OBJECTIVE: The outcome of patients with COVID-19 improved over the pandemic, including patients with systemic rheumatic diseases. However, data on patients with systemic sclerosis (SSc) are lacking. This study aimed to assess the outcome of patients with both SSc and COVID-19 over several waves. METHODS: Patients with both SSc and COVID-19 who were registered in the European Scleroderma Trials and Research group (EUSTAR) were collected between April 2020 and April 2021. Patients were assigned to waves 1, 2, or 3 depending on the date of their COVID-19 diagnosis. Primary endpoints were death, intensive care unit stay, or ventilatory support (severe outcome). Subgroup analyses of patients who were hospitalized or died were conducted. General and SSc-specific characteristics and treatment were compared over the waves. Descriptive statistics and multivariate logistic regression were applied. RESULTS: A total of 333 patients were included; 57 patients (17%) had a severe outcome, and 30 patients (9%) died. Compared to wave 1, significantly fewer patients with SSc suffered from severe COVID-19 in waves 2 and 3 (28.2% vs 9.8% and 12.7%; P < 0.001), fewer patients required hospitalization (46.7% vs 19.6% and 25.5%; P < 0.001) or ventilatory support (24.0% vs 8.7% and 10.9%; P = 0.001), and fewer patients died (15.7% vs 5.0% and 7.5%; P = 0.011). Patients were significantly younger, more often men, had less frequent arterial hypertension, and less SSc cardiac involvement over waves 1 to 3. Patients received significantly less medium to high doses of corticosteroids as they did SSc treatment. CONCLUSION: The outcome of patients with both SSc and COVID-19 improved significantly over time because of intrinsic and extrinsic factors.
BACKGROUND: To date there remains much ambiguity in the literature regarding the immunological interplay between SARS-CoV-2 and HIV and the true risk posed to coinfected individuals. There has been little conclusive data regarding the use of CD4 cell count and HIV viral load stratification as predictors of COVID-19 severity in this cohort. METHODS: We performed a retrospective, observational cohort study on people living with HIV (PLWH) who contracted COVID-19 in central and eastern Europe. We enrolled 536 patients from 16 countries using an online survey. We evaluated patient demographics, HIV characteristics and COVID-19 presentation and outcomes. Statistical analysis was performed using SPSS 20.1. RESULTS: The majority of the study cohort were male (76.4%) and 152 (28.3%) had a significant medical comorbidity. Median CD4 cell count at COVID-19 diagnosis was 605 cells/μL [interquartile range (IQR) 409-824]. The majority of patients on antiretroviral therapy (ART) were virally suppressed (92%). In univariate analysis, CD4 cell count <350 cells/μL was associated with higher rates of hospitalization (p < 0.0001) and respiratory failure (p < 0.0001). Univariate and multivariate analyses found that an undetectable HIV VL was associated with a lower rate of hospitalization (p < 0.0001), respiratory failure (p < 0.0001), ICU admission or death (p < 0.0001), and with a higher chance of full recovery (p < 0.0001). CONCLUSION: We can conclude that detectable HIV viral load was an independent risk factor for severe COVID-19 illness and can be used as a prognostic indicator in this cohort.
- MeSH
- COVID-19 * epidemiologie komplikace MeSH
- HIV infekce * komplikace farmakoterapie epidemiologie MeSH
- lidé MeSH
- počet CD4 lymfocytů MeSH
- respirační insuficience * MeSH
- retrospektivní studie MeSH
- SARS-CoV-2 MeSH
- testování na COVID-19 MeSH
- virová nálož MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
- Geografické názvy
- východní Evropa MeSH
First edition 70 stran : ilustrace ; 23 cm
The publication focuses on methods of RT-qPCR testing of viral respiratory diseases, for example COVID-19. Intended for professional public.
- MeSH
- infekce dýchací soustavy diagnóza MeSH
- polymerázová řetězová reakce metody MeSH
- testování na COVID-19 metody MeSH
- virologie MeSH
- virové nemoci diagnóza MeSH
- Publikační typ
- monografie MeSH
- Konspekt
- Patologie. Klinická medicína
- NLK Obory
- pneumologie a ftizeologie
- diagnostika
BACKGROUND: Testing of pooled samples is an effective strategy for increasing testing capacity while saving resources and time. This study aimed to validate pooled testing and gather real-life data on its use for Covid-19 surveillance with a gargle lavage (GL) self-sampling strategy. METHODS: Two-stage pooled testing with pools of 6 and 12 samples was used for preventive testing of an asymptomatic population and Covid-19 surveillance in Czech schools. Both GL and nasopharyngeal swabs were used for sampling. RESULTS: In total, 61,111 samples were tested. The use of pooled testing for large-scale Covid-19 surveillance reduced consumable costs by almost 75% and increased testing capacity up to 3.8-fold compared to standard methods. RT-PCR experiments revealed a minimal loss of sensitivity (0-2.2%) when using pooled samples, enabling the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) genes with Ct values >35. The minor loss of sensitivity was counterbalanced by a significantly increased throughput and the ability to substantially increase testing frequencies. CONCLUSIONS: Pooled testing is considerably more cost-effective and less time-consuming than standard testing for large-scale Covid-19 surveillance even when the prevalence of SARS-CoV-2 is fluctuating. Gargle lavage self-sampling is a non-invasive technique suitable for sample collection without a healthcare worker's assistance.
