Journal of clinical virology plus最新文献

Background

T cells and regulatory T cells (Tregs) play a critical role in viral infectious immunity. Exhaustion of T cells during infection and decreased Tregs both contribute to the exacerbation of the disease. In the present study, we assessed T cells and regulatory T cells of COVID-19 patients and a control group according to the expression of the PD-1 molecule.

Methods

Forty-two COVID-19 patients and 40 controls were enrolled in the study. In COVID-19 patients, blood samples were collected on the first day of their hospitalization. Regulatory T cells (CD4+, CD25+, FOXP3+), CD4+PD-1+, and PD-1+ regulatory T cells were assessed by flow cytometry.

Results

The percentage of CD4+PD-1 + T cells in COVID-19 patients was significantly higher compared to the control group (P < 0.0001). The percentage of PD-1+ regulatory T cells was significantly increased in the patient group compared to the control group (P < 0.0001). However, the Treg percentage was significantly decreased in the patient group compared to the control group (P < 0.0001). The frequency of CD4+PD-1 + T cells, Tregs, and PD-1+ Tregs had acceptable sensitivity and specificity for assisting in the diagnosis of severe/critical COVID-19. The declined Tregs and enhanced CD4+CD25+, CD4+PD-1+, and PD-1 + T cells were associated with disease severity.

Conclusion

The decrease in Tregs and the increase in exhaustion of these cells and T cells play an important role in COVID-19 pathogenesis. These immune parameters could be used as meaningful indicators for assisting in the diagnosis of severe/critical COVID-19.

Background

The swift global spread of coronavirus disease 2019 (COVID-19), a respiratory ailment primarily marked by pulmonary symptoms, has been linked to the involvement of various organs, including the intestines, kidneys, throat, and ears. Otitis media with effusion (OME), often succeeding an upper respiratory tract infection, mirrors its incidence. As a respiratory infectious disease, it prompts the query of whether the COVID-19 pandemic has spurred an uptick in OME and whether the COVID-19 virus persists in middle ear effusion (MEE) for an extended period.

Methods

To gauge the incidence of OME in the population during the COVID-19 pandemic, a tailored questionnaire was disseminated and subsequently analyzed. Assessing the rise in OME incidence during the pandemic, we compared the proportion of OME cases in the otology outpatient department between pandemic and non-pandemic periods. Statistical analysis involved a t-test. Simultaneously, MEE was collected from patients with COVID-19-associated OME during the pandemic to ascertain the presence of SARS-CoV-2 in MEE via polymerase chain reaction.

Results

Based on the questionnaire data, the estimated OME incidence in the population is approximately 31.4 %. In contrast to the non-pandemic period, the percentage variation in the OME outpatient proportion was 71.4 % (P < 0.05). Among the 61 MEE samples, 13 polymerase chain reaction results were positive, constituting 21.31 %. Nasopharyngeal swabs yielded negative results. Notably, only one patient experienced OME recurrence after 1 month of auripuncture.

Conclusions

COVID-19 can trigger an escalation in OME cases. Even when nasopharyngeal swabs show negative results, SARS-CoV-2 can endure in MEE for an extended duration, suggesting the potential for asymptomatic COVID-19 transmission and recurrence within the population.

Despite recent efforts to control and eradicate the hepatitis C virus (HCV), Iran still faces significant gaps and challenges in HCV epidemiological data. Accurate prevalence estimates based on comprehensive and up-to-date evidence compilations are critical in eliminating the virus. We used a qualitative approach in summarizing the findings of the included studies. The prevalence of HCV is within the range of 1.26 % (1.02 - 1.56). The introduction of strict screening protocols for blood transfusions has significantly reduced the incidence of transfusion-related HCV transmission in recent years though unsafe injection practices, men who have sex with men (MSM), and injecting drug use are still the primary risk factors for transmission. Studies indicate that the predominant HCV genotype in the country is genotype 1a, closely followed by genotypes 3a and 1b. Population-based studies and comprehensive national HCV surveillance systems are lacking. More efforts are needed to ensure the sustainability of HCV screening and infection control programs in Iran.

Hepatitis E virus (HEV) is a pathogen that causes hepatitis. There are few reports of HEV seroprevalence among people with human immunodeficiency virus (PWH) in Japan. This study aimed to determine the HEV seroprevalence among PWH at our hospital. Anti-HEV IgG was tested for using enzyme immunoassays and immunoblot assays. Clinical information was obtained from medical records and additional patient questionnaires. Sixty-eight PWH were included in this study. Four patients (5.9 %) showed HEV IgG seropositivity with both methods, while one patient (1.5 %) was seropositive using only the immunoblot assay, and three patients (4.4 %) were seropositive using only the enzyme immunoassay. There was a significant difference in age between anti-HEV IgG-seropositive and -negative individuals (median, 57.5 and 48.0 years, respectively; p = 0.012). There were no significant differences in the other clinical characteristics. Our results revealed that age is a risk factor for HEV infection among PWH.

