Context: The COVID-19 pandemic has had profound impacts on public health, resulting in nearly 1 million deaths. Emerging evidence suggests an association between certain metabolites produced by gut microbiota and potential alterations in the severity of infection. Trimethylamine N-oxide (TMAO) is a waste metabolite generated by gut microbes from dietary choline and betaine. Evidence Acquisition: Several investigations have indicated an association between serum TMAO concentrations and the development of inflammation and thrombosis. Trimethylamine N-oxide, produced by the gut microbiome in a state of dysbiosis, upregulates various molecular mechanisms, such as the nuclear factor kappa (NF-kB) molecular pathway, and promotes the expression of scavenger receptors (SRs) on the surfaces of macrophages, leading to foam cell formation and inflammation. High levels of TMAO have been shown to induce the expression of pro-inflammatory cytokines like tumor necrosis factor-alpha (TNF-α) and interleukin 1β (IL-1β) while reducing the expression of anti-inflammatory cytokines such as interleukin-10 (IL-10). Additionally, gut-derived TMAO enhances platelet aggregation and adhesion to collagen, increasing the risk of thrombosis. Conclusions: Understanding the association between gut microbiome compositions such as gut TMAO and their effects on SARS-CoV-19 infection progression helps to control disease severity. In this review, we presented a hypothesis that the gut TMAO has the potential to increase COVID-19 disease severity.
{"title":"The Association Between the Gut Microbiome and COVID-19 Severity: The Potential Role of TMAO Produced by the Gut Microbiome","authors":"Milad Shahini Shams Abadi, Rozita Khodashahi, Mohsen Aliakbarian, Fatemeh Beiraghdar, Mohammad-Hassan Arjmand","doi":"10.5812/archcid-140346","DOIUrl":"https://doi.org/10.5812/archcid-140346","url":null,"abstract":"Context: The COVID-19 pandemic has had profound impacts on public health, resulting in nearly 1 million deaths. Emerging evidence suggests an association between certain metabolites produced by gut microbiota and potential alterations in the severity of infection. Trimethylamine N-oxide (TMAO) is a waste metabolite generated by gut microbes from dietary choline and betaine. Evidence Acquisition: Several investigations have indicated an association between serum TMAO concentrations and the development of inflammation and thrombosis. Trimethylamine N-oxide, produced by the gut microbiome in a state of dysbiosis, upregulates various molecular mechanisms, such as the nuclear factor kappa (NF-kB) molecular pathway, and promotes the expression of scavenger receptors (SRs) on the surfaces of macrophages, leading to foam cell formation and inflammation. High levels of TMAO have been shown to induce the expression of pro-inflammatory cytokines like tumor necrosis factor-alpha (TNF-α) and interleukin 1β (IL-1β) while reducing the expression of anti-inflammatory cytokines such as interleukin-10 (IL-10). Additionally, gut-derived TMAO enhances platelet aggregation and adhesion to collagen, increasing the risk of thrombosis. Conclusions: Understanding the association between gut microbiome compositions such as gut TMAO and their effects on SARS-CoV-19 infection progression helps to control disease severity. In this review, we presented a hypothesis that the gut TMAO has the potential to increase COVID-19 disease severity.","PeriodicalId":51793,"journal":{"name":"Archives of Clinical Infectious Diseases","volume":"23 6","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139125894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mahdie Poudine, Abolfazl Parsi-Moud, Amir Hossein Mohagheghi-Fard, Z. Bameri, Ilia Mirzaei, Motahareh Shahkhah, Ehsan Tohidi-Zadeh, Ebrahim Kord
Background: Chikungunya virus (CHIKV) spreads by Aedes mosquitoes in tropical and subtropical regions. Due to the geographical and social situation of the border cities of Sistan and Baluchestan province, this study was conducted to evaluate the prevalence of the Chikungunya infection in the southeastern cities of Iran using enzyme-linked immunosorbent assay (ELISA). Methods: In this cross-sectional study, 203 participants were randomly selected from 4 southeastern cities of Iran (Taftan, Sib-and-Suran, Mehrestan, and Mirjaveh). First, sociodemographic and clinical data were gathered by a questionnaire. Next, individual blood samples were taken, and ELISA was performed to measure anti-CHIKV IgG levels. Results: The participants’ ages ranged from 6 - 50 years, with 27.5% of them being 21 - 30 years old. Based on the results, 17 cases (8.37%) had episodes of fever, 13 (6.40%) had fever and arthralgia, and 12 (5.91%) had a history of hospitalization. In addition, there were 3 positive samples (1.48%). One of these people lived in Mehrestan, and two lived in Sib-and-Suran. The incidence of the virus infection was significantly higher in the age groups of 41 - 50 and 21 - 30 years old (P = 0.046). The likelihood of CHIKV infection was higher in farmers, independent contractors, and housewives (P = 0.001). Moreover, the most indicative clinical symptoms were the simultaneous occurrence of fever and arthralgia. Conclusions: The findings of this study confirm the presence of CHIKV in Sistan and Baluchestan. The geographic distribution of the positive samples indicates that other factors are involved in the spread of infection besides the tropical climate and proximity to Pakistan.
