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1.
J Infect Chemother ; 27(1): 70-75, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32950393

RESUMO

OBJECTIVES: The symptoms of Coronavirus disease 2019 (COVID-19) vary among patients. The aim of this study was to investigate the clinical manifestation and disease duration in young versus elderly patients. METHODS: We retrospectively analyzed 187 patients (87 elderly and 100 young patients) with confirmed COVID-19. The clinical characteristics and chest computed tomography (CT) extent as defined by a score were compared between the two groups. RESULTS: The numbers of asymptomatic cases and severe cases were significantly higher in the elderly group (elderly group vs. young group; asymptomatic cases, 31 [35.6%] vs. 10 [10%], p < 0.0001; severe cases, 25 [28.7%] vs. 8 [8.0%], p = 0.0002). The proportion of asymptomatic patients and severe patients increased across the 10-year age groups. There was no significant difference in the total CT score and number of abnormal cases. A significant positive correlation between the disease duration and patient age was observed in asymptomatic patients (ρ = 0.4570, 95% CI 0.1198-0.6491, p = 0.0034). CONCLUSIONS: Although the extent of lung involvement did not have a significant difference between the young and elderly patients, elderly patients were more likely to have severe clinical manifestations. Elderly patients were also more likely to be asymptomatic and a source of COVID-19 viral shedding.


Assuntos
Infecções Assintomáticas/epidemiologia , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Eliminação de Partículas Virais , Adulto , Fatores Etários , Idoso , Betacoronavirus , Infecções por Coronavirus/diagnóstico por imagem , Infecções por Coronavirus/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/patologia , Estudos Retrospectivos , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X
2.
mSphere ; 5(6)2020 11 11.
Artigo em Inglês | MEDLINE | ID: mdl-33177214

RESUMO

Viral shedding patterns and their correlations with immune responses are still poorly characterized in mild coronavirus (CoV) disease 2019 (COVID-19). We monitored shedding of viral RNA and infectious virus and characterized the immune response kinetics of the first five patients quarantined in Geneva, Switzerland. High viral loads and infectious virus shedding were observed from the respiratory tract despite mild symptoms, with isolation of infectious virus and prolonged positivity by reverse transcriptase PCR (RT-PCR) until days 7 and 19 after symptom onset, respectively. Robust innate responses characterized by increases in activated CD14+ CD16+ monocytes and cytokine responses were observed as early as 2 days after symptom onset. Cellular and humoral severe acute respiratory syndrome (SARS)-CoV-2-specific adaptive responses were detectable in all patients. Infectious virus shedding was limited to the first week after symptom onset. A strong innate response, characterized by mobilization of activated monocytes during the first days of infection and SARS-CoV-2-specific antibodies, was detectable even in patients with mild disease.IMPORTANCE This work is particularly important because it simultaneously assessed the virology, immunology, and clinical presentation of the same subjects, whereas other studies assess these separately. We describe the detailed viral and immune profiles of the first five patients infected by SARS-CoV-2 and quarantined in Geneva, Switzerland. Viral loads peaked at the very beginning of the disease, and infectious virus was shed only during the early acute phase of disease. No infectious virus could be isolated by culture 7 days after onset of symptoms, while viral RNA was still detectable for a prolonged period. Importantly, we saw that all patients, even those with mild symptoms, mount an innate response sufficient for viral control (characterized by early activated cytokines and monocyte responses) and develop specific immunity as well as cellular and humoral SARS-CoV-2-specific adaptive responses, which already begin to decline a few months after the resolution of symptoms.


Assuntos
Imunidade Adaptativa , Betacoronavirus/imunologia , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/virologia , Imunidade Inata , Pneumonia Viral/imunologia , Pneumonia Viral/virologia , Carga Viral , Eliminação de Partículas Virais , Adulto , Idoso , Anticorpos Antivirais/metabolismo , Betacoronavirus/isolamento & purificação , Biomarcadores/metabolismo , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Citocinas/metabolismo , Humanos , Cinética , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/diagnóstico , Índice de Gravidade de Doença
4.
Ther Adv Respir Dis ; 14: 1753466620963035, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33138694