Background

Most children are afflicted by a mild SARS-CoV-2-infection course in comparison to adults. However, data about differences between the experienced symptoms of pediatric/adolescent in comparison to adult athletes are sparse.

Methods

Competitive athletes of any age, who presented for preparticipation screening 04/2020–10/2021 with confirmed SARS-CoV-2-infection were included in this study, stratified for pediatric/adolescent (≤18years) or adult age (>18years) and both age-groups were compared regarding symptoms.

Results

Overall, 157 athletes with former SARS-CoV-2-infection (mean age 22.0 [18.0/27.0] years; 35.0 % females) were included in our study 04/2020 – 10/2021; among them, 40 (25.5 %) were pediatric/adolescent and 117 (74.5 %) adult athletes.

Pediatric/adolescent athletes had significantly more often an asymptomatic SARS-CoV-2-infection (22.5% vs. 6.0 %, P = 0.003). Symptoms of cold and flu-like symptoms (81.2% vs. 57.5 %, P = 0.003) and neurological symptoms (83.8% vs. 60.0 %, P = 0.002) were more often detected in adult athletes, while respiratory and cardiac symptoms were similar prevalent in both groups.

Age ≤ 18 years was independently associated with higher prevalence of asymptomatic SARS-CoV-2-infection (OR 5.12 [95 %CI 1.71–15.33], P = 0.004), but reduced occurrence of cold and flu-like symptoms (OR 0.27 [95 %CI 0.12–0.62], P = 0.002) and of neurological symptoms (OR 0.29 [95 %CI 0.13–0.67], P = 0.003). The included athletes were very rarely affected by adverse events. Pneumonia was detected in one adult athlete (0.9% vs. 0 %). None of the included athletes were afflicted by myocarditis or other serious adverse events.

Conclusions

Pediatric/adolescent athletes had more often an asymptomatic SARS-CoV-2-infection or were afflicted by only mild symptoms, while adult athletes suffered from larger symptom-burden predominantly driven by neurologic symptoms.

Background

Globally, rotavirus A (RV) is a leading cause of acute gastroenteritis (AGE) in young children under 5 years. The main aim of this study was to describe the prevalence of RV in children with and without diarrhea whose age ranged from 3 months to 5 years from two different hospitals of Nepal. We also described the diversity of rotavirus circulating during the pre-vaccination period in Nepal between 2006–2009.

Materials and methods

A total of 2400 stool samples collected from children's years with diarrhea (cases, N = 1200) and without diarrhea (controls, N = 1200) were tested for the presence of RV by both enzyme-linked immunosorbent assay and real-time reverse transcription polymerase chain reaction (RT-PCR). All samples positive for RT PCR and/or ELISA were further characterized for G and P genotypes by conventional RT-PCR.

Results

In total, 500 of the 2398 (20.8 %) samples (424 cases and 76 controls), were positive for RV. The most frequently detected G-types were G12, G1, and G9 and P-types were P[8] and P[6]. The predominant genotypes G12P[6], G12P[8], G1P[8] and G9P[8] were identified in 27.8 %, 24.2 %, 11.8 % and 10.8 % of the samples, respectively.

Conclusion

This study observed high prevalence of G12P[6] rotavirus circulating in Nepal before vaccine introduction and they may pose an emerging challenge to current and future vaccine. Therefore, continuous molecular surveillance of circulating genotypes and emerging rotavirus strain should be carried out to better understand the effectiveness of vaccination program.

Background/purpose

HPV infection is the primary cause of cervical cancer, and genotype distribution varies according to geographical location and carcinogenicity. Therefore, identifying HPV genotype and its association with cervical cancer features is critical for screening, diagnosis, and therapy.

Methods

Data from Vietnamese women with HPV-positive cervical cancer were collected from the northern region. The HPV genotype was identified using the Cobas^®®4800 HPV system, whereas the nucleotide sequences of the E6, E7, and L1 genes were used to identify lineages and sublineages using DNASTAR, Bioedit, ATGC 7.2, and MEGA 11.0.10 softwares.

Results

Of the 180 patients infected with HPV, 82.8 % revealed single infections, and 17.2 % showed multiple infections. HPV16 (64.4 %), HPV18 (28.9 %), and other HPVs (6.7 %) were the most prevalent HPV genotypes. HPV16 lineages included European (sublineage A1 (11.2 %), A2 (1.72 %), and A3 (25.86 %); Asian (sublineage A4 (53.85 %); African-American (sublineage D1 (5.17 %); and Asian-American (sublineage D3 (2.59 %). The HPV18 lineage includes Asian-Ameridian (sublineages A1 (100 %)). HPV18 revealed a higher rate of cervical cancer, cervicitis, warts, and ulcers than HPV16 and other high-risk genotypes in the 35–54–year–old group, but did not show a difference in cancer stages.