{"title":"Seroprevalence of Chikungunya Virus Infection in Sistan and Baluchestan Province, Iran: A Pilot Study","authors":"Mahdie Poudine, Abolfazl Parsi-Moud, Amir Hossein Mohagheghi-Fard, Z. Bameri, Ilia Mirzaei, Motahareh Shahkhah, Ehsan Tohidi-Zadeh, Ebrahim Kord","doi":"10.5812/archcid-139238","DOIUrl":"https://doi.org/10.5812/archcid-139238","url":null,"abstract":"Background: Chikungunya virus (CHIKV) spreads by Aedes mosquitoes in tropical and subtropical regions. Due to the geographical and social situation of the border cities of Sistan and Baluchestan province, this study was conducted to evaluate the prevalence of the Chikungunya infection in the southeastern cities of Iran using enzyme-linked immunosorbent assay (ELISA). Methods: In this cross-sectional study, 203 participants were randomly selected from 4 southeastern cities of Iran (Taftan, Sib-and-Suran, Mehrestan, and Mirjaveh). First, sociodemographic and clinical data were gathered by a questionnaire. Next, individual blood samples were taken, and ELISA was performed to measure anti-CHIKV IgG levels. Results: The participants’ ages ranged from 6 - 50 years, with 27.5% of them being 21 - 30 years old. Based on the results, 17 cases (8.37%) had episodes of fever, 13 (6.40%) had fever and arthralgia, and 12 (5.91%) had a history of hospitalization. In addition, there were 3 positive samples (1.48%). One of these people lived in Mehrestan, and two lived in Sib-and-Suran. The incidence of the virus infection was significantly higher in the age groups of 41 - 50 and 21 - 30 years old (P = 0.046). The likelihood of CHIKV infection was higher in farmers, independent contractors, and housewives (P = 0.001). Moreover, the most indicative clinical symptoms were the simultaneous occurrence of fever and arthralgia. Conclusions: The findings of this study confirm the presence of CHIKV in Sistan and Baluchestan. The geographic distribution of the positive samples indicates that other factors are involved in the spread of infection besides the tropical climate and proximity to Pakistan.","PeriodicalId":51793,"journal":{"name":"Archives of Clinical Infectious Diseases","volume":" 5","pages":""},"PeriodicalIF":1.4,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139136253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Masoumeh Farahani, B. Alirezaie, M. Padyab, Fatemeh Esna-ashari, Davood Bahador, Raza Shahbazi, Ashraf Mohammadi
Background: Passively acquired maternal antibodies through the placenta and/or breastfeeding may protect neonates against SARS-CoV-2 before they are considered eligible for active immunization. Objectives: This study aimed to determine the concentration and correlation of maternal and cord blood anti-SARS-CoV-2 IgG antibodies in Iranian seropositive women. In this preliminary study, attempts were also made to assess the effects of some variables on the transplacental transfer efficiency. Methods: From September 2021 to November 2021, pregnant women presenting to Kamali Hospital in Karaj, Iran, were enrolled in this monocentric study. The maternal and neonatal demographic characteristics were collected. The maternal and cord blood spike protein-specific antibody levels, measured at delivery (119 paired samples), were evaluated by the enzyme-linked immunosorbent assay (ELISA). Results: Based on the transplacental antibody transfer ratios, the participants were divided into 2 groups: Transfer ratio ≤ 1 (n = 53) and transfer ratio > 1 (n = 66). The results revealed that anti-SARS-CoV-2 IgG antibodies were transferred across the placenta in all seropositive pregnant Iranian women, and a significant correlation was found between maternal and cord blood-specific IgG antibody levels (r = 0.9646; P < 0.05). A relatively efficient transplacental transfer ratio was observed in Iranian seropositive women (transfer ratio > 1 in 66 out of 119 individuals; 55.46%). Although there were significant differences in the transplacental transfer ratio regarding the neonatal birth weight and maternal body mass index (BMI), more extensive investigations with a larger sample size are needed to confirm the significant association of these variables with the transplacental transfer efficiency of specific SARS-CoV-2 IgG antibodies. Conclusions: The present study highlighted the importance of vaccination during pregnancy to improve neonatal immune responses against SARS-CoV-2.
