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1.
Genes (Basel) ; 12(7)2021 06 24.
Artigo em Inglês | MEDLINE | ID: mdl-34202464

RESUMO

ABO blood system is an inborn trait determined by the ABO gene. The genetic-phenotypic mechanism underneath the four mutually exclusive and collectively exhaustive types of O, A, B and AB could theoretically be elucidated. However, genetic polymorphisms in the human populations render the link elusive, and importantly, past studies using genetically determined rather than biochemically determined ABO types were not and could not be evaluated for the inference errors. Upon both blood-typing and genotyping a cohort of 1008 people of the Han Chinese population, we conducted a genome-wide association study in parallel with both binomial and multinomial log-linear models. Significant genetic variants are all mapped to the ABO gene, and are quantitatively evaluated for binary and multi-class classification performances. Three single nucleotide polymorphisms of rs8176719, rs635634 and rs7030248 would together be sufficient to establish a multinomial predictive model that achieves high accuracy (0.98) and F1 scores (micro 0.99 and macro 0.97). Using the set of identified ABO-associated genetic variants as instrumental variables, we demonstrate the application in causal analysis by Mendelian randomization (MR) studies on blood pressures (one-sample MR) and severe COVID-19 with respiratory failure (two-sample MR).


Assuntos
Sistema ABO de Grupos Sanguíneos/sangue , Sistema ABO de Grupos Sanguíneos/genética , COVID-19/genética , Polimorfismo de Nucleotídeo Único , Adulto , Grupo com Ancestrais do Continente Asiático/genética , Pressão Sanguínea/genética , COVID-19/etiologia , Estudos de Coortes , Feminino , Predisposição Genética para Doença , Estudo de Associação Genômica Ampla , Humanos , Masculino , Análise da Randomização Mendeliana , Pessoa de Meia-Idade , Modelos Estatísticos , Testes Sorológicos
2.
BMC Infect Dis ; 21(1): 688, 2021 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-34271860

RESUMO

BACKGROUND: Being able to use COVID-19 RT-PCR Ct values as simple clinical markers of disease outcome or prognosis would allow for the easy and proactive identification and triaging of high-risk cases. This study's objective was thus to explore whether a correlation exists between COVID-19 viral loads, as indicated by RT-PCR Ct values, and disease severity, as indicated by respiratory indices. RESULTS: A multi-centre cross-sectional retrospective study was conducted, using data obtained from Bahrain's National COVID-19 Task force's centralised database. The study period ranged from May 2, 2020 to July 31, 2020. A multivariable logistic regression was used to assess for a correlation using data from a total of 1057 admitted COVID-19 cases. The covariates adjusted for included sex, age, presentation, and comorbidities. In our cohort, Ct value showed no statistical significance for an association with requirement for oxygenation on admission (Odds ratio 1.046; 95%CI 0.999 to 1.096, p = 0.054). CONCLUSION: Viral load, as indicated by Ct values, did not seem to be associated with requirement for oxygenation on admission in our cohort. We postulate however that time since onset of symptom may have acted as an unaccounted-for confounder. As such, RT-PCR Ct values may not be a useful prognostic clinical tool in isolation.


Assuntos
COVID-19/diagnóstico , COVID-19/patologia , SARS-CoV-2/fisiologia , Carga Viral/fisiologia , Adulto , Idoso , Barein/epidemiologia , COVID-19/epidemiologia , COVID-19/virologia , Estudos de Coortes , Comorbidade , Estudos Transversais , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Pulmão/patologia , Pulmão/virologia , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Reação em Cadeia da Polimerase Via Transcriptase Reversa , SARS-CoV-2/genética , SARS-CoV-2/isolamento & purificação , Testes Sorológicos , Índice de Gravidade de Doença , Carga Viral/estatística & dados numéricos
3.
Nat Commun ; 12(1): 4383, 2021 07 19.
Artigo em Inglês | MEDLINE | ID: mdl-34282139

RESUMO

In February and March 2020, two mass swab testing campaigns were conducted in Vo', Italy. In May 2020, we tested 86% of the Vo' population with three immuno-assays detecting antibodies against the spike and nucleocapsid antigens, a neutralisation assay and Polymerase Chain Reaction (PCR). Subjects testing positive to PCR in February/March or a serological assay in May were tested again in November. Here we report on the results of the analysis of the May and November surveys. We estimate a seroprevalence of 3.5% (95% Credible Interval (CrI): 2.8-4.3%) in May. In November, 98.8% (95% Confidence Interval (CI): 93.7-100.0%) of sera which tested positive in May still reacted against at least one antigen; 18.6% (95% CI: 11.0-28.5%) showed an increase of antibody or neutralisation reactivity from May. Analysis of the serostatus of the members of 1,118 households indicates a 26.0% (95% CrI: 17.2-36.9%) Susceptible-Infectious Transmission Probability. Contact tracing had limited impact on epidemic suppression.