- MeSH
- COVID-19 * diagnóza epidemiologie MeSH
- lidé MeSH
- nazofarynx * virologie MeSH
- odběr biologického vzorku * metody MeSH
- SARS-CoV-2 * genetika izolace a purifikace MeSH
- senzitivita a specificita MeSH
- testování na COVID-19 průkazem nukleové kyseliny metody MeSH
- testování na COVID-19 metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
BACKGROUND: Although people with HIV might be at risk of severe outcomes from infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; coronavirus 2019 [COVID-19]), regional and temporal differences in SARS-CoV-2 testing in people with HIV across Europe have not been previously described. METHODS: We described the proportions of testing, positive test results, and hospitalizations due to COVID-19 between 1 January 2020 and 31 December 2021 in the EuroSIDA cohort and the factors associated with being tested for SARS-CoV-2 and with ever testing positive. RESULTS: Of 9012 participants, 2270 (25.2%, 95% confidence interval [CI] 24.3-26.1) had a SARS-CoV-2 polymerase chain reaction test during the study period (range: 38.3% in Northern to 14.6% in Central-Eastern Europe). People from Northern Europe, women, those aged <40 years, those with CD4 cell count <350 cells/mm3, and those with previous cardiovascular disease or malignancy were significantly more likely to have been tested, as were people with HIV in 2021 compared with those in 2020. Overall, 390 people with HIV (4.3%, 95% CI 3.9-4.8) tested positive (range: 2.6% in Northern to 7.1% in Southern Europe), and the odds of testing positive were higher in all regions than in Northern Europe and in 2021 than in 2020. In total, 64 people with HIV (0.7%, 95% CI 0.6-0.9) were hospitalized, of whom 12 died. Compared with 2020, the odds of positive testing decreased in all regions in 2021, and the associations with cardiovascular disease, malignancy, and use of tenofovir disoproxil fumarate disappeared in 2021. Among study participants, 58.9% received a COVID-19 vaccine (range: 72.0% in Southern to 14.8% in Eastern Europe). CONCLUSIONS: We observed large heterogeneity in SARS-CoV-2 testing and positivity and a low proportion of hospital admissions and deaths across the regions of Europe.
- MeSH
- COVID-19 * epidemiologie diagnóza MeSH
- dospělí MeSH
- HIV infekce * farmakoterapie epidemiologie MeSH
- hospitalizace * statistika a číselné údaje MeSH
- kohortové studie MeSH
- lidé středního věku MeSH
- lidé MeSH
- počet CD4 lymfocytů MeSH
- rizikové faktory MeSH
- SARS-CoV-2 * MeSH
- senioři MeSH
- testování na COVID-19 statistika a číselné údaje metody MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- Geografické názvy
- Evropa MeSH
Global impact of COVID-19 pandemic has heightened the urgency for efficient virus detection and identification of variants such as the Q57H mutation. Early and efficient detection of SARS-CoV-2 among densely populated developing countries is paramount objective. Although RT-PCR assays offer accuracy, however, dependence on expansive kits and availability of allied health resources pose an immense challenge for developing countries. In the current study, RT-LAMP based detection of SARS-Cov-2 with subsequent confirmation of Q57H variant through ARMS-PCR was performed. Among the 212 collected samples, 134 yielded positive results, while 78 tested negative using RT-LAMP. Oropharyngeal swabs of suspected individuals were collected and processed for viral RNA isolation. Isolated viral RNA was processed further by using either commercially available WarmStart Master Mix or our in house developed LAMP master mix separately. Subsequently, the end results of each specimen were evaluated by colorimetry. For LAMP assays, primers targeting three genes (ORF1ab, N and S) were designed using PrimerExplorer software. Interestingly, pooling of these three genes in single reaction tube increased sensitivity (95.5%) and specificity (93.5%) of LAMP assay. SARS-CoV-2 positive specimens were screened further for Q57H mutation using ARMS-PCR. Based on amplicon size variation, later confirmed by sequencing, our data showed 18.5% samples positive for Q57H mutation. Hence, these findings strongly advocate use of RT-LAMP-based assay for SARS-CoV-2 screening within suspected general population. Furthermore, ARMS-PCR also provides an efficient mean to detect prevalent mutations against SARS-Cov-2.