{"title":"Transplacental Transfer Efficiency of SARS-CoV-2-Specific IgG Antibodies in Iranian Seropositive Mothers: A Monocentric Study in Karaj, Iran","authors":"Masoumeh Farahani, B. Alirezaie, M. Padyab, Fatemeh Esna-ashari, Davood Bahador, Raza Shahbazi, Ashraf Mohammadi","doi":"10.5812/archcid-139871","DOIUrl":"https://doi.org/10.5812/archcid-139871","url":null,"abstract":"Background: Passively acquired maternal antibodies through the placenta and/or breastfeeding may protect neonates against SARS-CoV-2 before they are considered eligible for active immunization. Objectives: This study aimed to determine the concentration and correlation of maternal and cord blood anti-SARS-CoV-2 IgG antibodies in Iranian seropositive women. In this preliminary study, attempts were also made to assess the effects of some variables on the transplacental transfer efficiency. Methods: From September 2021 to November 2021, pregnant women presenting to Kamali Hospital in Karaj, Iran, were enrolled in this monocentric study. The maternal and neonatal demographic characteristics were collected. The maternal and cord blood spike protein-specific antibody levels, measured at delivery (119 paired samples), were evaluated by the enzyme-linked immunosorbent assay (ELISA). Results: Based on the transplacental antibody transfer ratios, the participants were divided into 2 groups: Transfer ratio ≤ 1 (n = 53) and transfer ratio > 1 (n = 66). The results revealed that anti-SARS-CoV-2 IgG antibodies were transferred across the placenta in all seropositive pregnant Iranian women, and a significant correlation was found between maternal and cord blood-specific IgG antibody levels (r = 0.9646; P < 0.05). A relatively efficient transplacental transfer ratio was observed in Iranian seropositive women (transfer ratio > 1 in 66 out of 119 individuals; 55.46%). Although there were significant differences in the transplacental transfer ratio regarding the neonatal birth weight and maternal body mass index (BMI), more extensive investigations with a larger sample size are needed to confirm the significant association of these variables with the transplacental transfer efficiency of specific SARS-CoV-2 IgG antibodies. Conclusions: The present study highlighted the importance of vaccination during pregnancy to improve neonatal immune responses against SARS-CoV-2.","PeriodicalId":51793,"journal":{"name":"Archives of Clinical Infectious Diseases","volume":"64 4","pages":""},"PeriodicalIF":1.4,"publicationDate":"2023-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138967137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Alian, Masoud Maboudi, Tahereh Shokohi, A. Khalatbari
Introduction: Cryptococcal meningitis is a significant leading cause of death among individuals with HIV worldwide. It is caused by Cryptococcus neoformans and the C. gattii species complex. The primary predisposing factor is HIV, but it can also be observed in conditions such as immunodeficiency, sarcoidosis, liver disease, solid organ transplantation, and steroid treatment. Case Presentation: This report discusses a 61-year-old man with a medical history of liver transplantation, open-heart surgery, diabetes, hypertension, and previous cryptococcal meningitis. He had been receiving antifungals and was discharged in good condition to continue maintenance treatment at home. During his latest admission, he was hospitalized to investigate weakness and suspicious ulcerated skin lesions refractory to glucantime through biopsy. Two days after hospitalization and before receiving the biopsy result, the patient gradually developed lethargy, headache, and nausea. Laboratory examinations of cerebrospinal fluid (CSF) and skin biopsies revealed encapsulated yeast cells identified as Cryptococcus neoformans using culture media and the PCR method. The patient died shortly after receiving liposomal amphotericin B and oral fluconazole. Conclusions: This case emphasizes the importance of follow-up visits for high-risk patients, early screening for fungal infections, and long-term antifungal treatment, especially in immunocompromised patients, to reduce unfavorable outcomes.