Assuntos
Anticorpos Antivirais/imunologia , Teste para COVID-19/métodos , COVID-19/imunologia , COVID-19/transmissão , SARS-CoV-2/imunologia , Testes Sorológicos/métodos , COVID-19/diagnóstico , COVID-19/epidemiologia , Teste de Ácido Nucleico para COVID-19 , Busca de Comunicante , Feminino , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Itália/epidemiologia , Masculino , Nucleocapsídeo , Estudos Soroepidemiológicos , Glicoproteína da Espícula de Coronavírus/imunologia
4.
BMC Infect Dis ; 21(1): 530, 2021 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-34090366

RESUMO

BACKGROUND: Cytomegalovirus (CMV) is reported to have thrombogenic characteristics that activate factor X in vitro and stimulate the production of factor VIII and von Willebrand factor (vWF). Thrombosis associated with CMV infection is prevalent among immunocompromised patients and predominantly presents as a solitary large thrombus in the deep vein, pulmonary artery, splanchnic arteriovenous ducts, or other similar sites. Multiple thrombi, however, are rarely observed in such cases. Here, we report about an immunocompetent man with multiple microthrombi associated with CMV infection. CASE PRESENTATION: A 72-year-old Japanese man who complained of abdominal pain was hospitalized with multiple colonic stenosis. He was later diagnosed with CMV enterocolitis and treated with ganciclover from Day 27 post-admission. During hospitalization, the patient developed thrombi in his fingers. He was initially treated with anticoagulant therapy (rivaroxaban); however, the therapy was discontinued owing to a prolonged activated thromboplastin time and an elevated international normalized ratio of prothrombin time. Instead, vitamin K and fresh-frozen plasma were administered. Nevertheless, his coagulation profile remained abnormal. Eventually, he developed colonic perforation and had to undergo emergency surgery. An intraoperative specimen showed several microthrombi in the middle and small arteriovenous ducts of his small and large intestines. The patient's coagulopathy improved preoperatively, and his overall condition improved postoperatively. Since the activation of ADAMTS13 was reduced remarkably, the thrombotic tendency was determined to be a thrombotic microangiopathy-like condition owing to increased vWF. We could not attribute the coagulopathy to any other cause except CMV infection; therefore, we concluded that this was a case of multiple thrombosis associated with CMV. CONCLUSIONS: We present an extremely rare case of a patient with multiple thrombotic microangiopathy-like microthrombosis caused by CMV infection. Our findings suggest that CMV infection may be considered as a differential diagnosis for immunocompetent individuals who present with thrombosis of unspecified cause.


Assuntos
Infecções por Citomegalovirus/complicações , Enterocolite/tratamento farmacológico , Ganciclovir/uso terapêutico , Rivaroxabana/uso terapêutico , Trombose/diagnóstico , Proteína ADAMTS13/metabolismo , Idoso , Anticoagulantes/uso terapêutico , Antivirais/uso terapêutico , Citomegalovirus/efeitos dos fármacos , Citomegalovirus/isolamento & purificação , Infecções por Citomegalovirus/tratamento farmacológico , Enterocolite/complicações , Enterocolite/virologia , Humanos , Perfuração Intestinal/cirurgia , Masculino , Testes Sorológicos , Trombose/complicações
5.
Rev Sci Tech ; 40(1): 299-309, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34140723

RESUMO

To select, interpret, and assess the fitness-for-purpose of diagnostic tests, we need to compare the likelihoods of test results being true vs. false across both infected and non-infected individuals. Diagnostic sensitivity (DSe) and specificity (DSp) report the accuracy of classification in infected and non-infected individuals separately and do not compare these likelihoods directly. Positive and negative predictive values combine these likelihoods, but they also heavily depend on the prevalence in the tested populations and, therefore, cannot be generalised. We propose the adoption of the diagnostic likelihood ratio (LR), which balances the likelihoods of true vs. false results and is population independent. As a relative measure, LR ignores the absolute accuracy of tests, and two tests with different accuracy profiles may have the same LR. This can be easily mitigated by using listed complementary measures of accuracy, including DSe and DSp, or ancillary selection criteria. Overall, LR is a more relevant and universal measure of diagnostic test accuracy, which makes it the logical next-generation measure to adopt. We illustrate the applications and benefits of LR using three assays certified by the World Organisation for Animal Health as serological tests for bovine tuberculosis.


