SARS‐CoV‐2 intrahost evolution in immunocompromised patients in comparison with immunocompetent populations after treatment

Journal of Medical Virology, Journal Year: 2023, Volume and Issue: 95(6)

Published: June 1, 2023

Abstract Many evidence suggests that long‐lasting infection can develop with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). This occurrence has been widely described in immunocompromised individuals. In these patients, ineffective clearance of virus provides an opportunity for developing immune escape mutants. study aimed to characterize SARS‐CoV‐2 intrahost evolution five comparison immunocompetent COVID‐19 patients during treatment. We performed next‐generation sequencing (NGS) on collected two oropharyngeal samples from and before after this study, we detected alpha delta variants SARS‐CoV‐2. The most common substitutions structural proteins variant were S‐ΔY143‐144, A570D, D614G D1118H, N‐R203K G204R, S‐T19R, G142D, E156G, 157‐158del, L452R, T478K, D614G, D950N N‐D63G, R203M D377Y dominant. variations nonstructural accessory including nsp3‐A488S, P1228L, nsp6‐T77A, nsp12‐P323L, G671S, nsp13‐P77L, NS3‐S26L, NS7a‐T120I detected. Also some infrequent seen patients. After treatment, nsp12‐V166A was emerged as a remdesivir resistance S‐L452M patient variable immunodeficiency. S‐E484Q lymphoma leukemia. showed the possibility genetic diversity development new mutations Therefore, surveillance any is necessary.

Language: Английский

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Predicting adverse outcomes in pregnant patients positive for SARS-CoV-2: a machine learning approach- a retrospective cohort study

BMC Pregnancy and Childbirth, Journal Year: 2023, Volume and Issue: 23(1)

Published: Aug. 2, 2023

Abstract Background Pregnant people are particularly vulnerable to SARS-CoV-2 infection and ensuing severe illness. Predicting adverse maternal perinatal outcomes could aid clinicians in deciding on hospital admission early initiation of treatment affected individuals, streamlining the triaging processes. Methods An international repository 1501 SARS-CoV-2-positive cases pregnancy was created, consisting demographic variables, patient comorbidities, laboratory markers, respiratory parameters, COVID-19-related symptoms. Data were filtered, preprocessed, feature selection methods used obtain optimal subset for training a variety machine learning models predict or fetal/neonatal death critical Results The Random Forest model demonstrated best performance among trained models, correctly identifying 83.3% high-risk patients 92.5% low-risk patients, with an overall accuracy 89.0%, AUC 0.90 (95% Confidence Interval 0.83 0.95), recall, precision, F1 score 0.85, 0.94, 0.89, respectively. This achieved using 25 features containing characteristics, symptoms, clinical signs, markers. These included BMI, gravidity, parity, existence pre-existing conditions, nicotine exposure, anti-hypertensive medication administration, fetal malformations, antenatal corticosteroid presence dyspnea, sore throat, fever, fatigue, duration symptom phase, pneumonia, need oxygen disease-related inpatient treatment, lab markers including sFLT-1/PlGF ratio, platelet count, LDH. Conclusions We present first COVID-19 prognostication pipeline specifically pregnant while utilizing large data repository. Our accurately identifies those at risk illness deterioration, presenting promising tool advancing personalized medicine COVID-19.

Language: Английский

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The Multi-faceted Effects of COVID-19 on Female Reproductive Health: An Updated Narrative Review

Cureus, Journal Year: 2024, Volume and Issue: unknown

Published: April 9, 2024

Concerns about the SARS-CoV-2 pandemic's possible impact on sexual and reproductive health have grown significantly. In this narrative review, latest research effects of infection several facets is reviewed. The review starts initially by going through consequences female menstrual cycles. virus may interfere with cycle, which could affect hormone synthesis endometrial reactions, according to newly available evidence. Menstrual blood loss be impacted COVID-19's potential influence endothelial cell function systemic hemostasis. Hypothalamic amenorrhea brought severe COVID-19 disease. There little subject, although most women resume their regular cycles after 1-2 months recuperation. also examines how assisted technology (ART) treatments. are few clinical data, some points embryo quality. Overall, ART results, however, did not materially change from time before epidemic. Obstetric problems more likely when occurs during pregnancy, especially in third trimester. Even though maternal death rate still low, pregnant women, those comorbidities, experience serious sickness. emphasizes vaccine affects cycles, showing brief, modest modifications without hazards. Also included psychological family planning choices pandemic. conclusion, offers a thorough assessment complicated changing health. different requirements people couples pandemic highlighted, underscoring necessity for ongoing study specialized healthcare practices.

Language: Английский

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Shift in SARS-CoV-2 variants of concern from Delta to Omicron was associated with reduced hospitalizations, increased risk of breakthrough infections but lesser disease severity

Journal of Infection and Public Health, Journal Year: 2024, Volume and Issue: 17(6), P. 1100 - 1107

Published: May 3, 2024

COVID-19 epidemiology changed with the emergence of SARS-CoV-2 variants concern (VOC). Pakistan administered mostly inactivated vaccines. We investigated association between VOC and breakthrough infections in a mixed-vaccination-status population Karachi.

