Corpus overview


MeSH Disease

Human Phenotype


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    Clinical utility of targeted SARS-CoV-2 serology testing to aid the diagnosis and management of suspected missed, late or post-COVID-19 infection syndromes: results from a pilot service

    Authors: Nicola Sweeney; Blair Merrick; Suzanne Pickering; Rui Pedro Galao; Alina Botgros; Harry D. Wilson; Adrian W. Signell; Gilberto Betancor; Mark Kia Ik Tan; John Ramble; Neophytos Kouphou; Sam Acors; Carl Graham; Jeffrey Seow; Eithne MacMahon; Stuart J. D. Neil; Michael H. Malim; Katie Doores; Sam Douthwaite; Rahul Batra; Gaia Nebbia; Jonathan D. Edgeworth

    doi:10.1101/2020.07.10.20150540 Date: 2020-07-11 Source: medRxiv

    Objectives: Determine indications and clinical utility of SARS-CoV-2 serology testing in adults TRANS and children TRANS. Design: Prospective evaluation of initial three weeks of a daily Monday to Friday pilot SARS-CoV-2 serology service for patients. Setting: Early post 'first-wave' SARS-CoV-2 transmission TRANS period at single centre London teaching hospital that provides care to the local community, as well as regional and national referral pathways for specialist services. Participants: 110 (72 adults TRANS, 38 children TRANS, age TRANS range 0-83 years, 52.7% female TRANS (n=58)). Interventions: Patient serum SERO from vetted referrals tested on CE marked and internally validated lateral flow immunoassay SERO (LFIA) (SureScreen Diagnostics) detecting antibodies to SARS-CoV-2 SERO spike proteins, with result and clinical interpretation provided to the direct care team. Main outcome measures: Performance SERO characteristics, source and nature of referrals, feasibility and clinical utility of the service, particularly the benefit for clinical decision-making. Results: The LFIA was deemed suitable for clinical advice and decision making following evaluation with 310 serum samples SERO from SARS-CoV-2 PCR positive patients and 300 pre-pandemic samples, giving a sensitivity SERO and specificity of 96.1% and 99.3% respectively. For the pilot, 115 referrals were received leading to 113 tests performed on 108 participants (sample not available for two participants); paediatrics (n=35), medicine (n=69), surgery (n=2) and general practice (n=2). 43.4% participants (n=49) had detectable antibodies to SARS-CoV-2 SERO. There were three main indications for serology; new acute presentations potentially triggered by recent COVID-19 infection e.g. PIMS-TS (n=26) and pulmonary embolism HP pulmonary embolism MESHD (n=5), potential missed diagnoses in context of a recent compatible illness (n=40), and making infection control and immunosuppression treatment decisions in persistently SARS-CoV-2 RNA PCR positive individuals (n=6). Conclusions: This study shows acceptable performance SERO characteristics, feasibility and clinical utility of a SARS-CoV-2 serology service using a rapid, inexpensive and portable assay for adults TRANS and children TRANS presenting with a range of clinical indications. Results correlated closely with a confirmatory in-house ELISA SERO. The study showed the benefit of introducing a serology service where there is a reasonable pre-test probability, and the result can be linked with clinical advice or intervention. Experience thus far is that the volume of requests from hospital referral routes are manageable within existing clinical and laboratory services; however, the demand from community referrals has not yet been assessed. Given recent evidence for a rapid decline in antibodies SERO, particularly following mild infection MESHD, there is likely a limited window of opportunity to realise the benefit of serology testing for individuals infected during the 'first-wave' before they potentially fall HP below a measurable threshold. Rapidly expanding availability of serology services for NHS patients will also help understand the long-term implications of serostatus and prior infection MESHD in different patient groups, particularly before emergence of any 'second-wave' outbreak or introduction of a vaccination programme.

    High Resolution CHEST MESHD CT(HRCT) Evaluation in Patients Hospitalized with COVID-19 Infection

    Authors: Maulin Patel; Junad Chowdhury; Matthew Zheng; Osheen Abramian; Steven Verga; Huaqing Zhao; Nicole Patlakh; David Fleece; Nicholas Montecalvo; Gary Cohen; Maruti Kumaran; Chandra Dass; Gerard Criner

