COVID-19 re-infection or persistent infection in patient with acute myeloid leukaemia M3: a mini review.

Coronavirus disease 2019 (COVID-19) pandemic has affected more than 40 million people worldwide. Some patients had episodes of symptom recurrence after the first episode of infection with variable intervals. There are multiple issues and hypotheses about re-infection or re-activation of the virus, especially in immunocompromised patients. In this paper, we present details of an individual with a recent history of COVID-19 who proceeded to acute myeloid leukaemia M3 and immunosuppression by chemotherapy, then we review some recently published articles about possible re-infection or re-activation.

Demographics, laboratory parameters and outcomes of 1061 patients with coronavirus disease 2019: a report from Tehran, Iran.

We aimed to determine the characteristics of coronavirus disease 2019 (COVID-2019) among the Iranian population. In this study, we collected and analysed the demographics, laboratory findings and outcomes of patients with COVID-19 who were admitted to Masih Daneshvari Hospital in Tehran, Iran between 20 February 2020 and 2 April 2020. Among 1061 patients, 692 (65.2%) were male and the median age was 55 years (interquartile range (IQR), 44-66 years). Totally, 129 (12.2%) patients died during hospitalization in the ward or intensive care unit. From the remaining 932 individuals, 46 (5.0%) were admitted to the intensive care unit and 886 (95.0%) were hospitalized in the ward. Those patients who died were significantly older than those hospitalized in the ward (p < 0.001). The median absolute number of lymphocytes was 1.2 × 103/µL (IQR 0.9 × 103 to 1.6 × 103/µL) and 708 (66.7%) patients had lymphopenia (absolute lymphocyte count <1500/µL). Among the laboratory tests, D-dimer, serum ferritin and albumin had the strongest correlations with mortality (r = 0.455, r = 0.412, r = -0.406, respectively; p < 0.001 for each one). In conclusion, laboratory findings could provide useful information with regard to the management of individuals with COVID-19.

IL-2-inducible T-cell kinase deficiency with pulmonary manifestations due to disseminated Epstein-Barr virus infection.

IL-2-inducible T-cell kinase (ITK) deficiency is a rare inherited immunodeficiency disease characterized by homozygous mutations in the ITK gene and the inability to control Epstein-Barr virus (EBV) infection leading to EBV-associated lymphoproliferative disorders of B cell origin. Many aspects of its clinical presentation and immunologic phenotype are still unclear to clinicians. We report on a 14-year-old female patient with complaints of an 8-month history of cough and fever. Imaging studies revealed diffuse pulmonary nodules and mediastinal lymphadenopathy. Transbronchial lung biopsy showed nonmalignant polyclonal B cell proliferation. High titers of EBV DNA were detected by PCR analysis in bronchoalveolar lavage fluid, bone marrow, and blood. Genomic analysis revealed a homozygous single base pair deletion in exon 5 of the ITK gene (c.468delT) in this patient. Treatment with rituximab (anti-CD20 mab) resulted in complete clinical remission with resolution of pulmonary lesions and a negative EBV titer in serum. All patients with EBV-associated lymphoproliferative disorders should be analyzed for mutations in ITK.

Sequence and phylogenetic analyses of neuraminidase gene of Iranian seasonal influenza H1N1 viruses from 2005-2009 and corresponding vaccine strains.

Prophylaxis of influenza A virus infections is based on the vaccines inducing antibodies to the major viral antigens, hemagglutinin (HA) and neuraminidase (NA). Since these antigens continuously change during virus replication in various hosts, only the currently circulating strains should be used in the vaccines. Besides, monitoring of the naturally occurring changes in HA, NA, and respective genes, especially those associated with resistance to the NA inhibitors is necessary. The NA genes of 30 Iranian isolates of influenza H1N1 virus from the seasons 2005-2009 were sequenced and subjected to the sequence and phylogenetic analyses. The seasonal isolates turned out to be closely related to the corresponding vaccine strains, except for the 2007-2008 isolates, which also displayed a higher nucleotide variation. A resistance to the NA inhibitors was found in the 2008-2009 isolates only. The average nucleotide identities of the isolates with corresponding vaccine strains for the years 2005-2009 were 98.83%, 98.55%, 98.7%, 97.55%, and 98.76%, respectively.

Analysis of the hemagglutinin and neuraminidase genes of human Influenza A/H3N2 viruses circulating in iran between 2005 and 2007: antigenic and phylogenetic relationships to vaccine strains.

OBJECTIVES: To study the antigenic variations in influenza A/H3N2 viruses circulating in Iran for characterization and phylogenetic relationships to vaccine strains. METHODS: RT-PCR, full sequencing of hemagglutinin (HA) and neuraminidase (NA) genes and analysis by sequence handling and phylogenetic programs were done. RESULTS: The HA sequences of 2007 isolates fell within the clade represented by the HA of A/Brisbane/10/07 and characterized by the amino acid changes relative to the HA of A/Wisconsin/67/05, G50E and K140I. The only isolate in 2006 fell within A/Berlin/02/06 with V112I and K173E changes. The 2005 isolates characterized by Y159F, S189N and S227P changes within A/California/07/04. In all isolates we had E190D which is important because this was responsible for the loss of ability of A/H3N2 viruses to bind to chicken red blood cells. There were some substitutions in the antigenic sites of the HA. Similar to other studies, conserved residues for catalytic sites and also framework sites of NA supporting the catalytic residues were detected. We had some changes in the variable regions of the NA head domain. CONCLUSION: Comparison between Iranian viruses and vaccine strains showed high similarity between them and vaccine strains used in the northern hemisphere.