Language: Английский

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Diabetes and susceptibility to COVID-19: Risk factors and preventive and therapeutic strategies

World Journal of Diabetes, Journal Year: 2024, Volume and Issue: 15(8), P. 1663 - 1671

Published: July 25, 2024

Coronavirus disease 2019 (COVID-19) is a highly infectious caused by novel human coronavirus called severe acute respiratory syndrome 2 (SARS-CoV-2). Diabetes well-known risk factor for diseases with high prevalence and increased severity. Here, we elucidated the possible factors vulnerability of diabetic patients to SARS-CoV-2 infection more COVID-19 illness. The worsened prognosis both diabetes may be attributable host receptor angiotensin-converting enzyme 2-assisted viral uptake. Moreover, insulin resistance often associated impaired mucosal skin barrier integrity, resulting in mic-robiota dysbiosis, which increases susceptibility infections. It also higher levels pro-inflammatory cytokines from an immune system diabetics, inducing cytokine storm excessive inflammation. This review describes mellitus its complications, explains factors, such as characteristics patient lifestyle, contribute COVID-19, discusses preventive therapeutic strategies COVID-19-positive patients.

Language: Английский

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Repercussões da pandemia de covid-19 na Mortalidade Materna no estado de Mato Grosso do Sul

Saúde em Debate, Journal Year: 2025, Volume and Issue: 49(144)

Published: Feb. 7, 2025

RESUMO O período gestacional é caracterizado por alterações fisiológicas que acarretam desfechos evoluem negativamente. A pandemia de covid-19 teve altas taxas óbito em mulheres no mundo. Este estudo objetivou analisar as repercussões da perfil epidemiológico Mortalidade Materna. Trata-se um transversal comparativo entre os períodos anterior (2018-2019) e inicial (2020-2021). Os dados foram coletados base Secretaria Estado Saúde do Mato Grosso Sul analisados R-Studio. Foram analisadas 118 mortes maternas. 51 ocorreram 2018-2019 67 2020-2021. razão Materna passou 57,97 para 80,25. Anos Potenciais Vida Perdidos aumentaram 1774,41 2237,34. Puérperas tiveram elevadas mortalidade. doença respiratória prevalência 2,18 (IC=1,34-3,52) o 2020-2021, quando comparado com 2018-2019. resultados evidenciam a vulnerabilidade das ciclo gravídico puerperal às doenças alto contágio virulência elevada, como covid-19. ampliação acesso ocasiona prevenção óbitos evitáveis, desencadeiam sociais econômicas negativas toda população.

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A prospective, longitudinal, case–control study to evaluate the neurodevelopment of children from birth to adolescence exposed to COVID-19 in utero

BMC Pediatrics, Journal Year: 2023, Volume and Issue: 23(1)

Published: Jan. 30, 2023

The Coronavirus disease (COVID-19) pandemic has created unprecedented acute global health challenges. However, it also presents a set of unquantified and poorly understood risks in the medium to long term, specifically, children whose mothers were infected with severe respiratory syndrome coronavirus 2 (SARS-CoV-2) during pregnancy. Infections pregnancy can increase risk atypical neurodevelopment offspring, but long-term neurodevelopmental impact utero COVID-19 exposure is unknown. Prospective, longitudinal studies are needed evaluate exposed SARS-CoV2 define this risk.We have designed prospective, case-controlled study investigate impacts on utero. Women SARS-CoV-2 will be recruited from Monash Health, Royal Women's Hospital Western Health (Melbourne, Australia) Londrina Municipal Maternity Lucilla Ballalai PUCPR Medical Clinical (Londrina, Brazil). A control group 2:1 ratio (2 non-exposed: 1 mother infant dyad) comprising women who gave birth same month delivery, similar age did not contract their recruited. We aim recruit 170 340 non-exposed mother-infant dyads. socio-demographic data collected directly medical records. Biospecimens clinical epidemiological offspring at multiple time points through 15 years using standardised sample collection, neurological behavioural measures.The mapped trajectories comparisons between indicate potential for an neurodevelopment. This significant implications strategic planning mental paediatrics sectors monitoring globally.