    doi:10.1101/2020.05.26.20114082 Date: 2020-05-28 Source: medRxiv

    Abstract Introduction: Currently the main diagnostic modality for COVID-19 (Coronavirus disease-2019) is reverse transcriptase polymerase chain reaction (RT-PCR) via nasopharyngeal swab which has high false negative rates. We evaluated the performance SERO of high-resolution computed tomography (HRCT) imaging in the diagnosis of suspected COVID-19 infection MESHD compared to RT-PCR nasopharyngeal swab alone in patients hospitalized for suspected COVID-19 infection MESHD. Methods: This was a retrospective analysis of 324 consecutive patients admitted to Temple University Hospital. All hospitalized patients who had RT-PCR testing and HRCT were included in the study. HRCTs were classified as Category 1, 2 or 3. Patients were then divided into four groups based on HRCT category and RT-PCR swab results for analysis. Results: The average age TRANS of patients was 59.4 (+15.2) years and 123 (38.9%) were female TRANS. Predominant ethnicity was African American 148 (46.11%). 161 patients tested positive by RT-PCR, while 41 tested positive by HRCT. 167 (52.02%) had category 1 scan, 63 (19.63%) had category 2 scan and 91 (28.35%) had category 3 HRCT scans. There was substantial agreement between our radiologists for HRCT classification ({kappa} = 0.64). Sensitivity SERO and specificity of HRCT classification system was 77.6 and 73.7 respectively. Ferritin, LDH, AST and ALT were higher in Group 1 and D-dimers levels was higher in Group 3; differences however were not statistically significant. Conclusion: Due to its high infectivity and asymptomatic TRANS transmission TRANS, until a highly sensitive and specific COVID-19 test is developed, HRCT should be incorporated into the assessment of patients who are hospitalized with suspected COVID-19.

    Repeated seroprevalence SERO of anti-SARS-CoV-2 IgG antibodies SERO in a population-based sample from Geneva, Switzerland

    Authors: Silvia Stringhini; Ania Wisniak; Giovanni Piumatti; Andrew S Azman; Stephen A Lauer; Helene Baysson; David De Ridder; Dusan Petrovic; Stephanie Schrempft; Kailing Marcus; Isabelle Arm-Vernez; Sabine Yerly; Olivia Keiser; Samia Hurst; Klara Posfay-Barbe; Didier Trono; Didier Pittet; Laurent Getaz; Francois Chappuis; Isabella Eckerle; Nicolas Vuilleumier; Benjamin Meyer; Antoine Flahault; Laurent Kaiser; Idris Guessous

    doi:10.1101/2020.05.02.20088898 Date: 2020-05-06 Source: medRxiv

    Background: Assessing the burden of COVID-19 based on medically-attended case counts is suboptimal given its reliance on testing strategy, changing case definitions and the wide spectrum of disease presentation. Population-based serosurveys provide one avenue for estimating infection MESHD rates and monitoring the progression of the epidemic, overcoming many of these limitations. Methods: Taking advantage of a pool of adult TRANS participants from population-representative surveys conducted in Geneva, Switzerland, we implemented a study consisting of 8 weekly serosurveys among these participants and their household members older than 5 years. We tested each participant for anti-SARS-CoV-2- IgG antibodies SERO using a commercially available enzyme-linked immunosorbent assay SERO (Euroimmun AG, Lubeck, Germany). We estimated seroprevalence SERO using a Bayesian regression model taking into account test performance SERO and adjusting for the age TRANS and sex of Geneva's population. Results: In the first three weeks, we enrolled 1335 participants coming from 633 households, with 16% <20 years of age TRANS and 53.6% female TRANS, a distribution similar to that of Geneva. In the first week, we estimated a seroprevalence SERO of 3.1% (95% CI 0.2-5.99, n=343). This increased to 6.1% (95% CI 2.6-9.33, n=416) in the second, and to 9.7% (95% CI 6.1-13.11, n=576) in the third week. We found that 5-19 year-olds (6.0%, 95% CI 2.3-10.2%) had similar seroprevalence SERO to 20-49 year olds (8.5%, 95%CI 4.99-11.7), while significantly lower seroprevalence SERO was observed among those 50 and older (3.7%, 95% CI 0.99-6.0, p=0.0008). Interpretation: Assuming that the presence of IgG antibodies SERO is at least in the short-term associated with immunity, these results highlight that the epidemic is far from burning out simply due to herd immunity. Further, no differences in seroprevalence SERO between children TRANS and middle age TRANS adults TRANS are observed. These results must be considered as Switzerland and the world look towards easing restrictions aimed at curbing transmission TRANS.