导言：隐球菌性脑膜炎是导致全球艾滋病病毒感染者死亡的一个重要原因。它是由新生隐球菌和加特纳隐球菌复合菌引起的。主要诱发因素是艾滋病病毒，但在免疫缺陷、肉样瘤病、肝脏疾病、实体器官移植和类固醇治疗等情况下也可发生。病例介绍：本报告讨论的是一名 61 岁男子，病史包括肝移植、开胸手术、糖尿病、高血压和既往隐球菌性脑膜炎。他一直在接受抗真菌治疗，出院时情况良好，可以在家继续维持治疗。最近一次入院时，他因虚弱和葡萄糖醛酸难治性可疑溃疡性皮损而住院。住院两天后，在得到活检结果之前，患者逐渐出现嗜睡、头痛和恶心。脑脊液（CSF）和皮肤活检的实验室检查发现了包裹的酵母细胞，使用培养基和 PCR 方法鉴定为新生隐球菌。患者在接受脂质体两性霉素 B 和口服氟康唑治疗后不久死亡。结论：本病例强调了对高危患者进行随访、及早筛查真菌感染和长期抗真菌治疗的重要性，尤其是对免疫力低下的患者，以减少不良后果的发生。
{"title":"Recurrent Fatal Cryptococcal Meningitis in a Patient with Liver Transplant: A Case Report and Review of Literature","authors":"S. Alian, Masoud Maboudi, Tahereh Shokohi, A. Khalatbari","doi":"10.5812/archcid-140298","DOIUrl":"https://doi.org/10.5812/archcid-140298","url":null,"abstract":"Introduction: Cryptococcal meningitis is a significant leading cause of death among individuals with HIV worldwide. It is caused by Cryptococcus neoformans and the C. gattii species complex. The primary predisposing factor is HIV, but it can also be observed in conditions such as immunodeficiency, sarcoidosis, liver disease, solid organ transplantation, and steroid treatment. Case Presentation: This report discusses a 61-year-old man with a medical history of liver transplantation, open-heart surgery, diabetes, hypertension, and previous cryptococcal meningitis. He had been receiving antifungals and was discharged in good condition to continue maintenance treatment at home. During his latest admission, he was hospitalized to investigate weakness and suspicious ulcerated skin lesions refractory to glucantime through biopsy. Two days after hospitalization and before receiving the biopsy result, the patient gradually developed lethargy, headache, and nausea. Laboratory examinations of cerebrospinal fluid (CSF) and skin biopsies revealed encapsulated yeast cells identified as Cryptococcus neoformans using culture media and the PCR method. The patient died shortly after receiving liposomal amphotericin B and oral fluconazole. Conclusions: This case emphasizes the importance of follow-up visits for high-risk patients, early screening for fungal infections, and long-term antifungal treatment, especially in immunocompromised patients, to reduce unfavorable outcomes.","PeriodicalId":51793,"journal":{"name":"Archives of Clinical Infectious Diseases","volume":"56 44","pages":""},"PeriodicalIF":1.4,"publicationDate":"2023-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138995579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. E. Tsygankova, A. Gerasimov, V. Chulanov, O. Darvina, K. Umbetova, V. A. Malov, E. Volchkova
Background: Currently, the global HIV epidemic remains ongoing, with a significant number of patients having undiagnosed advanced HIV disease. Providing medical care to patients with both COVID-19 and advanced HIV disease presents specific challenges due to the simultaneous lung damage caused by the SARS-CoV-2 virus and opportunistic pathogens. Objectives: This study aimed to explain the rationale behind recommending HIV screening for patients with severe COVID-19. Methods: A single-center retrospective cohort study was conducted using electronic medical records from a specialized hospital in Moscow that focused on coinfection with HIV/COVID-19. Among the 3,563 patients hospitalized in the relevant departments during the study period, 408 patients were included based on the inclusion/exclusion criteria. Out of the 408 patients with both COVID-19 and advanced HIV disease, 132 individuals were newly diagnosed with HIV infection, while 276 individuals had a previously established HIV diagnosis. Results: The mortality rate in the group of patients with COVID-19 and advanced HIV disease was 31.7% (95% CI, 27.3 - 36.3%). Among patients with COVID-19 and newly diagnosed advanced HIV disease, the mortality rate was 45.5% (95% CI, 37.1 - 54%), while in the group of patients with previously diagnosed advanced HIV disease, the mortality rate was 25% (95% CI, 20.2 - 30.4%). The proportion of individuals with critical CT-4 lung disease in the first group was 32.3% compared to 9.4% in the second group (P < 0.001). The median CD4+ count was 20 cells/µL in the first group compared with 88 cells/µL in the second group (P < 0.001). Conclusions: The presence of pneumocystis pneumonia increased the risk of death by 2.51 times in patients with COVID-19 and newly diagnosed advanced HIV disease. Additionally, Kaposi's sarcoma increased the risk of death by 1.31 times in the same patient group. Furthermore, the detection of HIV infection for the first time during hospitalization due to COVID-19 in the entire study cohort increased the risk of death by 2.21 times.