Language: Английский

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Severe fetal brain damage subsequent to acute maternal hypoxemic deterioration in COVID‐19

Ultrasound in Obstetrics and Gynecology, Journal Year: 2021, Volume and Issue: 58(3), P. 490 - 491

Published: July 28, 2021

Coronavirus disease 2019 (COVID-19) following severe acute respiratory syndrome coronavirus 2 infection can cause complications in pregnancy, impacting neonatal outcome. There is evidence that, during women become more susceptible to cell-mediated viral infections due their physiological adaptation. Subsequently, they prone cardiopulmonary decompensation caused by reduced pulmonary and cardiac reserves1. As a consequence, the rate of admission intensive care unit (ICU) slightly higher pregnant compared with non-pregnant COVID-19 (7% vs 4%)2. Hypoxemia as result maternal failure leading inadequate oxygen supply placenta fetus fetal distress3, 4. We report case rapidly progressing pregnancy. The patient was 36-year-old woman, gravida 6, para 4, who developed symptoms at 25 + 5 weeks gestation. One week after admission, her saturation (SpO2) dropped suddenly 87%, while receiving 3 L/min supplemental oxygen. She then transferred ICU, where lung function deteriorated rapidly, requiring intubation venovenous extracorporeal membrane oxygenation (ECMO) within 6 h admission. During intubation, she suffered cardiogenic shock accompanied renal failure, high dose catecholamines dialysis. In this critical state, lowest SpO2 77% cardiotocography (CTG) showed intermittent prolonged bradycardia (heart 86 bpm). Given pathological CTG, Cesarean section considered. However, condition general anesthesia not feasible. Antiviral therapy remdesivir initiated, betamethasone administered for maturation. catecholamine dosage steadily, weaned from ECMO 27 weeks. first ultrasound scan performed 0 normal, appropriately male normal Doppler values. Within next few days, we observed localized cerebral hyperechogenicity, bleeding, followed formation porencephalic cysts disintegration cerebellar hemispheres (Figure 1a). worsening ventriculomegaly, fading basal ganglia ruptured falx cerebri 1b, Videoclip S1). Middle artery peak systolic velocity increased 85.3 cm/s (multiples median 2.3), indicating bleeding anemia. mother counseled regarding unfavorable outcome child, risk disability. After consideration, opted termination Feticide labor induction were 30 (birth weight 1591 g). Samples amniotic fluid, blood, chorionic villi cerebrospinal fluid collected time feticide virological studies (Table 1) genetic tests (no anomaly). autopsy an atrophic cortex dilated ventricles hydrocephalus addition intraventricular bleeding. Changes hypoxia discerned throughout entire central nervous system. No microangiopathy, thromboembolism or systemic fetoplacental inflammation found. placental tissue, there minor regressive changes compatible without signs villitis intervillitis. observation massive brain damage secondary deterioration highlights importance close monitoring sufficient (SpO2 > 95%)5 Data available on request authors. S1 Neurosonography 29 gestation showing macrocephaly cysts, lateral, third fourth ventricles, ganglia. corpus callosum detectable cerebellum had undergone cystic transformation hemispheres. Please note: publisher responsible content functionality any supporting information supplied Any queries (other than missing content) should be directed corresponding author article.

Language: Английский

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Maternal and Neonatal Outcomes in Pregnant Women With Coronavirus Disease 2019 in Korea

Journal of Korean Medical Science, Journal Year: 2022, Volume and Issue: 37(41)

Published: Jan. 1, 2022

This study aimed to describe the maternal, obstetrical, and neonatal outcomes in pregnant women with coronavirus disease 2019 (COVID-19) identify predictors associated severity of COVID-19.This multicenter observational included consecutive admitted because COVID-19 confirmed using reverse transcriptase-polymerase chain reaction (RT-PCR) test at 15 hospitals Republic Korea between January 2020 December 2021.A total 257 62 newborns were this study. Most patients developed during third trimester. Nine (7.4%) pregnancy-related complications. All received inpatient treatment, whom 9 (3.5%) required intensive care, but none them died. The gestational age diagnosis (odds ratio [OR], 1.096, 95% confidence interval [CI], 1.04-1.15) parity (OR, 1.703, CI, 1.13-2.57) identified as significant risk factors severe diseases. Among who delivered, 78.5% underwent cesarean section. Preterm birth (38.5%), premature rupture membranes (7.7%), miscarriage (4.6%) occurred, there was no stillbirth or death. RT-PCR newborns' amniotic fluid umbilical cord blood samples negative for acute respiratory syndrome 2.At time diagnosis, severity. Vertical transmission not observed, maternal did significantly affect prognosis.

Language: Английский

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Respiratory perspective of COVID-19 in pregnancy

The Journal of Infection in Developing Countries, Journal Year: 2023, Volume and Issue: 17(01), P. 23 - 36

Published: Jan. 31, 2023

The coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome 2 (SARS-CoV-2), was declared a global pandemic in March 2020 World Health Organization (WHO). By February 2022, had infected more than 500 million people globally. COVID-19 frequently manifests as pneumonia and mortality is mainly distress (ARDS). Previous studies have reported that pregnant women are at higher risk of SARS-CoV-2 infection complications can happen due to alterations immune response, physiology, hypercoagulable state, placental pathology. Clinicians face challenge selecting proper treatment for patients with different physiological characteristics compared non-pregnant population. Furthermore, drug safety both patient fetus should also be considered. Efforts prevent COVID-19, including prioritizing vaccination women, essential break chain transmission This review aims summarize current literature regarding effect its clinical manifestations, treatment, complications, prevention.

Language: Английский

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