RESUMO

AIM: To investigate clinical characteristics and identify risk factors for severity of coronavirus disease 2019 (COVID-19) pneumonia outside of Wuhan, China. MATERIALS AND METHODS: We included 213 patients with confirmed COVID-19 who had been discharged or died by 15 March 2020. We retrospectively collected epidemiological, clinical, laboratory, computed tomography imaging and outcome data. Clinical characteristics were described and relative risk factors were compared. RESULTS: Most clinical characteristics of this study were similar to those from studies in Wuhan, but there were lower mortality rate and milder severity. The median time from onset of symptoms to confirmation and hospitalization was 4 and 5 days, respectively. The median virus clearance and shedding times were 10 and 15 days, respectively. When the severe/critical group was compared with the mild/moderate group, significant risk factors included: older age; dyspnea; hypertension; poor appetite; fatigue; higher white cell count, neutrophil count, prothrombin time, creatine kinase, creatine kinase-MB, D-dimer, alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH) and C-reactive protein; and lower lymphocyte count and albumin (p < 0.05). In the intensive care unit (ICU) group compared with the non-ICU group, risk factors included: older age; chronic obstructive pulmonary disease (COPD); dyspnea; poor appetite; higher white cell count, D-dimer, ALT, AST and LDH; and lower lymphocyte count and albumin (p < 0.05). Independent risk factors associated with the severe/critical group were dyspnea [odds ratio (OR) = 19.48], ALT (OR = 6.02) and albumin (OR = 3.36). Independent risk factors associated with the ICU group were dyspnea (OR = 8.88), COPD (OR = 31.80), D-dimer (OR = 8.37), ALT (OR = 28.76) and LDH (OR = 9.95) (p < 0.05). CONCLUSION: The severity of COVID-19 outside Wuhan, China was milder than that within Wuhan. The clinical infective period was long, and the longest virus shedding time was 35 days. The most important risk factors were dyspnea, COPD, D-dimer, ALT, LDH and albumin.The reviews of this paper are available via the supplemental material section.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico , Pneumonia Viral/complicações , Pneumonia Viral/diagnóstico , Adulto , China , Infecções por Coronavirus/mortalidade , Cuidados Críticos , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/mortalidade , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Taxa de Sobrevida , Avaliação de Sintomas , Fatores de Tempo , Tomografia Computadorizada por Raios X , Eliminação de Partículas Virais
5.
Curr Med Sci ; 40(5): 817-821, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33123896

RESUMO

In the period of regular epidemic prevention and control of Coronavirus disease 2019 (COVID-19) in our country, work resumption has been fully advanced. But there are still new sporadic local cases and imported cases across the country. In this situation, whether kindergartens reopening will increase the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spread still remains uncertain. We reviewed two pediatric patients with moderate COVID-19, collected the epidemiologic information and monitored the cycle threshold value of rectal specimen and the viral loads, and discussed the transmission of SARS-CoV-2 in pediatric patients and the virulence of feces in children with moderate COVID-19, in order to analyze the risk of kindergartens reopening.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/prevenção & controle , Fezes/virologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Betacoronavirus/genética , Betacoronavirus/patogenicidade , Pré-Escolar , China/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Feminino , Humanos , Pandemias/estatística & dados numéricos , Pais , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Instituições Acadêmicas , Carga Viral , Eliminação de Partículas Virais
6.
Viruses ; 12(10)2020 10 20.
Artigo em Inglês | MEDLINE | ID: mdl-33092065

RESUMO

BACKGROUND: RT-PCR on nasopharyngeal (NPS)/oropharyngeal swabs is the gold standard for diagnosis of SARS-CoV-2 infection and viral load monitoring. Oral fluid (OF) is an alternate clinical sample, easy and safer to collect and could be useful for COVID-19 diagnosis, monitoring viral load and shedding. METHODS: Optimal assay conditions and analytical sensitivity were established for the commercial Simplexa™ COVID-19 Direct assay adapted to OF matrix. The assay was used to test 337 OF and NPS specimens collected in parallel from 164 hospitalized patients; 50 bronchoalveolar lavage (BAL) specimens from a subgroup of severe COVID-19 cases were also analysed. RESULTS: Using Simplexa™ COVID-19 Direct on OF matrix, 100% analytical detection down to 1 TCID50/mL (corresponding to 4 × 103 copies (cp)/mL) was observed. No crossreaction with other viruses transmitted through the respiratory toute was observed. Parallel testing of 337 OF and NPS samples showed highly concordant results (κ = 0.831; 95 % CI = 0.771-0.891), and high correlation of Ct values (r = 0.921; p < 0.0001). High concordance and elevated correlation was observed also between OF and BAL. Prolonged viral RNA shedding was observed up to 100 days from symptoms onset (DSO), with 32% and 29% positivity observed in OF and NPS samples, respectively, collected between 60 and 100 DSO. CONCLUSIONS: Simplexa™ COVID-19 Direct assays on OF have high sensitivity and specificity to detect SARS-CoV-2 RNA and provide an alternative to NPS for diagnosis and monitoring SARS-CoV-2 shedding.