Assuntos
Testes Diagnósticos de Rotina , Animais , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Testes Sorológicos/veterinária
6.
Proc Natl Acad Sci U S A ; 118(25)2021 06 22.
Artigo em Inglês | MEDLINE | ID: mdl-34083352

RESUMO

Quantitatively describing the time course of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection within an infected individual is important for understanding the current global pandemic and possible ways to combat it. Here we integrate the best current knowledge about the typical viral load of SARS-CoV-2 in bodily fluids and host tissues to estimate the total number and mass of SARS-CoV-2 virions in an infected person. We estimate that each infected person carries 109 to 1011 virions during peak infection, with a total mass in the range of 1 µg to 100 µg, which curiously implies that all SARS-CoV-2 virions currently circulating within human hosts have a collective mass of only 0.1 kg to 10 kg. We combine our estimates with the available literature on host immune response and viral mutation rates to demonstrate how antibodies markedly outnumber the spike proteins, and the genetic diversity of virions in an infected host covers all possible single nucleotide substitutions.


Assuntos
COVID-19/virologia , SARS-CoV-2/fisiologia , Carga Viral , Vírion/fisiologia , Humanos , Testes Sorológicos
7.
BMC Infect Dis ; 21(1): 609, 2021 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-34171990

RESUMO

BACKGROUND: The prevalence of hepatitis C virus (HCV) among people who inject drugs (PWID) continues to be a major public-health burden in this highly stigmatised population. To halt transmission of HCV, rapid HCV self-testing kits represent an innovative approach that could enable PWID to know their HCV status and seek treatment. As no HCV test has yet been licenced for self-administration, it is crucial to obtain knowledge around the factors that may deter or foster delivery of HCV self-testing among PWID in resource-constrained countries. METHODS: A qualitative study to assess values and preferences relating to HCV self-testing was conducted in mid-2020 among PWID in the Bishkek and Chui regions of Kyrgyzstan. Forty-seven PWID participated in 15 individual interviews, two group interviews (n = 12) and one participatory action-research session (n = 20). Responses were analysed using a thematic analysis approach with 4 predefined themes: awareness of HCV and current HCV testing experiences, and acceptability and service delivery preferences for HCV self-testing. Informants' insights were analysed using a thematic analysis approach. This research received local ethics approval. RESULTS: Awareness of HCV is low and currently PWID prefer community-based HCV testing due to stigma encountered in other healthcare settings. HCV self-testing would be accepted and appreciated by PWID. Acceptability may increase if HCV self-testing: was delivered in pharmacies or by harm reduction associations; was free of charge; was oral rather than blood-based; included instructions with images and clear information on the test's accuracy; and was distributed alongside pre- and post-testing counselling with linkage to confirmatory testing support. CONCLUSIONS: HCV self-testing could increase awareness of and more frequent testing for HCV infection among PWID in Kyrgyzstan. It is recommended that peer-driven associations are involved in the delivery of any HCV self-testing. Furthermore, efforts should be maximised to end discrimination against PWID at the healthcare institutions responsible for confirmatory HCV testing and treatment provision.


Assuntos
Autoavaliação Diagnóstica , Hepatite C/diagnóstico , Preferência do Paciente , Abuso de Substâncias por Via Intravenosa , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Redução do Dano , Hepacivirus/isolamento & purificação , Hepatite C/complicações , Hepatite C/epidemiologia , Hepatite C/psicologia , Humanos , Quirguistão/epidemiologia , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Preferência do Paciente/psicologia , Preferência do Paciente/estatística & dados numéricos , Prevalência , Autoteste , Testes Sorológicos/métodos , Valores Sociais , Abuso de Substâncias por Via Intravenosa/diagnóstico , Abuso de Substâncias por Via Intravenosa/epidemiologia , Abuso de Substâncias por Via Intravenosa/psicologia , Abuso de Substâncias por Via Intravenosa/virologia , Inquéritos e Questionários , Adulto Jovem
8.
Rev Chilena Infectol ; 38(2): 281-289, 2021 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-34184720

RESUMO

BACKGROUND: Human brucellosis is a global health problem. Mexico is one of the main countries affected; timely diagnosis and serological tests are the basis for detection. AIM: To know the frequency of confirmed cases of brucellosis in different of Family Medicine Units of the Mexican Social Security Institute in the state of Puebla, Mexico. METHODS: Cross-sectional study in patients of both genders, adults and pediatrics, with clinical manifestations suggestive of brucellosis; serological tests were performed for the confirmatory diagnosis. RESULTS: Out of a total of 77 patients, 39 (50.6%) were positive, 21 (27.3%) cases coming out of infection, 9 (11.7%) were negative and 8 (10.4%) were defined with immunological memory; of positive cases, 32 (82.1%) were found in the adult group and 30 (76.9%) were female. CONCLUSION: Around half of samples were confirmed as brucellosis, the clinical manifestations of the patients studied were non-specific, which highlights the importance of laboratory diagnosis.