Conclusions

HPV16 and HPV18 genotypes are common in cervical cancer in northern Vietnam, with European, Asian, and Asian–Amerindian lineages predominating. HPV18 causes cervical cancer at a higher rate than other genotypes in the 35–54–year–old age group; thus, early identification of the genotype is critical for more successful therapy.

Background

Very limited literature on the clinical course of COVID-19 among liver transplant recipients (LT) is available from India. The present study aimed to evaluate the clinical and mutational profile of SARS-CoV-2 among LT.

Methodology

This was a retrospective study including LT cases in whom SARS-CoV-2 RT-PCR testing was requested between April 2020 and December 2022. Detailed mutational analysis was performed by comparing LT COVID-19 positive study group i.e. LT-CoV(+) with two control groups. One including COVID-19 positive with underlying chronic liver disease (CLD) i.e. CLD-CoV(+) and other including COVID-19 positive outpatients without any underlying LD i.e. NLD-CoV(+)

Results

Among 213 cases, 48 (22.5 %) were positive [LT-CoV(+)] and the remaining 165 (77.5 %) were negative [LT-CoV(-)] for SARS-CoV-2. Of these, 49 % had mild, 14 % moderate and 37 % had severe COVID-19. Mortality was recorded in 11 (23 %) cases, the majority being non-vaccinated. Severe COVID-19 with intensive care requirement was significantly higher among recipients with >5 years since transplant compared to recipients with ≤5 years (p = 0.02). Among 40 samples subjected to whole genome sequencing, 19 (47.5 %) were Delta, 15 (37.5 %) Omicron, and 6 (15 %) were other variants. COVID-19 severity was significantly higher in LT-CoV(+/D) with no significant difference in mortality (p = 0.122). No significant differences in mutational load and in fraction of deleterious mutations were observed between LT-/CLD-/NLD-CoV(+) groups for either Delta or Omicron.

Conclusion

An overall fatality rate of 23 % was recorded among LT recipients. Longer duration since transplant was associated with severe clinical course. However, no significant difference in mutation load between studied groups was observed.

Background

This study aimed to evaluate the impact of remdesivir, alone or in combination with corticosteroids, on the time to death in COVID-19 patients.

Methods

This retrospective cohort study was conducted between March 20, 2020, and March 18, 2021, on 5318 patients with confirmed COVID-19 at three tertiary educational hospitals in Tehran, Iran. The treated group consisted of COVID-19 patients who received remdesivir, either alone or in combination with corticosteroids, while the untreated group included infected patients who did not receive these treatments. The two groups were matched by propensity score matching method, which adjusted for 92 confounding factors such as demographic, sign and symptom, clinical, and treatment-related factors, to provide balanced covariates between the treated and untreated groups.

Results

Of the 4,322 patients, 791 received remdesivir alone and 694 received remdesivir combined with corticosteroids. Among the patients who received remdesivir, 456 were male, and the mean (±standard deviation) age was 59.52±16.49 with a median hospitalization stay of 8 (interquartile range: 5–13) days. After applying the nearest neighbor propensity score matching method, there were no significant differences found in the hazard of death between patients who received remdesivir alone and those who did not receive treatment (hazard ratio: 0.94; 95 % confidence interval: 0.76, 1.16). In addition, the combination of remdesivir and corticosteroids was not associated with a reduced hazard of death (hazard ratio: 1.00; 95 % confidence interval: 0.80, 1.26). The median hospitalization stay was significantly longer in the group treated with remdesivir (alone/combined with corticosteroids) compared to the untreated group, both before and after matching.

Conclusion

No association was observed between remdesivir treatment (alone/combined with corticosteroids) and a reduced hazard of death among COVID-19 patients. However, longer hospitalization stays were observed in patients receiving remdesivir, either alone or in combination with corticosteroids, compared to the untreated group.

Objective

To investigate the efficacy and safety of intravenous peramivir compared to oral oseltamivir for pediatric influenza by a method of meta-analysis.

Methods

Clinical trials involving intravenous peramivir versus oral oseltamivir therapy in children with influenza were searched from six databases until July 2023. Data were processed using Stata 15.0 software.

Results

Seven published articles were identified in this review. The combined results exhibited that the clinical effective rate in the peramivir group (76.09 %) was higher than that in the oseltamivir group (58.85 %) (RR= 1.12, 95 %CI: 1.01∼1.24, P = 0.038). The incidence of adverse reactions in the peramivir group (13.31 %) was lower than that in the oseltamivir group (17.34 %) (RR= 0.77, 95 %CI: 0.61–0.96, P = 0.023). Compared with the oseltamivir group, the peramivir group had lower recovery time of body temperature (WMD= -19.81, 95 %CI: -27.58∼-12.04, P < 0.001).

Conclusion

Compared with oral oseltamivir, intravenous peramivir has better efficacy and higher safety for pediatric influenza.