Assuntos
Betacoronavirus/fisiologia , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/virologia , Pneumonia Viral/virologia , Eliminação de Partículas Virais/fisiologia , Adulto , Idoso , Betacoronavirus/genética , Líquidos Corporais/virologia , Infecções por Coronavirus/diagnóstico , Testes Diagnósticos de Rotina , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Técnicas de Diagnóstico Molecular/métodos , Pandemias , Faringe/virologia , Pneumonia Viral/diagnóstico , RNA Viral/análise , Sensibilidade e Especificidade , Manejo de Espécimes , Carga Viral
7.
PLoS One ; 15(10): e0236905, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33119712

RESUMO

Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although Thailand has been fairly effective at controlling the spread of COVID-19, continued disease surveillance and information on antibody response in recovered patients and their close contacts remain necessary in the absence of approved vaccines and antivirals. Here, we examined 217 recovered COVID-19 patients to assess their viral RNA shedding and residual antibodies against SARS-CoV-2. We also evaluated antibodies in blood samples from 308 close contacts of recovered COVID-19 patients. We found that viral RNA remained detectable in 6.6% of recovered COVID-19 cases and up to 105 days. IgM, IgG, and IgA antibodies against SARS-CoV-2 were detected in 13.8%, 88.5%, and 83.4% of the recovered cases 4-12 weeks after disease onset, respectively. Higher levels of antibodies detected were associated with severe illness patients experienced while hospitalized. Fifteen of the 308 contacts (4.9%) of COVID-19 cases tested positive for IgG antibodies, suggesting probable exposure. Viral clearance and the pattern of antibody responses in infected individuals are both crucial for effectively combating SARS-CoV-2. Our study provides additional information on the natural history of this newly emerging disease related to both natural host defenses and antibody duration.


Assuntos
Anticorpos Antivirais/isolamento & purificação , Infecções por Coronavirus/imunologia , Pneumonia Viral/imunologia , RNA Viral/isolamento & purificação , Sobreviventes , Eliminação de Partículas Virais , Adulto , Betacoronavirus , Ensaio de Imunoadsorção Enzimática , Características da Família , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Tailândia
8.
Cell Mol Immunol ; 17(11): 1119-1125, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33037400

RESUMO

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been redetected after discharge in some coronavirus disease 2019 (COVID-19) patients. The reason for the recurrent positivity of the test and the potential public health concern due to this occurrence are still unknown. Here, we analyzed the viral data and clinical manifestations of 289 domestic Chinese COVID-19 patients and found that 21 individuals (7.3%) were readmitted for hospitalization after detection of SARS-CoV-2 after discharge. First, we experimentally confirmed that the virus was involved in the initial infection and was not a secondary infection. In positive retests, the virus was usually found in anal samples (15 of 21, 71.4%). Through analysis of the intracellular viral subgenomic messenger RNA (sgmRNA), we verified that positive retest patients had active viral replication in their gastrointestinal tracts (3 of 16 patients, 18.7%) but not in their respiratory tracts. Then, we found that viral persistence was not associated with high viral titers, delayed viral clearance, old age, or more severe clinical symptoms during the first hospitalization. In contrast, viral rebound was associated with significantly lower levels of and slower generation of viral receptor-binding domain (RBD)-specific IgA and IgG antibodies. Our study demonstrated that the positive retest patients failed to create a robust protective humoral immune response, which might result in SARS-CoV-2 persistence in the gastrointestinal tract and possibly in active viral shedding. Further exploration of the mechanism underlying the rebound in SARS-CoV-2 in this population will be crucial for preventing virus spread and developing effective vaccines.


