key: cord-0830639-ziv0ksfj
authors: Supriya, Upadhyay; Sekhar, Sen Subhrendu; Chanda Debadatta, Dhar
title: Scenario of COVID-19 among HIV infected patients: Case studies from south eastern Assam, India
date: 2021-09-30
journal: Indian Journal of Medical Microbiology
DOI: 10.1016/j.ijmmb.2021.08.244
sha: 86ad564f74d4b40f90716ca962d130719a08fdfe
doc_id: 830639
cord_uid: ziv0ksfj

Background:The recent severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) pandemic has struck with the pre-existing HIV pandemic. Information about the frequency and seriousness of COVID-19 infection among immuno- compromised HIV patients is still unclear. To our knowledge till date, clinical data about COVID -19 in HIV infected pa- tients are limited with only few case series. Here, we present cases of two HIV patient with COVID-19 infection admitted at Silchar Medical College & Hospital (SMCH), Silchar, south-eastern Assam, India. Methods:This retrospective study was conducted in VRDL, Silchar Medical College, Silchar among COVID -19 positive patient for the duration of three months from 30th March to 29th June 2020. The aim of the study was to evaluate the scenario of HIV reactive cases among COVID-19 positive population. Results:Between 30th March to 29th June 2020, a total of 727 COVID-19 positive cases were diagnosed at VRDL, SMCH. During these three months only two HIV patients were diagnosed with SARS-COV-2 infection. Patient-1 was 20-year old male (unaware of his HIV status) while Patient-2 was 52 year old army personnel (on ART therapy). In patient-2 HIV was well suppressed with sufficiently high CD4 counts. Fortunately, both the patients were asymptomatic and healthy. The mainstay of treatment given for the patients consisted of hydroxychloroquine, multi-vitamins in addition to the ART drugs (only patient 2). Both patients had stable health conditions, did not have any complications during their entire stay in health care facility for COVID-19. Both were treated and were tested negative by RTPCR within 14-15 days like any other general patient. Conclusions:Although, HIV patients are considered as immunocompromised, but our experience suggests that well con- trolled HIV patients with COVID-19 may have satisfactory prognosis following proper medical care. Further, enlarged cohort studies are needed to better understand risk and clinical course of COVID-19 among HIV-infected people.

Background: The Coronavirus disease 2019 , an infectious disease caused by newly discovered Novel Coro-navirus. COVID-19 has spread worldwide causing a pandemic, with maximum death -cases. Hence there is an urgent need for vaccines and treatments to be developed to combat the COVID -19. To overcome this Micro RNA (miRNA) based therapy will be an effective option in controlling infection. The miRNA is a noncoding single -stranded RNA that is smaller in size (17-24nucleotides). They are also able to regulate the Gut Microbiota, an essential factor of host immune response. The usage of miRNA instead of other techniques has many advantages that include early detection, improved pathogen identification, detection of latent infection, personalized medicine. Methods: Selective COVID 19 genome sequences with special reference from India by NCBI genome database and Nextstrain.org. Coronavirus subtyping and Mutation analysis carried out by Genome Detective Coronavirus Typing Tool (version 1.1.3) and CLUSTAL OMEGA software. The prediction of antiviral miRNA are performed online by Tar-getscan.org Results: This study integrated selective bioinformatics tools and databases to investigate the COVID -19 sequences in India and the trialogue relationship between the miRNA with Coronavirus and Gut Microbiota. The miRNA is found to be a potential biomarker and also therapeutics for diseases in viral diseases. Conclusions: The miRNA has been extensively documented for their key roles in combating the disease and it is still an unexplored area. As the miRNA regulates the gene of the target, altering the expression can bring in a desired therapeu-tic outcome.