{"title":"Previously Diagnosed HIV Infection in Patients with COVID-19 and Advanced HIV Disease Improves Their Survival","authors":"A. E. Tsygankova, A. Gerasimov, V. Chulanov, O. Darvina, K. Umbetova, V. A. Malov, E. Volchkova","doi":"10.5812/archcid-142231","DOIUrl":"https://doi.org/10.5812/archcid-142231","url":null,"abstract":"Background: Currently, the global HIV epidemic remains ongoing, with a significant number of patients having undiagnosed advanced HIV disease. Providing medical care to patients with both COVID-19 and advanced HIV disease presents specific challenges due to the simultaneous lung damage caused by the SARS-CoV-2 virus and opportunistic pathogens. Objectives: This study aimed to explain the rationale behind recommending HIV screening for patients with severe COVID-19. Methods: A single-center retrospective cohort study was conducted using electronic medical records from a specialized hospital in Moscow that focused on coinfection with HIV/COVID-19. Among the 3,563 patients hospitalized in the relevant departments during the study period, 408 patients were included based on the inclusion/exclusion criteria. Out of the 408 patients with both COVID-19 and advanced HIV disease, 132 individuals were newly diagnosed with HIV infection, while 276 individuals had a previously established HIV diagnosis. Results: The mortality rate in the group of patients with COVID-19 and advanced HIV disease was 31.7% (95% CI, 27.3 - 36.3%). Among patients with COVID-19 and newly diagnosed advanced HIV disease, the mortality rate was 45.5% (95% CI, 37.1 - 54%), while in the group of patients with previously diagnosed advanced HIV disease, the mortality rate was 25% (95% CI, 20.2 - 30.4%). The proportion of individuals with critical CT-4 lung disease in the first group was 32.3% compared to 9.4% in the second group (P < 0.001). The median CD4+ count was 20 cells/µL in the first group compared with 88 cells/µL in the second group (P < 0.001). Conclusions: The presence of pneumocystis pneumonia increased the risk of death by 2.51 times in patients with COVID-19 and newly diagnosed advanced HIV disease. Additionally, Kaposi's sarcoma increased the risk of death by 1.31 times in the same patient group. Furthermore, the detection of HIV infection for the first time during hospitalization due to COVID-19 in the entire study cohort increased the risk of death by 2.21 times.","PeriodicalId":51793,"journal":{"name":"Archives of Clinical Infectious Diseases","volume":"81 9","pages":""},"PeriodicalIF":1.4,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138979428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Parisa Delkash, Amir Azimi, Niloufar Taherpour, Saeid Haji Aghajani
Background: This study aimed to investigate the incidence and clinical characteristics of flare-ups in patients with systemic lupus erythematosus (SLE) following immunization with inactivated SARS-CoV-2 vaccines. Methods: In this cross-sectional study at Imam Hossein Hospital's Rheumatology Clinic (Iran), we investigated 72 SLE patients in remission who received the Sinopharm BIBP inactivated COVID-19 vaccine. Their post-vaccination status was monitored for 3 months using the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) checklist by an internal medicine specialist. Results: Fourteen patients (19.44%) experienced symptom flare-ups after vaccination. The most common symptoms were arthritis (64.29%) and skin rash (21.43%). Age, sex, organ involvement, and treatment regimen did not significantly differ between those with and without symptom recurrence (P > 0.05). The second vaccine dose led to more flare-ups compared to the first dose (12.12% vs. 8.33%, P < 0.001). However, the severity of symptom recurrence, measured by the SLEDAI-2K score (P = 0.763), and the interval from vaccination to symptom recurrence (P = 0.075) did not significantly differ between the 2 groups. Except for 2 patients, none of the participants required hospitalization, and flare-up symptoms were effectively managed by prednisolone dosage adjustments. For these 2 patients, the treatment regimen was changed, and the steroid dose was increased; one of them was admitted to the hospital, and the other one was managed on an outpatient basis. Conclusions: The incidence of flare-ups in SLE patients in remission following COVID-19 vaccination with Sinopharm BIBP vaccine was low; most of them were mild and did not require hospitalization, except for 1 patient who was hospitalized after the first dose of vaccination and received rituximab due to vasculitis flare. These findings highlight vaccine safety and underscore the importance of close monitoring, especially after the second dose.