Assuntos
Betacoronavirus/fisiologia , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico , Trato Gastrointestinal/virologia , Pneumonia Viral/diagnóstico , Anticorpos Antivirais/metabolismo , Infecções por Coronavirus/imunologia , Epitopos/imunologia , Humanos , Imunidade Humoral , Imunoglobulina A/metabolismo , Imunoglobulina G/metabolismo , Pandemias , Pneumonia Viral/imunologia , Ligação Proteica , Domínios Proteicos/imunologia , Testes Sorológicos , Glicoproteína da Espícula de Coronavírus/imunologia , Carga Viral , Eliminação de Partículas Virais
10.
Crit Care ; 24(1): 610, 2020 10 16.
Artigo em Inglês | MEDLINE | ID: mdl-33066801

RESUMO

BACKGROUND: Data on SARS-CoV-2 load in lower respiratory tract (LRT) are scarce. Our objectives were to describe the viral shedding and the viral load in LRT and to determine their association with mortality in critically ill COVID-19 patients. METHODS: We conducted a binational study merging prospectively collected data from two COVID-19 reference centers in France and Switzerland. First, we described the viral shedding duration (i.e., time to negativity) in LRT samples. Second, we analyzed viral load in LRT samples. Third, we assessed the association between viral presence in LRT and mortality using mixed-effect logistic models for clustered data adjusting for the time between symptoms' onset and date of sampling. RESULTS: From March to May 2020, 267 LRT samples were performed in 90 patients from both centers. The median time to negativity was 29 (IQR 23; 34) days. Prolonged viral shedding was not associated with age, gender, cardiac comorbidities, diabetes, immunosuppression, corticosteroids use, or antiviral therapy. The LRT viral load tended to be higher in non-survivors. This difference was statistically significant after adjusting for the time interval between onset of symptoms and date of sampling (OR 3.78, 95% CI 1.13-12.64, p = 0.03). CONCLUSIONS: The viral shedding in LRT lasted almost 30 days in median in critically ill patients, and the viral load in the LRT was associated with the 6-week mortality.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/diagnóstico , Pneumonia Viral/diagnóstico , Síndrome do Desconforto Respiratório do Adulto/terapia , Síndrome do Desconforto Respiratório do Adulto/virologia , Sistema Respiratório/virologia , Idoso , Infecções por Coronavirus/mortalidade , Estado Terminal/mortalidade , Feminino , França/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/mortalidade , Estudos Prospectivos , Respiração Artificial , Suíça/epidemiologia , Carga Viral , Eliminação de Partículas Virais
11.
mSphere ; 5(5)2020 10 07.
Artigo em Inglês | MEDLINE | ID: mdl-33028689

RESUMO

Since the outbreak of coronavirus disease 2019 (COVID-19) in Wuhan, China, it has rapidly spread around the world. Persons with asymptomatic disease exhibit viral shedding, resulting in transmission, which presents disease control challenges. However, the clinical characteristics of these asymptomatic individuals remain elusive. We collected samples of 25 asymptomatic and 27 symptomatic COVID-19 patients. Viral titers of throat swabs were determined by quantitative reverse transcription-PCR (qRT-PCR). COVID-19 IgG and IgM were examined. Complete blood counts were determined, and serum biochemistry panels were performed. Cytokines, including gamma interferon (IFN-γ), tumor necrosis factor alpha (TNF-α), interleukin 2 (IL-2), IL-4, IL-6, and IL-10 were evaluated. T cell, B cell, and NK cell counts were measured using flow cytometry. Although similar viral loads were detected, asymptomatic patients had significantly faster virus turnover than symptomatic patients. Additionally, asymptomatic patients had higher counts of lymphocytes, T cells, B cells, and NK cells. While liver damage was observed in symptomatic patients, as indicated by elevated liver enzymes and decreased liver-synthesized proteins in the blood, asymptomatic patients showed normal liver measurements. Lactate dehydrogenase, a COVID-19 risk factor, was significantly lower in asymptomatic patients. These results suggest that asymptomatic COVID-19 patients had normal clinical indicators and faster viral clearance than symptomatic patients. Lymphocytes may play a role in their asymptomatic phenotype. Since asymptomatic patients may be a greater risk of virus transmission than symptomatic patients, public health interventions and a broader range of testing may be necessary for the control of COVID-19.IMPORTANCE Asymptomatic transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a potential problem for pandemic control through public health strategies. Our results demonstrate that asymptomatic COVID-19 patients have better outcomes than symptomatic patients. This may have been due to more active cellular immune responses and normal liver function. Since asymptomatic patients have no clinical symptoms which can easily prevent timely diagnosis and treatment, they may cause a greater risk of virus transmission than symptomatic patients, which poses a major challenge to infection control. Evidence suggests that nonpharmaceutical public health interventions, like social distancing and face mask ordinances, play important roles in the control of COVID-19. Looking forward, it may be necessary to proceed cautiously while reopening businesses in areas of epidemicity to prevent potential waves of COVID-19 in the future.