Assuntos
Brucella , Brucelose , Adulto , Brucelose/diagnóstico , Brucelose/epidemiologia , Criança , Estudos Transversais , Feminino , Humanos , Masculino , México/epidemiologia , Testes Sorológicos
9.
J Zoo Wildl Med ; 52(2): 671-679, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34130410

RESUMO

Island species are particularly vulnerable to environmental disturbances and introduced pathogens. Conducting health assessments of wild populations in the Galápagos improves the ability of wildlife managers and veterinarians to detect deteriorations in health status. Seabirds in particular are useful species to monitor due to their colonial breeding and wide migration range. Nazca boobies (Sula granti) in a breeding colony at Daphne Major (n = 30) were given physical examinations, and blood samples were collected for hematology and biochemistry using an iSTAT Portable Clinical Analyzer. Female boobies had longer wing length than males, as well as lower blood urea nitrogen, creatinine, and white blood cell counts. This could be attributed to sexual dimorphism or differences in foraging and mating strategies between the sexes. The time between capture and blood collection had a significant inverse relationship on plasma sodium, potassium, hemoglobin, anion gaps, and lymphocyte counts, suggesting that blood sampling in Nazca boobies should be done in less than 5 m to avoid the impacts of stress on hematological parameters. This is the first health assessment on the breeding colony of Nazca boobies at Daphne Major, and the results can inform future monitoring in this species as well as other sulids.


Assuntos
Doenças das Aves/diagnóstico , Aves/sangue , Animais , Doenças das Aves/epidemiologia , Equador/epidemiologia , Feminino , Testes Hematológicos/veterinária , Masculino , Testes Sorológicos/veterinária
10.
Pathology ; 53(5): 645-651, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34119335

RESUMO

During New Zealand's first outbreak in early 2020 the Southern Region had the highest per capita SARS-CoV-2 infection rate. Polymerase chain reaction (PCR) testing was initially limited by a narrow case definition and limited laboratory capacity, and cases may have been missed. Our objectives were to evaluate the Abbott SARS-CoV-2 IgG nucleocapsid assay, alongside spike-based assays, and to determine the frequency of antibodies among PCR-confirmed and probable cases, and higher risk individuals in the Southern Region of New Zealand. Pre-pandemic sera (n=300) were used to establish assay specificity and sera from PCR-confirmed SARS-CoV-2 patients (n=78) to establish sensitivity. For prevalence analysis, all samples (n=1214) were tested on the Abbott assay, and all PCR-confirmed cases (n=78), probable cases (n=9), and higher risk individuals with 'grey-zone' (n=14) or positive results (n=11) were tested on four additional SARS-CoV-2 serological assays. The median time from infection onset to serum collection for PCR-confirmed cases was 14 weeks (range 11-17 weeks). The Abbott assay demonstrated a specificity of 99.7% (95% CI 98.2-99.99%) and a sensitivity of 76.9% (95% CI 66.0-85.7%). Spike-based assays demonstrated superior sensitivity ranging 89.7-94.9%. Nine previously undiagnosed sero-positive individuals were identified, and all had epidemiological risk factors. Spike-based assays demonstrated higher sensitivity than the Abbott IgG assay, likely due to temporal differences in antibody persistence. No unexpected SARS-CoV-2 infections were found in the Southern Region of New Zealand, supporting the elimination status of the country at the time this study was conducted.


Assuntos
Anticorpos Antivirais/sangue , COVID-19/imunologia , SARS-CoV-2/imunologia , Testes Sorológicos/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Proteínas do Nucleocapsídeo de Coronavírus/imunologia , Feminino , Humanos , Imunoglobulina G/sangue , Masculino , Pessoa de Meia-Idade , Nova Zelândia , Fosfoproteínas/imunologia , Sensibilidade e Especificidade , Adulto Jovem
11.
BMC Neurol ; 21(1): 236, 2021 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-34167488

