Loss of SARS-CoV-2 Seropositivity among Healthy Young Adults over Seven Months

ObjectiveWe conducted a longitudinal study to estimate immunity produced in response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among university students over seven months. MethodsAll participants were attending a public university and resided in Pitt County, North Carolina. University students enrolled weekly for 10 weeks between August 26, 2020 and October 28, 2020, resulting in 136 young adults completing at least one study visit by November 17, 2020. Enrolled students completed an online survey and nasal swab collection at two week intervals and monthly blood collection between August 26, 2020 and March 31, 2021. ResultsAmongst 695 serum samples tested during follow-up, the prevalence of a positive result for anti-nucleocapsid antibodies (N-IgG) was 9.78%. In 22 students with more than one positive N-IgG serum sample, 68.1% of group had decline of N-IgG below positive threshold over 140 days. Anti-spike antibodies were detected in all 11 vaccinated students who were vaccinated during March 2021. ConclusionsIn healthy young adults, N-IgG wanes below detectable threshold within five months. S-IgG remained consistently elevated months after infection, and significantly increased after vaccination.

Acute appendicitis located within Amyand's hernia-a complex case with concurrent acute cholecystitis.

Amyand's hernia is the presence of the vermiform appendix within an inguinal hernia sac. It is rare, and even rarer is the presence of acute appendicitis within the sac. It presents in a variety of different ways and often is only diagnosed intra-operatively. We present the case of a 90 year old male with extensive co-morbidities presenting with right upper quadrant pain, who on computed tomography scan of the abdomen, had acute cholecystitis alongside acute appendicitis within Amyand's hernia. Ultimately given his co-morbidities, a conservative approach with prolonged antibiotic therapy was adopted, with a successful outcome. This case highlights that although classifications for treatment of Amyand's hernia exist, careful clinical assessment is warranted in each case to ensure optimal outcome based upon individual circumstances.