Assuntos
Infecções Assintomáticas , Betacoronavirus , Infecções por Coronavirus/diagnóstico , Pneumonia Viral/diagnóstico , Adulto , Betacoronavirus/isolamento & purificação , Biomarcadores/sangue , Estudos de Casos e Controles , China , Técnicas de Laboratório Clínico , Infecções por Coronavirus/sangue , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Pneumonia Viral/sangue , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Estudos Retrospectivos , Eliminação de Partículas Virais
12.
Cell Mol Biol (Noisy-le-grand) ; 66(6): 148-156, 2020 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-33040802

RESUMO

Investigating the infectivity of body fluid can be useful for preventative measures in the community and ensuring safety in the operating rooms and on the laboratory practices. We performed a literature search of clinical trials, cohorts, and case series using PubMed/MEDLINE, Google Scholar, and Cochrane library, and downloadable database of CDC. We excluded case reports and searched all-language articles for review and repeated until the final drafting. The search protocol was registered in the PROSPERO database. Thirty studies with urinary sampling for viral shedding were included. A total number of 1,271 patients were enrolled initially, among which 569 patients had undergone urinary testing. Nine studies observed urinary viral shedding in urine from 41 patients. The total incidence of urinary SARS-CoV-2 shedding was 8%, compared to 21.3% and 39.5 % for blood and stool, respectively. The summarized risk ratio (RR) estimates for urine positive rates compared to the pharyngeal rate was 0.08. The pertaining RR urine compared to blood and stool positive rates were 0.20 and 0.33, respectively. Our review concludes that not only the SARS-CoV-2 can be excreted in the urine in eight percent of patients but also its incidence may have associations with the severity of the systemic disease, ICU admission, and fatality rates. Moreover, the findings in our review suggest that a larger population size may reveal more positive urinary cases possibly by minimizing biases.


Assuntos
Betacoronavirus/genética , Técnicas de Laboratório Clínico , Infecções por Coronavirus/epidemiologia , Fezes/virologia , Pneumonia Viral/epidemiologia , Urina/virologia , Viremia/diagnóstico , Eliminação de Partículas Virais , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/virologia , Feminino , Humanos , Incidência , Lactente , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Pandemias , Admissão do Paciente , Pneumonia Viral/mortalidade , Pneumonia Viral/virologia , RNA Viral/genética , Reação em Cadeia da Polimerase em Tempo Real , Índice de Gravidade de Doença , Adulto Jovem
13.
Infect Dis Poverty ; 9(1): 143, 2020 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-33076968

RESUMO

BACKGROUND: Effective management of imported cases is an important part of epidemic prevention and control. Hainan Province, China reported 168 coronavirus disease 2019 (COVID-19), including 112 imported cases on February 19, 2020, but successfully contained the epidemic within 1 month. We described the epidemiological and clinical characteristics of COVID-19 in Hainan and compared these features between imported and local cases to provide information for other international epidemic areas. METHODS: We included 91 patients (56 imported and 35 local cases) from two designated hospitals for COVID-19 in Haikou, China, from January 20 to February 19, 2020. Data on the demographic, epidemiological, clinical and laboratory characteristics were extracted from medical records. Patients were followed until April 21, 2020, and the levels of antibodies at the follow-ups were also analysed by the Wilcoxon matched-pairs signed ranks test. RESULTS: Of the 91 patients, 78 (85.7%) patients were diagnosed within the first three weeks after the first case was identified (Day 1: Jan 22, 2020), while the number of local cases started to increase during the third week. No new cases occurred after Day 29. Fever and cough were two main clinical manifestations. In total, 15 (16.5%) patients were severe, 14 (15.4%) had complicated infections, nine (9.9%) were admitted to the intensive care unit, and three died. The median duration of viral shedding in feces was longer than that in nasopharyngeal swabs (19 days vs 16 days, P = 0.007). Compared with local cases, imported cases were older and had a higher incidence of fever and concurrent infections. There was no difference in outcomes between the two groups. IgG was positive in 92.8% patients (77/83) in the follow-up at week 2 after discharge, while 88.4% patients (38/43) had a reduction in IgG levels in the follow-up at week 4 after discharge, and the median level was lower than that in the follow-up at week 2 (10.95 S/Cut Off (S/CO) vs 15.02 S/CO, P <  0.001). CONCLUSION: Imported cases were more severe than local cases but had similar prognoses. The level of IgG antibodies declined from week 6 to week 8 after onset. The short epidemic period in Hainan suggests that the epidemic could be quickly brought under control if proper timely measures were taken.