背景:本研究旨在探讨系统性红斑狼疮(SLE)患者接种SARS-CoV-2灭活疫苗后急性发作的发生率和临床特点。方法:在伊朗伊玛目侯赛因医院风湿病诊所的横断面研究中，我们调查了72例接受国药BIBP灭活疫苗的缓解期SLE患者。他们接种疫苗后的状态由内科专家使用系统性红斑狼疮疾病活动指数2000 (SLEDAI-2K)检查表监测3个月。结果:14例(19.44%)患者接种疫苗后出现症状发作。最常见的症状是关节炎(64.29%)和皮疹(21.43%)。有无症状复发的患者年龄、性别、脏器受累情况、治疗方案差异无统计学意义(P > 0.05)。与第一剂疫苗相比，第二剂疫苗导致更多的急性发作(12.12% vs. 8.33%， P < 0.001)。然而，以SLEDAI-2K评分衡量的症状复发严重程度(P = 0.763)和从接种疫苗到症状复发的时间间隔(P = 0.075)在两组之间无显著差异。除2例患者外，所有患者均无需住院治疗，并通过调整泼尼松龙剂量有效控制发作症状。这2例患者改变治疗方案，增加类固醇剂量;其中一人入院，另一人在门诊接受治疗。结论:接种国药BIBP疫苗后缓解期SLE患者急性发作发生率较低;除1例患者在接种第一剂疫苗后住院并因血管炎发作接受利妥昔单抗治疗外，其余病例均为轻度，无需住院治疗。这些发现强调了疫苗的安全性，并强调了密切监测的重要性，特别是在第二次接种后。
{"title":"The Role of Sinopharm BIBP COVID-19 Vaccine Immunization in Systemic Lupus Erythematous Flare-up","authors":"Parisa Delkash, Amir Azimi, Niloufar Taherpour, Saeid Haji Aghajani","doi":"10.5812/archcid-139989","DOIUrl":"https://doi.org/10.5812/archcid-139989","url":null,"abstract":"Background: This study aimed to investigate the incidence and clinical characteristics of flare-ups in patients with systemic lupus erythematosus (SLE) following immunization with inactivated SARS-CoV-2 vaccines. Methods: In this cross-sectional study at Imam Hossein Hospital's Rheumatology Clinic (Iran), we investigated 72 SLE patients in remission who received the Sinopharm BIBP inactivated COVID-19 vaccine. Their post-vaccination status was monitored for 3 months using the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) checklist by an internal medicine specialist. Results: Fourteen patients (19.44%) experienced symptom flare-ups after vaccination. The most common symptoms were arthritis (64.29%) and skin rash (21.43%). Age, sex, organ involvement, and treatment regimen did not significantly differ between those with and without symptom recurrence (P > 0.05). The second vaccine dose led to more flare-ups compared to the first dose (12.12% vs. 8.33%, P < 0.001). However, the severity of symptom recurrence, measured by the SLEDAI-2K score (P = 0.763), and the interval from vaccination to symptom recurrence (P = 0.075) did not significantly differ between the 2 groups. Except for 2 patients, none of the participants required hospitalization, and flare-up symptoms were effectively managed by prednisolone dosage adjustments. For these 2 patients, the treatment regimen was changed, and the steroid dose was increased; one of them was admitted to the hospital, and the other one was managed on an outpatient basis. Conclusions: The incidence of flare-ups in SLE patients in remission following COVID-19 vaccination with Sinopharm BIBP vaccine was low; most of them were mild and did not require hospitalization, except for 1 patient who was hospitalized after the first dose of vaccination and received rituximab due to vasculitis flare. These findings highlight vaccine safety and underscore the importance of close monitoring, especially after the second dose.","PeriodicalId":51793,"journal":{"name":"Archives of Clinical Infectious Diseases","volume":"58 24","pages":""},"PeriodicalIF":1.4,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138597427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Zeinali, S. Doosti, Behzad Amiri, Gidiglo Nutifafa Godwin, R. Mehdizad
Introduction: Crimean Congo hemorrhagic fever (CCHF) is a tick-borne, zoonotic disease distributed globally. As the clinical features of CCHF and COVID-19 are similar, getting an early and reliable diagnosis may be difficult. Case Presentation: We report the first misdiagnosed case of CCHF in the setting of a COVID-19 pandemic from Ravansar County of Kermanshah province in Iran. Our patient was initially misdiagnosed with COVID-19, got hospitalized, but later tested positive for CCHF. However, the delay in diagnosis caused her death. Conclusions: Crimean Congo hemorrhagic fever should be considered among people in endemic areas who show COVID-19 symptoms for urgent medical attention.