- MeSH
- COVID-19 * diagnóza MeSH
- diagnostické techniky molekulární metody MeSH
- lidé MeSH
- pandemie MeSH
- polymerázová řetězová reakce MeSH
- RNA virová genetika MeSH
- SARS-CoV-2 * genetika MeSH
- senzitivita a specificita MeSH
- testování na COVID-19 MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Over the past decade, the use of deep learning has been widely increasing in the medical image diagnosis field. Deep learning-based methods' (DLMs) performance strongly relies on training data. Therefore, researchers often focus on collecting as much data as possible from different medical facilities or developing approaches to avoid the impact of inter-category imbalance (ICI), which means a difference in data quantity among categories. However, due to the ICI within each medical facility, medical data are often isolated and acquired in different settings among medical facilities, known as the issue of intra-source imbalance (ISI) characteristic. This imbalance also impacts the performance of DLMs but receives negligible attention. In this study, we study the impact of the ISI on DLMs by comparison of the version of a deep learning model that was trained separately by an intra-source imbalanced chest X-ray (CXR) dataset and an intra-source balanced CXR dataset for COVID-19 diagnosis. The finding is that using the intra-source imbalanced dataset causes a serious training bias, although the dataset has a good inter-category balance. In contrast, the deep learning model performed a reliable diagnosis when trained on the intra-source balanced dataset. Therefore, our study reports clear evidence that the intra-source balance is vital for training data to minimize the risk of poor performance of DLMs.
- MeSH
- COVID-19 * diagnostické zobrazování MeSH
- deep learning * MeSH
- hrudník MeSH
- lidé MeSH
- rentgenové záření MeSH
- testování na COVID-19 MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
BACKGROUND AND AIM: Primary health care (PHC) supported long-term care facilities (LTCFs) in attending COVID-19 patients. The aim of this study is to describe the role of PHC in LTCFs in Europe during the early phase of the pandemic. METHODS: Retrospective descriptive study from 30 European countries using data from September 2020 collected with an ad hoc semi-structured questionnaire. Related variables are SARS-CoV-2 testing, contact tracing, follow-up, additional testing, and patient care. RESULTS: Twenty-six out of the 30 European countries had PHC involvement in LTCFs during the COVID-19 pandemic. PHC participated in initial medical care in 22 countries, while, in 15, PHC was responsible for SARS-CoV-2 test along with other institutions. Supervision of individuals in isolation was carried out mostly by LTCF staff, but physical examination or symptom's follow-up was performed mainly by PHC. CONCLUSION: PHC has participated in COVID-19 pandemic assistance in LTCFs in coordination with LTCF staff, public health officers, and hospitals.
- MeSH
- COVID-19 * epidemiologie MeSH
- dlouhodobá péče MeSH
- lidé MeSH
- pandemie MeSH
- primární zdravotní péče MeSH
- retrospektivní studie MeSH
- SARS-CoV-2 MeSH
- testování na COVID-19 MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Evropa MeSH
Ciele: Prvotným cieľom nášho monitorovania bolo zistiť dĺžku pretrvávania hladín protilátok po podaní mRNA vakcíny Comirnaty (Pfizer/BioNTech). Druhým cieľom bola analýza vplyvu vybraných faktorov na hladinu protilátok. Metódy: Súbor pozostával z 250 zamestnancov laboratórií Medirex, a. s. Na kvantitatívne stanovenie špecifických protilátok IgG anti-S1 a anti-S2 proti SARS-CoV-2 bola použitá chemiluminiscenčná imunoanalýza. Z analýzy bolo vyradených 29 osôb pre extrémne hodnoty hladín protilátok v jednotlivých meraniach. Analyzoval sa vplyv pohlavia, veku, BMI, pridružených ochorení a nežiadúcich účinkov po vakcinácii mRNA vakcínou Comirnaty (Pfizer/BioNTech) na hladinu protilátok. Porovnanie sa vykonalo na piatich odberoch v rozmedzí od 2 týždňov od podania 1. dávky po 36 týždňov od podania 2. dávky mRNA vakcíny. Po piatom odbere sa súbor rozdelil na dve skupiny. Prvá skupina sa očkovala 3. dávkou a druhá skupina ostala ako kontrolný súbor. Posledný (šiesty) odber sme vykonali v skupine s boostrom 3. dávky vakcíny 2 týždne po podaní boostra a v kontrolnej skupine v 11. mesiaci od podania 2. dávky vakcíny. Medzi 8. až 10. mesiacom od podania 2. dávky sme vykonali test bunkovej imunity. Výsledky: Pozitívnu hladinu protilátok malo v 36. týždni 99,6 % účastníkov. V kontrolnej skupine boli prítomné protilátky aj v 11. mesiaci od podania 2. dávky. Signifikantne vyššie hladiny protilátok boli u ženského pohlavia, mladších jedincov a pri vybraných nežiadúcich účinkoch. Reaktívne špecifické T lymfocyty boli prítomné u 65,6 % testovaných medzi 36. až 44. týždňom. Záver: Protilátková odpoveď klesá s časom od podania 2. dávky, avšak v kontrolnej skupine bola aj v 48. týždni stále prítomná. Efekt podania boostra na hladinu protilátok bol jednoznačne preukázaný. Súvislosť bunkovej imunity s hladinou protilátok ani s prítomnými protilátkami sme nepotvrdili.