Assuntos
Doenças Transmissíveis Importadas/epidemiologia , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Adulto , Idoso , Betacoronavirus/isolamento & purificação , China/epidemiologia , Doenças Transmissíveis Importadas/diagnóstico , Doenças Transmissíveis Importadas/terapia , Doenças Transmissíveis Importadas/virologia , Infecções por Coronavirus/virologia , Fezes/virologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/virologia , Estudos Retrospectivos , Tórax/diagnóstico por imagem , Resultado do Tratamento , Eliminação de Partículas Virais
14.
Epidemiol Infect ; 148: e247, 2020 10 14.
Artigo em Inglês | MEDLINE | ID: mdl-33050973

RESUMO

Dromedary camels remain the currently identified reservoir for the Middle East respiratory syndrome coronavirus (MERS-CoV). The virus is released in the secretions of the infected camels, especially the nasal tract. The virus shedding curve through the nasal secretions was studied. Although human transmission of the virus through the respiratory tract of close contact people with dromedary reported previously, the exact mechanism of transmission is still largely unknown. The main goal of this study was to check the possibility of MERS-CoV shedding in the exhaled air of the infected camels. To achieve this goal, we conducted a follow-up study in one of the dromedary camel herds, December 2018-April 2019. We tested nasal swabs, breath samples from animals within this herd by the real-time PCR. Our results showed that some of the tested nasal swabs and breath were positive from 24 March 2019 until 7 April 2019. The phylogenetic analysis of the obtained S and N gene sequences revealed the detected viruses are clustering together with some human and camel samples from the eastern region, especially from Al-Hufuf city, as well as some samples from Qatar and Jordon. These results are clearly showing the possibility of shedding of the virus in the breath of the infected camels. This could explain, at least in part, the mechanism of transmission of MERS-CoV from animals to humans. This study is confirming the shedding of MERS-CoV in the exhaled air of the infected camels. Further studies are needed for a better understanding of the MERS-CoV.


Assuntos
Camelus/virologia , Coronavírus da Síndrome Respiratória do Oriente Médio/isolamento & purificação , Animais , Testes Respiratórios , Coronavírus da Síndrome Respiratória do Oriente Médio/classificação , Coronavírus da Síndrome Respiratória do Oriente Médio/genética , Nariz/virologia , Filogenia , RNA Viral/análise , Eliminação de Partículas Virais
15.
BMJ Case Rep ; 13(10)2020 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-33012717

RESUMO

We present a case of COVID-19 in an immunocompetent patient with risk factors for severe disease who recovered after prolonged swab positivity of 61 days postsymptom onset without significant respiratory and organ dysfunction. We discuss the reasons behind her prolonged swab positivity in the context of current SARS-CoV-2 knowledge, document the trend in her inflammatory response and swab results, and discuss the implications swab positivity had on her isolation and recovery.


Assuntos
Betacoronavirus/imunologia , Infecções por Coronavirus/imunologia , Hospedeiro Imunocomprometido/imunologia , Pneumonia Viral/imunologia , Eliminação de Partículas Virais/imunologia , Idoso , Infecções por Coronavirus/terapia , Feminino , Humanos , Pandemias , Pneumonia Viral/terapia , Tempo , Carga Viral/imunologia
16.
Urol J ; 17(5): 433-441, 2020 09 05.
Artigo em Inglês | MEDLINE | ID: mdl-32888186