RESUMO

BACKGROUND: Neurocysticercosis (NCC) is the most common helminthic infection of the central nervous system (CNS) caused by the larval stage of Taenia solium. Accurate and early diagnosis of NCC remains challenging due to its heterogeneous clinical manifestations, neuroimaging deficits, variable sensitivity, and specificity of serological tests. Next-generation sequencing (NGS)-based pathogen analysis in patient's cerebrospinal fluid (CSF) with NCC infection has recently been reported indicating its diagnostic efficacy. In this case study, we report the diagnosis of a NCC patient with a symptomatic history of over 20 years using NGS analysis and further confirmation of the pathology by immunological tests. CASE PRESENTATION: This study reports the clinical imaging and immunological features of a patient with a recurrent headache for more than 20 years, which worsened gradually with the symptom of fever for more than 7 years and paroxysmal amaurosis for more than 1 year. By utilizing NGS technique, the pathogen was detected in patient's CSF, and the presence of Taenia solium-DNA was confirmed by a positive immunological reaction to cysticercus IgG antibody in CSF and serum samples. The symptoms of the patient were alleviated, and the CSF condition was improved substantially after the anti-helminthic treatment. CONCLUSIONS: This study suggests that combining CSF NGS with cysticercus IgG testing may be a highly promising approach for diagnosing the challenging cases of NCC. Further studies are needed to evaluate the parasitic DNA load in patients' CSF for the diagnosis of disease severity, stage, and monitoring of therapeutic responses.


Assuntos
Sequenciamento de Nucleotídeos em Larga Escala , Neurocisticercose , Testes Sorológicos , Taenia solium , Animais , Anticorpos Anti-Helmínticos/sangue , DNA de Helmintos/genética , Humanos , Técnicas de Diagnóstico Molecular , Neurocisticercose/diagnóstico , Neurocisticercose/imunologia , Neurocisticercose/parasitologia , Taenia solium/genética , Taenia solium/imunologia
12.
Viruses ; 13(5)2021 05 12.
Artigo em Inglês | MEDLINE | ID: mdl-34066205

RESUMO

This study describes a case of SARS-CoV-2 reinfection confirmed by whole-genome sequencing in a healthy physician who had been working in a COVID-19 hospital in Italy since the beginning of the pandemic. Nasopharyngeal swabs were obtained from the patient at each presentation as part of routine surveillance. Nucleic acid amplification testing was performed on the two samples to confirm SARS-CoV-2 infection, and serological tests were used to detect SARS-CoV-2 IgG antibodies. Comparative genome analysis with whole-genome sequencing was performed on nasopharyngeal swabs collected during the two episodes of COVID-19. The first COVID-19 episode was in March 2020, and the second was in January 2021. Both SARS-CoV-2 infections presented with mild symptoms, and seroconversion for SARS-CoV-2 IgG was documented. Genomic analysis showed that the viral genome from the first infection belonged to the lineage B.1.1.74, while that from the second infection to the lineage B.1.177. Epidemiological, clinical, serological, and genomic analyses confirmed that the second episode of SARS-CoV-2 infection in the healthcare worker met the qualifications for "best evidence" for reinfection. Further studies are urgently needed to assess the frequency of such a worrisome occurrence, particularly in the light of the recent diffusion of SARS-CoV-2 variants of concern.


Assuntos
COVID-19/transmissão , Reinfecção/genética , SARS-CoV-2/patogenicidade , Adulto , Anticorpos Antivirais/genética , COVID-19/genética , Feminino , Genoma Viral/genética , Pessoal de Saúde , Humanos , Imunoglobulina G , Itália/epidemiologia , Reinfecção/metabolismo , SARS-CoV-2/genética , Testes Sorológicos , Sequenciamento Completo do Genoma/métodos
13.
Pan Afr Med J ; 39: 3, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34178231

RESUMO

While molecular techniques remain the gold standard for diagnosis of acute SARS-CoV-2 infection, serological tests have the unique potential to ascertain how much of the population has been exposed to the COVID-19 pathogen. There have been limited published studies to date documenting the performance of SARS-CoV-2 antibody assays in Nigeria and so we evaluated the diagnostic performance of five (5) immunoassay on a set of clinical samples. Five automated immunoassays (2019-nCoV IgG/IgM antibody determination kit, Tigsun COVID-19 combo IgM/IgG rapid test, rapid response COVID-19 IgG/IgM test, COVID-19 IgM-IgG combined antibody rapid test, iChroma COVID-19 Ab) were tested. Three hundred and fourteen specimens were analyzed from health care workers who tested positive PCR for SARS-CoV-2 with symptoms consistent with SARS-CoV-2 receiving treatment at two treatment centres in Nasarawa State from March to September, 2020 with control of 134 health care workers who tested negative PCR for SARS-CoV-2 with no symptoms to SARS-CoV-2. The median patients' age was 40 years (IQR 39.8-41), majority were male and were on admission. The SARS-CoV-2 IgG/IgM antibody evaluated kits had a sensitivity of 33% (2019-nCoV IgG/IgM antibody determination kit), 22% (Tigsun COVID-19 combo IgM/IgG rapid test), 43% (rapid response COVID-19 IgG/IgM test), 44% (COVID-19 IgM-IgG combined antibody rapid test), 25% (iChroma COVID-19 Ab), 100% sensitivity, accuracy of 68.5% and Kappa coefficient of 0.7 and rapid response COVID-19 IgG/IgM test cassette had a sensitivity of 33%, specificity of 100% and accuracy of 72.5% with Kappa coefficient 0.7. The Tigsun COVID-19 combo IgM/IgG rapid test (lateral flow), positive, COVID-19 IgM-IgG combined antibody rapid test and iChroma COVID-19 Ab RT all had sensitivity of zero percent. Serology was complementary to RT-PCR for the diagnosis of COVID-19 at least 14 days after onset of symptoms. The assay panel needs to be improved to serve as an option for the diagnosis of SARS-CoV-2 in resource constrained settings where there are limited molecular diagnostics testing panels.