Aims: The primary aim of our monitoring was to determine the duration of persistence of antibody levels following administration of the Comirnaty (Pfizer/BioNTech) mRNA vaccine. The second aim was to analyse the effect of selected factors on the level of antibodies. Methods: The study cohort consisted of 250 employees of the Medirex JSC laboratories. For the quantitative determination of specific IgG anti-S1 and anti-S2 antibodies to SARS-CoV-2, chemiluminescence immunoassay was used. Twenty-nine subjects were excluded from the analysis due to extreme values of antibody levels in individual measurements. The effect of gender, age, BMI, comorbidity, and adverse reactions after vaccination with the Comirnaty (Pfizer/BioNTech) mRNA vaccine on antibody levels was analysed. Comparisons were made for five samples collected from two weeks after the 1st dose to 36 weeks after the 2nd dose of the mRNA vaccine. After the fifth sampling, the cohort was divided into two groups. Group 1 received the 3rd dose, and Group 2 were controls. We performed the last (sixth) sample collection two weeks after booster administration in Group 1and 11 months after the 2nd dose of the vaccine in controls. Between months 8 and 10 after the 2nd dose, we performed a cellular immunity test. Results: Altogether 99.6% of the participants had a positive antibody level at week 36. Antibodies were still present in controls at month 11 after the 2nd dose. Significantly higher antibody levels were found in females, younger subjects, and those with selected adverse reactions. Reactive specific T lymphocytes were present in 65.6% of the subjects between weeks 36 and 44. Conslusion: The antibody response decreased with the time since the 2nd dose but was still present in the control group at week 48. The effect of booster on antibody levels was clearly demonstrated. We have not confirmed an association of cellular immunity with the level of antibodies or with the antibodies present.
- MeSH
- lidé MeSH
- protilátky virové analýza farmakologie imunologie krev MeSH
- SARS-CoV-2 imunologie izolace a purifikace MeSH
- sérologické testování na COVID-19 * klasifikace metody statistika a číselné údaje MeSH
- vakcína BNT162 aplikace a dávkování farmakologie imunologie MeSH
- vakcíny proti COVID-19 analýza farmakologie klasifikace krev MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- klinická studie MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Slovenská republika MeSH
BackgroundThe sensitivity and specificity of selected antigen detection rapid diagnostic tests (AG-RDTs) for SARS-CoV-2 were determined in the unvaccinated population when the Delta variant was circulating. Viral loads, dynamics, symptoms and tissue tropism differ between Omicron and Delta.AimWe aimed to compare AG-RDT sensitivity and specificity in selected subgroups during Omicron vs Delta circulation.MethodsWe retrospectively paired AG-RDT results with PCRs registered in Czechia's Information System for Infectious Diseases from 1 to 25 December 2021 (Delta, n = 20,121) and 20 January to 24 February 2022 (Omicron, n = 47,104).ResultsWhen confirmatory PCR was conducted on the same day as AG-RDT as a proxy for antigen testing close to peak viral load, the average sensitivity for Delta was 80.4% and for Omicron 81.4% (p < 0.05). Sensitivity in vaccinated individuals was lower for Omicron (OR = 0.94; 95% confidence interval (CI): 0.87-1.03), particularly in reinfections (OR = 0.83; 95% CI: 0.75-0.92). Saliva AG-RDT sensitivity was below average for both Delta (74.4%) and Omicron (78.4%). Tests on the European Union Category A list had higher sensitivity than tests in Category B. The highest sensitivity for Omicron (88.5%) was recorded for patients with loss of smell or taste, however, these symptoms were almost 10-fold less common than for Delta. The sensitivity of AG-RDTs performed on initially asymptomatic individuals done 1, 2 or 3 days before a positive PCR test was consistently lower for Omicron compared with Delta.ConclusionSensitivity for Omicron was lower in subgroups that may become more common if SARS-CoV-2 becomes an endemic virus.
- MeSH
- COVID-19 * diagnóza MeSH
- lidé MeSH
- reinfekce MeSH
- retrospektivní studie MeSH
- SARS-CoV-2 genetika MeSH
- testování na COVID-19 MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