{"title":"A Case Report of Crimean-Congo Hemorrhagic Fever in Iran","authors":"M. Zeinali, S. Doosti, Behzad Amiri, Gidiglo Nutifafa Godwin, R. Mehdizad","doi":"10.5812/archcid-132680","DOIUrl":"https://doi.org/10.5812/archcid-132680","url":null,"abstract":"Introduction: Crimean Congo hemorrhagic fever (CCHF) is a tick-borne, zoonotic disease distributed globally. As the clinical features of CCHF and COVID-19 are similar, getting an early and reliable diagnosis may be difficult. Case Presentation: We report the first misdiagnosed case of CCHF in the setting of a COVID-19 pandemic from Ravansar County of Kermanshah province in Iran. Our patient was initially misdiagnosed with COVID-19, got hospitalized, but later tested positive for CCHF. However, the delay in diagnosis caused her death. Conclusions: Crimean Congo hemorrhagic fever should be considered among people in endemic areas who show COVID-19 symptoms for urgent medical attention.","PeriodicalId":51793,"journal":{"name":"Archives of Clinical Infectious Diseases","volume":"9 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139233675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Mardani, S. D. Mousavi-Nasab, Maryam Shahali, Mohammad Javad Hossein Tehrani, Nayebali Ahmadi, F. Zali, Iraj Khodadadi
Background: Among the serum biomarkers of infectious diseases, calprotectin and heparin-binding protein (HBP) seem to be of clinical and diagnostic value in patients with COVID-19. Objectives: This study aimed to investigate the serum levels of calprotectin, HBP, and some other inflammatory markers in COVID-19 patients. Methods: In this case-control study, serum samples of 35 outpatients with COVID-19 and 35 healthy individuals were collected, and the levels of calprotectin, HBP, C-reactive protein (CRP), ferritin (FERR), as well as platelet (PLT) and neutrophil (NEU) counts and LDH activity, were determined. Results: At first, SARS-CoV2 viral RNA was detected in the pharyngeal swab specimens of COVID-19 patients. Calprotectin, FERR, and CRP levels, LDH activity, and PLT and NEU counts were found to be significantly higher in COVID-19 patients compared with controls (P < 0.05), whereas no statistically significant difference was observed in HBP level (P > 0.05). Serum calprotectin showed a significant correlation with CRP and FERR levels, LDH activity, and NEU count (P < 0.001). Conclusions: Our findings showed that an increment in serum calprotectin level, together with increased CRP levels, might be a promising indicator of SARS-CoV2 infection.
{"title":"Determination of Serum Calprotectin, Heparin-Binding Protein, and Some Inflammatory Factors in Patients with COVID-19","authors":"R. Mardani, S. D. Mousavi-Nasab, Maryam Shahali, Mohammad Javad Hossein Tehrani, Nayebali Ahmadi, F. Zali, Iraj Khodadadi","doi":"10.5812/archcid-139430","DOIUrl":"https://doi.org/10.5812/archcid-139430","url":null,"abstract":"Background: Among the serum biomarkers of infectious diseases, calprotectin and heparin-binding protein (HBP) seem to be of clinical and diagnostic value in patients with COVID-19. Objectives: This study aimed to investigate the serum levels of calprotectin, HBP, and some other inflammatory markers in COVID-19 patients. Methods: In this case-control study, serum samples of 35 outpatients with COVID-19 and 35 healthy individuals were collected, and the levels of calprotectin, HBP, C-reactive protein (CRP), ferritin (FERR), as well as platelet (PLT) and neutrophil (NEU) counts and LDH activity, were determined. Results: At first, SARS-CoV2 viral RNA was detected in the pharyngeal swab specimens of COVID-19 patients. Calprotectin, FERR, and CRP levels, LDH activity, and PLT and NEU counts were found to be significantly higher in COVID-19 patients compared with controls (P < 0.05), whereas no statistically significant difference was observed in HBP level (P > 0.05). Serum calprotectin showed a significant correlation with CRP and FERR levels, LDH activity, and NEU count (P < 0.001). Conclusions: Our findings showed that an increment in serum calprotectin level, together with increased CRP levels, might be a promising indicator of SARS-CoV2 infection.","PeriodicalId":51793,"journal":{"name":"Archives of Clinical Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2023-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139236753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chakameh Amini, Zahra Rahmani, S. Hosseini, Parmida Bagheri, Mehdi Goudarzi