Assuntos
Teste para COVID-19/métodos , COVID-19/diagnóstico , Imunoensaio/métodos , SARS-CoV-2/isolamento & purificação , Adulto , Anticorpos Antivirais/sangue , COVID-19/imunologia , Feminino , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Masculino , Nigéria , SARS-CoV-2/imunologia , Sensibilidade e Especificidade , Testes Sorológicos/métodos
14.
Pan Afr Med J ; 38: 185, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33995791

RESUMO

Since the onset of the COVID-19 pandemic, several small cohorts have reported the recurrent occurrence of venous thromboembolic disease (VTE), particulary pulmonary embolism, in serious patients hospitalized in intensive care units. We report the case of a patient who presented a minor COVID-19 infection treated on an outpatient basis with good clinical resolution. She developed a pulmonary embolism three weeks after the onset of symptoms. When she was admitted to the emergency room, the two real time reverse transcription polymerase chain reactions (RT-PCRs) performed were negative, moreover the anti-SARS-CoV-2 Immunoglobulin Gs (IgGs) serological test was positive and the chest scanner without and with injection of contrast product showed specific images of COVID-19 with intermediate pulmonary embolism according to the classification of the European society of cardiology (ESC). This observation is interesting since there are not many studies which address the question of the occurrence of late pulmonary embolism in patients with non-severe COVID-19 and raises the discussion on the criteria for the initiation of thromboembolic prophylaxis treatment at the first diagnosis of the disease and duration of that treatment.


Assuntos
COVID-19/complicações , Embolia Pulmonar/diagnóstico , Adulto , Feminino , Fibrinolíticos/administração & dosagem , Humanos , Embolia Pulmonar/virologia , Reação em Cadeia da Polimerase em Tempo Real , Testes Sorológicos , Índice de Gravidade de Doença , Fatores de Tempo
15.
BMC Infect Dis ; 21(1): 487, 2021 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-34044776

RESUMO

BACKGROUND: The World Health Organization (WHO) has targeted a reduction in viral hepatitis-related mortality by 65% and incidence by 90% by 2030, necessitating enhanced hepatitis B treatment and prevention programmes in low- and middle-income countries. Hepatitis B e antigen (HBeAg) status is used in the assessment of eligibility for antiviral treatment and for prevention of mother-to-child transmission (PMTCT). Accordingly, the WHO has classified HBeAg rapid diagnostic tests (RDTs) as essential medical devices. METHODS: We assessed the performance characteristics of three commercially available HBeAg RDTs (SD Bioline, Alere, South Africa; Creative Diagnostics, USA; and Biopanda Reagents, UK) in two hepatitis B surface antigen-positive cohorts in Blantyre, Malawi: participants of a community study (n = 100) and hospitalised patients with cirrhosis or hepatocellular carcinoma (n = 94). Two investigators, blinded to the reference test result, independently assessed each assay. We used an enzyme-linked immunoassay (Monolisa HBeAg, Bio-Rad, France) as a reference test and quantified HBeAg concentration using dilutions of the WHO HBeAg standard. We related the findings to HBV DNA levels, and evaluated treatment eligibility using the TREAT-B score. RESULTS: Among 194 HBsAg positive patients, median age was 37 years, 42% were femaleand 26% were HIV co-infected. HBeAg prevalence was 47/194 (24%). The three RDTs showed diagnostic sensitivity of 28% (95% CI 16-43), 53% (38-68) and 72% (57-84) and specificity of 96-100% for detection of HBeAg. Overall inter-rater agreement κ statistic was high at 0.9-1.0. Sensitivity for identifying patients at the threshold where antiviral treatment is recommended for PMTCT, with HBV DNA > 200,000 IU/ml (39/194; 20%), was 22, 49 and 54% respectively. Using the RDTs in place of the reference HBeAg assay resulted in 3/43 (9%), 5/43 (12%) and 8/43 (19%) of patients meeting the TREAT-B treatment criteria being misclassified as ineligible for treatment. A relationship between HBeAg concentration and HBeAg detection by RDT was observed. A minimum HBeAg concentration of 2.2-3.1 log10IU/ml was required to yield a reactive RDT. CONCLUSIONS: Commercially available HBeAg RDTs lack sufficient sensitivity to accurately classify hepatitis B patients in Malawi. This has implications for hepatitis B public health programs in sub-Saharan Africa. Alternative diagnostic assays are recommended.