https://doi.org/10.1016/j.ijmmb.2021.08.241

Begum Naila, Singh Amit. UPUMS, SAIFAI, ETAWAH Background:The recent emergence of SARS CoV2 pandemic has posed formidable challenges for the clinical laboratories seeking diagnostic confirmation. The clinical and epidemiologic management of the SARS-CoV-2 pandemic is critically dependent on molecular assays with short turn-around time. To face the current COVID 19 pandemic, the need for the automated rapid diagnostic tool is essential. Early diagnosis with XPERT Xpress SARS -CoV2 can aid in therapeutic man-agement and outbreak control Methods:A retrospective study was performed on a total of 373 samples (nasopharyngeal, oropharyngeal, nasal or mid turbinate swabs/aspirate) from clinically suspected cases of SARS CoV 2 infection from March 30, 2020, to November 15, 2020, in the department of microbiology of our institute. The specimens were collected, placed in VTM and run on the Gene Xpert Dx according to manufacturer's protocol. Results: Out of 373 samples tested 46 (12.3%) were positive, 319 (85.5%) were negative, 1 (0.26%) was presumptive positive and 7 (1.8%) samples were excluded due to Xpert error. Travel history was present in 79.2% of positive cases and 73.2% of the positive cases had flu-like symptoms (fever, dry cough, headache, myalgias, arthralgias and sore throat Results:Between 30th March to 29th June 2020, a total of 727 COVID-19 positive cases were diagnosed at VRDL, SMCH. During these three months only two HIV patients were diagnosed with SARS-COV-2 infection. Patient-1 was 20-year old male (unaware of his HIV status) while Patient-2 was 52 year old army personnel (on ART therapy). In patient-2 HIV was well suppressed with sufficiently high CD4 counts. Fortunately, both the patients were asymptomatic and healthy. The mainstay of treatment given for the patients consisted of hydroxychloroquine, multi-vitamins in addition to the ART drugs (only patient 2). Both patients had stable health conditions, did not have any complications during their entire stay in health care facility for COVID-19. Both were treated and were tested negative by RTPCR within 14-15 days like any other general patient. Conclusions:Although, HIV patients are considered as immunocompromised, but our experience suggests that well con-trolled HIV patients with COVID-19 may have satisfactory prognosis following proper medical care. Further, enlarged cohort studies are needed to better understand risk and clinical course of COVID-19 among HIV-infected people. Background:Severe acute respiratory syndrome coronavirus-2 is the virus that causes the respiratory illness coronavirus disease-2019 (COVID-19) that has infected millions of people worldwide. It has been reported that by the end of March 2020, this pandemic has affected almost 400 000 people in 168 countries on five continents. Older patients and those with comorbidities present with more severe infection and worse prognosis. Methods:A 52 year old male CML patient with fever and diabetes has reported at the COVID screening area of Silchar Medical College & Hospital (SMCH) for COVID-19 testing. Patient's nasopharyngeal and oropharyngeal swabs were taken for real time-PCR testing. Similar procedure was repeated for follow-up of samples. Results:Patient was confirmed COVID-19 positive by real time-PCR at VRDL, SMCH on 30th March, 2020, this was the first COVID-19 positive case reported from Assam. The patient admitted that he visited the COVID -19 hotspot in New Delhi in the second week of March and developed cough and fever subsequently. He was kept in isolation and under continuous monitoring by physicians. Within 10 days patient's temperature returned to normal with improvement in symptoms. However, repeated real-time RT-PCR test remained positive for COVID-19 infection till the 35th day of first positive declaration. This case is interesting because the estimated incubation period for COVID -19 infection was thought to be no more than 14 days. However, a retrospective review of the patient's condition suggested an incuba-tion period of more than 35 days. Conclusions:The clinical and biochemical data of COVID-19 might be partly masked by coexisting CML and prolonged shedding of virus may pose high risk to general population. Therefore individuals who are immunosuppressed must always be vigilant to protect their health, and that vigilance must extend to caregivers, as well. Background:A prospective study was conducted by Department of Molecular diagnostic laboratory, Deccan College of Medical Sciences to assess the importance of interpretation of a COVID-19 test result. This study strongly encourages us to manage patients with a high pre-clinical likelihood and typical clinical and radiological features as affected by COVID -19, independently of the result of real-time RT-PCR, especially if performed on specimens collected from the upper air-ways. Acquisition of lower respiratory tract samples should be considered in the event of one or more negative RT -PCR assays. Methods:Out of 500 cases, 400 suspicious of COVID-19 affected patients were subjected to HRCT, simultaneously after admission their Nasopharyngeal and Oro-pharyngeal swabs for RT-PCR Assays. Laboratory diagnosis through RT-PCR testing alone lacks adequate sensitivity and specificity to be recommended as the only valid criterion to confirm COVID -19 diagnosis. The leading role played by CT scan and repeat RT-PCR assay in the identification and management of especially false-negative patients with COVID-19-has been highlighted in this study. Results: 24 cases were found to positive after retested by RT-PCR. Real-time RT-PCR has intrinsic limitations that might significantly affect its accuracy in the diagnosis of COVID-19. False-negative results may depend on several preanalytical and analytical vulnerabilities, during specimen collection, transport, execution of test outside of the diagnostic window, PCR Inhibitors, use of nonvalidated assays. Moreover, the development of recombinant forms of SARS-CoV-2 may ad-versely affect the diagnostic accuracy of nucleic acid-based assays. Conclusions:If Covid-19 is suspected HRCT scan should be performed at hospital admission, together with or even be-fore or repeat sample, as this has been shown to correctly lead the clinical management yet from the earliest stage of the disease and to provide the highest detection rate after a very short time from symptoms onset. Hence, accurate diagnosis of SARS-CoV-2 holds the key in containing COVID-19 pandemic.

COVID-19), caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS CoV-2) was declared as a pandemic on March 11, 2020 by WHO. Laboratory diagnosis is essential not only for diagnosis and management but is also required for containment and mitigation strategies to prevent the transmission. Multiple ICMR-approved RT-PCR kits are currently available which are being used for diagnosis of COVID-19

Agreement of different kits was evaluated using Kappa analysis. Results:The results of the 45 samples of suspected COVID-19 cases were recorded as per the cycle threshold (Ct) provid-ed in the kit insert. Of these, 15 samples detected both E and RdRp genes and 30 were negative for both the genes of SARS CoV-2 by NIV, Pune COVID-19 RT-PCR kit. 15 samples which were positive by NIV, Pune kit were positive by all oth-er kits. Three kits showed 100% agreement with NIV, Pune COVID-19 RT-PCR kit and 4 kits had agreement of 91%

However, samples having Ct values 35 showed variable results with different RT-PCR kits; hence the results should be interpreted with caution