Background: Staphylococcus aureus is one of the most significant bacteria involved in ear infections. However, insights into the molecular attributes of S. aureus collected from patients with chronic otitis media have yet to be reported in Iran. Objectives: The objective of this study was to assess the molecular characteristics of S. aureus isolated from patients with chronic otitis media. Methods: A total of 55 S. aureus strains retrieved from patients with chronic otitis media were analyzed by the disk diffusion method and polymerase chain reaction (PCR) to identify the nucA gene. Isolates were genetically classified using the coagulase typing method. S. aureus protein A (spa) typing, staphylococcal cassette chromosome mec (SCCmec) typing, and multilocus sequence typing (MLST) were performed on isolates with resistance to specific antibiotics. Results: Overall, out of 55 S. aureus isolates, resistance to mupirocin, fusidic acid, and tigecycline was identified in 12.7%, 5.4%, and 3.6% of isolates, respectively. Fusidic acid-resistant isolates belonged to ST5-SCCmecII/t002/coaII. Two tigecycline-resistant isolates belonged to CC8/ST239-SCCmecIII/t234/coaVIII. One positive mecC isolate belonged to the CC/ST130-SCCmecXI/t843/coaIII clone. Isolates with the iMLSB phenotype belonged to CC/ST80-SCCmecIV/t044/coaII (4 isolates), CC8/ST239-SCCmecIII/t388/coaVI (3 isolates), and CC8/ST8-SCCmecIV/t008/coaIII (1 isolate). Conclusions: Our results indicated that S. aureus isolated from patients with chronic otitis media possesses a unique molecular profile with a high percentage of resistance to multiple medications. These findings suggest that resuming the molecular analysis to improve the control and prevention of ear infections related to S. aureus is necessary.
{"title":"First Report of the Emergence of mecC Gene and CC8/ST239 Tigecycline-Resistant Staphylococcus aureus Clonal Lineage Isolated from Chronic Suppurative Otitis Media","authors":"Chakameh Amini, Zahra Rahmani, S. Hosseini, Parmida Bagheri, Mehdi Goudarzi","doi":"10.5812/archcid-139695","DOIUrl":"https://doi.org/10.5812/archcid-139695","url":null,"abstract":"Background: Staphylococcus aureus is one of the most significant bacteria involved in ear infections. However, insights into the molecular attributes of S. aureus collected from patients with chronic otitis media have yet to be reported in Iran. Objectives: The objective of this study was to assess the molecular characteristics of S. aureus isolated from patients with chronic otitis media. Methods: A total of 55 S. aureus strains retrieved from patients with chronic otitis media were analyzed by the disk diffusion method and polymerase chain reaction (PCR) to identify the nucA gene. Isolates were genetically classified using the coagulase typing method. S. aureus protein A (spa) typing, staphylococcal cassette chromosome mec (SCCmec) typing, and multilocus sequence typing (MLST) were performed on isolates with resistance to specific antibiotics. Results: Overall, out of 55 S. aureus isolates, resistance to mupirocin, fusidic acid, and tigecycline was identified in 12.7%, 5.4%, and 3.6% of isolates, respectively. Fusidic acid-resistant isolates belonged to ST5-SCCmecII/t002/coaII. Two tigecycline-resistant isolates belonged to CC8/ST239-SCCmecIII/t234/coaVIII. One positive mecC isolate belonged to the CC/ST130-SCCmecXI/t843/coaIII clone. Isolates with the iMLSB phenotype belonged to CC/ST80-SCCmecIV/t044/coaII (4 isolates), CC8/ST239-SCCmecIII/t388/coaVI (3 isolates), and CC8/ST8-SCCmecIV/t008/coaIII (1 isolate). Conclusions: Our results indicated that S. aureus isolated from patients with chronic otitis media possesses a unique molecular profile with a high percentage of resistance to multiple medications. These findings suggest that resuming the molecular analysis to improve the control and prevention of ear infections related to S. aureus is necessary.","PeriodicalId":51793,"journal":{"name":"Archives of Clinical Infectious Diseases","volume":"3 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139246615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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