Assuntos
Testes Diagnósticos de Rotina/métodos , Antígenos E da Hepatite B/sangue , Vírus da Hepatite B/imunologia , Hepatite B/diagnóstico , Adulto , Antivirais/uso terapêutico , Coinfecção/virologia , DNA Viral/análise , Ensaio de Imunoadsorção Enzimática/métodos , Infecções por HIV/complicações , Hepatite B/complicações , Antígenos de Superfície da Hepatite B/análise , Vírus da Hepatite B/isolamento & purificação , Humanos , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Malaui , Masculino , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Testes Sorológicos
17.
Tijdschr Gerontol Geriatr ; 52(1)2021 Mar 23.
Artigo em Holandês | MEDLINE | ID: mdl-34057361

RESUMO

Despite compliance with national (RIVM) guidelines, nursing home Mariënburght (the Netherlands) was severely affected during the first COVID-19 wave: 68 (68%) of the residents were infected. This resulted in a large emotional impact on the (nursing) staff. This study aims to describe the experiences of (nursing) staff, as well as the results of serological tests on COVID-19 that have been administered to professionals. All professionals (n=281) were invited for group interviews to share their experiences concerning the COVID-19 outbreak and for a serological test for COVID-19. The 29 professionals participating in the group interviews mentioned negative and positive experiences about their fear and anxiety, the changed care for residents, the team spirit, the use of personal protective equipment and the testing policy. Out of 240 professionals who underwent the serological test and completed a questionnaire, 94 professionals (39%) had COVID-19 antibodies. In this group, 18 professionals (19%) indicated not having experienced any (physical) complaints related to COVID. Insight into the experiences of professionals resulted in essential learning points, in particular the importance of clear communication with and emotional support for staff. This study also reveals that many professionals of nursing home Mariënburght were affected by COVID-19. An important finding is the high percentage of asymptomatic employees (19% of 94 infected). Our results contributed to changed national testing policies and adapted recommendations in the use of personal protective equipment in nursing homes.


Assuntos
COVID-19 , Surtos de Doenças , Humanos , Países Baixos/epidemiologia , Casas de Saúde , SARS-CoV-2 , Testes Sorológicos
18.
Front Immunol ; 12: 580147, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33936026

RESUMO

The coronavirus disease 2019 (COVID-19) is widely spread and remains a global pandemic. Limited evidence on the systematic evaluation of the impact of treatment regimens on antibody responses exists. Our study aimed to analyze the role of antibody response on prognosis and determine factors influencing the IgG antibodies' seroconversion. A total of 1,111 patients with mild to moderate COVID-19 symptoms admitted to Leishenshan Hospital in Wuhan were retrospectively analyzed. A serologic SARS-CoV-2 IgM/IgG antibody test was performed on all the patients 21 days after the onset of symptoms. Patient clinical characteristics were compared. In the study, 42 patients progressed to critical illness, with 6 mortalities reported while 1,069 patients reported mild to moderate disease. Advanced age (P = 0.028), gasping (P < 0.001), dyspnea (P = 0.024), and IgG negativity (P = 0.006) were associated with progression to critical illness. The mortality rate in critically ill patients with IgG antibody was 6.45% (95% CI 1.12-22.84%) and 36.36% (95% CI 12.36-68.38%) in patients with no IgG antibody (P = 0.003). Symptomatic patients were more likely to develop IgG antibody responses than asymptomatic patients. Using univariable analysis, fever (P < 0.001), gasping (P = 0.048), cancer (P < 0.001), cephalosporin (P = 0.015), and chloroquine/hydroxychloroquine (P = 0.021) were associated with IgG response. In the multivariable analysis, fever, cancer, cephalosporins, and chloroquine/hydroxychloroquine correlated independently with IgG response. We determined that the absence of SARS-CoV-2 antibody IgG in the convalescent stage had a specific predictive role in critical illness progression. Importantly, risk factors affecting seropositivity were identified, and the effect of antimalarial drugs on antibody response was determined.


