spain).Method Five sewage treatment plants were selected in the main cities of Galicia. Thirteen psychoactive pharmaceutical compounds and one metabolite were chosen. In addition, tap water samples were taken from public places and private residences in the selected cities. Results In all the water samples analyzed, the highest concentrations corresponded to the group of anxiolytics. In particular, high concentrations of lorazepam were found in river and tap water samples. Conclusions This investigation demonstrates the presence of psychoactive pharmaceuticals in the watersheds of the autonomous region of Galicia and the conversion of metabolites to parent compounds. This work also shows the need to increase environmental monitoring of watersheds and to improve sewage and drinking water treatment processes to remove these pharmaceuticals (AU)

Psychoactive pharmaceutical residues in the watersheds of Galicia (Spain).

OBJECTIVE: To monitor the presence of pharmaceutical residues of 14 psychoactive drugs belonging to three therapeutic groups in the watersheds of Galicia (Spain). METHOD: Five sewage treatment plants were selected in the main cities of Galicia. Thirteen psychoactive pharmaceutical compounds and one metabolite were chosen. In addition, tap water samples were taken from public places and private residences in the selected cities. RESULTS: In all the water samples analyzed, the highest concentrations corresponded to the group of anxiolytics. In particular, high concentrations of lorazepam were found in river and tap water samples. CONCLUSIONS: This investigation demonstrates the presence of psychoactive pharmaceuticals in the watersheds of the autonomous region of Galicia and the conversion of metabolites to parent compounds. This work also shows the need to increase environmental monitoring of watersheds and to improve sewage and drinking water treatment processes to remove these pharmaceuticals.