RESUMO

OBJECTIVES: To review the current literature on the presence of COVID-19 virus in the urine of infected patients and to explore the clinical features that can predict the presence of COVID-19 in urine. MATERIALS AND METHODS: A systematic review of published literature between 30th December 2019 and 21st June 2020 was conducted on Pubmed, Google Scholar, Ovid, Scopus, and ISI web of science. Studies investigating urinary viral shedding of COVID-19 in infected patients were included. Two reviewers selected relative studies and performed quality assessment of individual studies. Meta-analysis was performed on the pooled case reports and cohort with a sample size of ≥ 9. RESULTS: Thirty-nine studies were finally included in the systematic review; 12 case reports, 26 case series, and one cohort study. Urinary samples from 533 patients were investigated. Fourteen studies reported the presence of COVID-19 in the urinary samples from 24 patients. The crude overall rate of COVID-19 detection in urinary samples was 4.5%. Considering case series and cohorts with a sample size of ≥ 9, the estimated viral shedding frequency was 1.18 % (CI 95%: 0.14 - 2.87) in the meta-analysis. Urinary viral load in most reports were lower than rectal or oropharyngeal samples. In adult patients, urinary shedding of COVID-19 was commonly detected in patients with moderate to severe disease (16 adult patients with moderate or severe disease versus two adult patients with mild disease). In children, urinary viral shedding of COVID-19 was reported in 4 children who all suffered from mild disease. Urinary viral shedding of COVID-19 was detected from day 1 to day 52 after disease onset. The pathogenicity of virus isolated from urine has been demonstrated in cell culture media in one study while another study failed to reveal replication of isolated viral RNA in cell cultures. Urinary symptoms were not attributed to urinary viral shedding. CONCLUSION: While COVID-19 is rarely detected in urine of infected individuals, infection transmission through urine still remains possible. In adult patients, infected urine is more likely in the presence of moderate or severe disease. Therefore, caution should be exerted when dealing with COVID-19 infected patients during medical interventions like endoscopy and urethral catheterization especially in symptomatic adult patients while in children caution should be exerted regardless of symptoms.


Assuntos
Betacoronavirus/genética , Infecções por Coronavirus/virologia , Pandemias , Pneumonia Viral/virologia , RNA Viral/análise , Sistema Urinário/virologia , Eliminação de Partículas Virais , Infecções por Coronavirus/epidemiologia , Humanos , Pneumonia Viral/epidemiologia
17.
J Zhejiang Univ Sci B ; 21(9): 749-751, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32893532

RESUMO

Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was found initially in Wuhan, China in early December 2019. The pandemic has spread to 216 countries and regions, infecting more than 23310 000 people and causing over 800 000 deaths globally by Aug. 24, 2020, according to World Health Organization (https://www.who.int/emergencies/diseases/ novel-coronavirus-2019). Fever, cough, and dyspnea are the three common symptoms of the condition, whereas the conventional transmission route for SARS-CoV-2 is through droplets entering the respiratory tract. To date, infection control measures for COVID-19 have been focusing on the involvement of the respiratory system. However, ignoring potential faecal transmission and the gastrointestinal involvement of SARS-CoV-2 may result in mistakes in attempts to control the pandemic.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Fezes/virologia , Gastroenteropatias/virologia , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Betacoronavirus/genética , China/epidemiologia , Infecções por Coronavirus/epidemiologia , Microbiologia Ambiental , Humanos , Modelos Biológicos , Pandemias , Pneumonia Viral/epidemiologia , RNA Viral/análise , RNA Viral/genética , Eliminação de Partículas Virais
19.
BMJ Case Rep ; 13(9)2020 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-32928812

RESUMO

A 33-year-old man with paranoid schizophrenia and a ventriculoperitoneal (VP) shunt was sent to our institution from an inpatient psychiatric facility due to concerns for the 2019 novel coronavirus (COVID-19). Per the facility, the patient had a fever and non-productive cough. On admission, the patient was afebrile and lacked subjective symptoms. A RNA reverse transcriptase PCR (RNA RT-PCR) test for COVID-19 was positive. A chest X-ray contained a small patchy opacity in the right middle lobe and another in the retrocardiac region concerning for pneumonia. Inflammatory markers were mildly elevated. He remained COVID-19 positive and asymptomatic for 36 days. This case details one asymptomatic carrier's course with persistently positive COVID-19 nasopharyngeal swabs. It demonstrates that a VP shunt could be a possible predisposition for prolonged viral shedding.


Assuntos
Infecções Assintomáticas , Betacoronavirus/genética , Infecções por Coronavirus/virologia , Pneumonia Viral/virologia , RNA Viral/análise , Derivação Ventriculoperitoneal , Adulto , Humanos , Masculino , Pandemias , Fatores de Tempo , Eliminação de Partículas Virais
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