Assuntos
Anticorpos Antivirais/imunologia , Antimaláricos/efeitos adversos , COVID-19/imunologia , Imunoglobulina G/imunologia , Adolescente , Adulto , Idoso , COVID-19/complicações , COVID-19/tratamento farmacológico , COVID-19/mortalidade , Cefalosporinas/efeitos adversos , China , Cloroquina/efeitos adversos , Convalescença , Feminino , Febre/complicações , Febre/virologia , Humanos , Hidroxicloroquina/efeitos adversos , Imunoglobulina M/imunologia , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Neoplasias/complicações , Neoplasias/virologia , Prognóstico , Estudos Retrospectivos , Fatores de Risco , SARS-CoV-2 , Soroconversão , Testes Sorológicos
19.
Front Cell Infect Microbiol ; 11: 579660, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33968792

RESUMO

Rising rates of syphilis (T. pallidum; Tp) requires rapid diagnosis and treatment to manage the growing epidemic. Syphilis serology is imperfect and requires interpretation of multiple tests while molecular diagnostics allows for potential yes-no identification of highly infective, primary anogenital lesions. Accuracy of this testing modality has thus far been limited to small, highly selective studies. Therefore, we retrospectively assessed a large, adult population of patients with anogenital lesions seen at Sexually Transmitted Infection (STI) clinics in Alberta, Canada who were screened for syphilis and herpes simplex (HSV) 1/2 using PCR to evaluate Tp-PCR versus serology to diagnose primary syphilis. 114 (3.1%) of the 3,600 adult patients had at least one Tp-PCR+ anogenital lesion with 99 (2.8%) patients having newly positive syphilis serology (new INNO-LIA positive or 4-fold RPR increase). Tp-PCR had a sensitivity of 49.3% (95% CI 42.6-56.1) and specificity of 99.9% (99.7-100.0). Positive predictive values and negative predictive values in the study population or when corrected for provincial prevalence were 97.4% (92.5-99.5) or 0.4% (0.4-1.2) and 96.7% (96.1-97.3) or 100.0% (100.0-100.0), respectively. Positive and negative likelihood ratios were estimated at 555 (178-1733) and 0.5 (0.4-0.6), respectively. Review of all Tp-PCR performed with or without exclusion of HSV-positive lesions resulted in no significant change in Tp-PCR characteristics. Interestingly, 12 of the Tp-PCR+ samples had negative serology at time of lesion sampling but became positive within our 28-day testing window. Overall, this study further supports the use of Tp-PCR as an accurate assay to rapidly identify, treat, and prevent the spread of primary syphilis.


Assuntos
Sífilis , Adulto , Estudos de Coortes , Humanos , Estudos Retrospectivos , Sensibilidade e Especificidade , Testes Sorológicos , Sífilis/diagnóstico , Sífilis/epidemiologia
20.
Clin Chim Acta ; 519: 172-182, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33939954

RESUMO

COVID-19, caused by SARS-CoV-2, is a highly infectious disease, and clinical laboratory detection has played important roles in its diagnosis and in evaluating progression of the disease. Nucleic acid amplification testing or gene sequencing can serve as pathogenic evidence of COVID-19 diagnosing for clinically suspected cases, and dynamic monitoring of specific antibodies (IgM, IgA, and IgG) is an effective complement for false-negative detection of SARS-CoV-2 nucleic acid. Antigen tests to identify SARS-CoV-2 are recommended in the first week of infection, which is associated with high viral loads. Additionally, many clinical laboratory indicators are abnormal as the disease evolves. For example, from moderate to severe and critical cases, leukocytes, neutrophils, and the neutrophil-lymphocyte ratio increase; conversely, lymphocytes decrease progressively but are over activated. LDH, AST, ALT, CK, high-sensitivity troponin I, and urea also increase progressively, and increased D-dimer is an indicator of severe disease and an independent risk factor for death. Severe infection leads to aggravation of inflammation. Inflammatory biomarkers and cytokines, such as CRP, SAA, ferritin, IL-6, and TNF-α, increase gradually. High-risk COVID-19 patients with severe disease, such as the elderly and those with underlying diseases (cardiovascular disease, diabetes, chronic respiratory disease, hypertension, obesity, and cancer), should be monitored dynamically, which will be helpful as an early warning of serious diseases.


Assuntos
COVID-19 , Serviços de Laboratório Clínico , Idoso , Humanos , Laboratórios , SARS-CoV-2 , Testes Sorológicos
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