Corpus overview


Overview

MeSH Disease

Human Phenotype

Dyspnea (2)

Fever (2)

Pneumonia (2)

Anosmia (1)

Leukopenia (1)


Transmission

Seroprevalence
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    SEROPREVALENCE SERO AND CLINICAL SPECTRUM OF SARS-CoV-2 INFECTION IN MESHD THE FIRST VERSUS THIRD TRIMESTER OF PREGNANCY

    Authors: Francesca Crovetto; Fatima Crispi; Elisa Llurba; Francesc Figueras; Maria Dolores Gomez-Roig; Eduard Gratacos

    doi:10.1101/2020.06.17.20134098 Date: 2020-06-19 Source: medRxiv

    Introduction: Case registries of pregnant women diagnosed with coronavirus disease MESHD (COVID-19) by polymerase chain reaction (PCR) have reported that the majority experienced mild infection MESHD, but up to 9% may require critical care. Most COVID-19 cases published were in the third trimester of pregnancy, which could reflect reporting bias, higher risk of infection TRANS risk of infection TRANS infection MESHD or increased disease severity in late pregnancy. Seroprevalence SERO studies may allow reliable estimates of the susceptibility to infection MESHD and clinical spectrum since they include asymptomatic TRANS and mild infections not tested for PCR. We evaluated the seroprevalence SERO and clinical presentation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection MESHD in pregnant women in the first and third trimester. Methods: The study was approved by the Institutional Review Board at each institution and informed consent was obtained. We recruited 874 consecutive pregnancies attending for first trimester screening (10-16 weeks of gestation, n=372) or delivery (n=502) from April 14 to May 5. All women were interviewed with a structured questionnaire for COVID-19 symptoms two months prior to sampling. SARS-CoV-2 IgG and IgM/IgA antibodies were tested SERO (COVID-19 VIRCLIA Monotest, Vircell Microbiologist, Spain; reported sensitivity SERO 70% IgG and 89% IgM/IgA, and specificity 89% and 99% respectively). Indeterminate results were re-tested (VITROS Immunodiagnostic Products Anti-SARS-CoV2 Total Tests, Ortho Clinical Diagnostics, USA; 100% sensitivity SERO and specificity) and re-classified as positive or negative. Women with COVID-19 were diagnosed and managed according to standard protocols and guidelines3,4. Statistical differences were tested using the {chi}2 test or Student t-test as appropriate (p<0.05). Results: A total of 125 of 874 women (14.3%) were positive for either IgG or IgM/IgA SARS-CoV-2 antibodies SERO, 54/372 (14.5%) in the first and 71/502 (14.1%) in the third trimester. A total of 75/125 (60%) reported no symptoms of COVID-19 in the past 2 months, whereas 44 (35.2%) reported one or more symptoms, of which 31 (24.8%) had at least 3 symptoms or anosmia HP anosmia MESHD and 8 (6.4%) dyspnea HP dyspnea MESHD. Overall, 7 women (5.6%) were admitted for persistent fever HP fever MESHD despite paracetamol and dyspnea HP dyspnea MESHD, of which 3 had signs of pneumonia HP pneumonia MESHD on chest radiography. All 3 had criteria for severity (bilateral chest condensation, respiratory rate>30 and leukopenia HP leukopenia MESHD) and required oxygen support but not critical care or mechanical ventilation, and they were all discharged well. The rates of symptomatic infection MESHD, hospital admission or dyspnea HP dyspnea MESHD were significantly higher in third trimester women (Table and Figure). Discussion: The 14.3% seroprevalence SERO of SARS-COV-2 in pregnant women in this study was substantially larger than the contemporary rates of PCR positive cases (0.78%) reported for women 20-40y in Barcelona. The data confirm that COVID-19 is asymptomatic TRANS in the majority of pregnant women6 and illustrate the value of seroprevalence SERO studies to capture the high proportion of asymptomatic TRANS or mild infections MESHD. In this study, none of the 125 pregnant women with SARS-CoV-2 infection MESHD required critical care as compared to 9% reported in cases diagnosed with PCR. However, the proportion of infections MESHD with symptoms or dyspnea HP dyspnea MESHD was remarkably higher in the third trimester, and these results are in line with COVID-19 registries, reporting that 81% of hospitalized women were in late pregnancy or peripartum. These results provide reassuring information that, even in settings with a high prevalence SERO, SARS-CoV-2 infection MESHD in pregnancy mostly presents with asymptomatic TRANS or mild clinical forms. The susceptibility to infection seemed to be the same in the first and the third trimesters of gestation. The data further suggest that, as with other respiratory viruses, COVID-19 could be more severe and require increased surveillance in late pregnancy. These findings should be confirmed and extended with larger consecutive prevalence SERO studies in pregnancy.

    SARS-CoV-2 Serology Results in the First COVID-19 Case in California: A Case Report and Recommendations for Serology Testing and Interpretation

    Authors: Richard B. Lanman, MD; Todd H. Lanman

    doi:10.21203/rs.3.rs-35358/v1 Date: 2020-06-12 Source: ResearchSquare

    Background: As countries in COVID-19 pandemic lockdown begin relaxation of shelter-in-place mitigation strategies, the role of serology testing escalates in importance. However, there are no clear guidelines as to when to use qualitative rapid diagnostic serology tests (RDTs) vs. SARS-CoV-2 viral RNA load (PCR) tests as an aid in acute diagnosis of patients presenting with flu-like symptoms, nor how to interpret serology test results in asymptomatic TRANS individuals or those with atypical COVID-19 symptomatology. Here we describe, in the context of the likely first case of COVID-19 in California, with an atypical presentation and not tested acutely, who nearly 3 months later was found to be IgM- and IgG+ positive for SARS-CoV-2 antibodies SERO, highlighting the role of RDT- based serology testing SERO and interpretation in retrospective diagnosis.Case Presentation: A 62-year-old male TRANS practicing neurosurgeon had onset of flu-like symptoms on January 20 with fatigue HP fatigue MESHD, slight cough HP only on deep inspiration, intermittent pleuritic chest pain MESHD chest pain HP unrelated to exertion, dyspnea HP dyspnea MESHD, and night sweats HP but without fever HP fever MESHD, sore throat or rhinorrhea HP rhinorrhea MESHD. He had recently traveled TRANS abroad but not to China. CT scan revealed right lower lobe infiltrate and effusion. Because of atypical symptoms, and low prevalence SERO of COVID-19 in January, community acquired pneumonia HP pneumonia MESHD was diagnosed and one week of doxycycline was prescribed without relief, followed by a second week of azithromycin with symptom remission. Three months later the physician-patient (author THL), tested positive for SARS-CoV-2 antibodies SERO by a serology point-of-care rapid diagnostic test (RDT).Conclusions: Serology testing may be an aid in acute diagnosis of COVID-19, especially in patients with atypical presentations, as well as in assessment of asymptomatic TRANS higher-risk persons such as healthcare workers for prior infection MESHD. Recommendations for serology testing and interpretation are explicated.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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