    Mental health status of the general population, healthcare professionals, and university students during 2019 coronavirus disease outbreak in Jordan: a cross-sectional study

    Authors: Abdallah Y Naser; Eman Zmaily Dahmash; Rabaa Al-Rousan; Hassan Alwafi; Hamzeh Mohammad Alrawashdeh; Imene Ghoul; Anwar Abidine; Mohammed A. Bokhary; H. T. AL-Hadithi; Dalia Ali; Rasha Abuthawabeh; Ghada Mohammad Abdelwahab; Yosra J Alhartani; Haneen Al Muhaisen; Ayah Dagash

    doi:10.1101/2020.04.09.20056374 Date: 2020-04-11 Source: medRxiv

    Background: The emergence of COVID-19 global pandemic coupled with high transmission TRANS rate and mortality has created an unprecedented state of emergency worldwide. This global situation may have a negative impact on the psychological well-being of individuals which in turn impacts individuals performance SERO. Methods: A cross-sectional study using an online survey was conducted in Jordan between 22nd and 28th of March 2020 to explore the mental health status ( depression MESHD and anxiety HP anxiety MESHD) of the general population, healthcare professionals, and university students during the COVID-19 outbreak. The Patient Health Questionnaire (PHQ-9) and Generalized Anxiety HP Anxiety MESHD Disorder-7 (GAD-7) were used to assess depression MESHD and anxiety HP anxiety MESHD among the study participants. Logistic regression analysis was used to identify predictors of depression MESHD and anxiety HP anxiety MESHD. Results: The prevalence SERO of depression MESHD and anxiety HP anxiety MESHD among the entire study participants was 23.8% and 13.1%, respectively. Anxiety HP Anxiety MESHD was most prevalent across university students 21.5%, followed by healthcare professionals 11.3%, and general population 8.8%. Females TRANS among healthcare professionals and university students, divorced healthcare professionals, pulmonologists, and university students with history of chronic disease MESHD were at higher risk of developing depression MESHD. Females TRANS, divorced participants among the general population, and university students with history of chronic disease MESHD and those with high income ([≥]1500 JD) were at higher risk of developing anxiety HP anxiety MESHD. Conclusions: During outbreaks, individuals are put under extreme stressful condition resulting in higher risk of developing anxiety HP anxiety MESHD and depression MESHD particularly for students and healthcare professionals. Policymakers and mental healthcare providers are advised to provide further mental support to these vulnerable groups during this pandemic.

    Modes of contact and risk of transmission TRANS in COVID-19 among close contacts TRANS

    Authors: Lei Luo; Dan Liu; Xin-long Liao; Xian-bo Wu; Qin-long Jing; Jia-zhen Zheng; Fang-hua Liu; Shi-gui Yang; Bi Bi; Zhi-hao Li; Jian-ping Liu; Wei-qi Song; Wei Zhu; Zheng-he Wang; Xi-ru Zhang; Pei-liang Chen; Hua-min Liu; Xin Cheng; Miao-chun Cai; Qing-mei Huang; Pei Yang; Xin-fen Yang; Zhi-gang Huang; Jin-ling Tang; Yu Ma; Chen Mao

    doi:10.1101/2020.03.24.20042606 Date: 2020-03-26 Source: medRxiv

    Background Rapid spread of SARS-CoV-2 in Wuhan prompted heightened surveillance in Guangzhou and elsewhere in China. Modes of contact and risk of transmission TRANS among close contacts TRANS have not been well estimated. Methods We included 4950 closes contacts TRANS from Guangzhou, and extracted data including modes of contact, laboratory testing, clinical characteristics of confirmed cases TRANS and source cases. We used logistic regression analysis to explore the risk factors associated with infection MESHD of close contacts TRANS. Results Among 4950 closes contacts TRANS, the median age TRANS was 38.0 years, and males TRANS accounted for 50.2% (2484). During quarantine period, 129 cases (2.6%) were diagnosed, with 8 asymptomatic TRANS (6.2%), 49 mild (38.0%), and 5 (3.9%) severe to critical cases. The sensitivity SERO of throat swab was 71.32% and 92.19% at first to second PCR test. Among different modes of contact, household TRANS contacts were the most dangerous in catching with infection of COVID-19, with an incidence of 10.2%. As the increase of age TRANS for close contacts TRANS and severity of source cases, the incidence of COVID-19 presented an increasing trend from 1.8% (0-17 years) to 4.2% (60 or over years), and from 0.33% for asymptomatic TRANS, 3.3% for mild, to 6.2% for severe and critical source cases, respectively. Manifestation of expectoration in source cases was also highly associated with an increased risk of infection TRANS risk of infection TRANS infection MESHD in their close contacts TRANS (13.6%). Secondary cases TRANS were in general clinically milder and were less likely to have common symptoms than those of source cases. Conclusions In conclusion, the proportion of asymptomatic TRANS and mild infections account for almost half of the confirmed cases TRANS among close contacts TRANS. The household contacts TRANS were the main transmission TRANS mode, and clinically more severe cases were more likely to pass the infection MESHD to their close contacts TRANS. Generally, the secondary cases TRANS were clinically milder than those of source cases.

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MeSH Disease
Human Phenotype

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