A recently emerging respiratory disease named coronavirus disease 2019 (COVID-19) has quickly spread across the world. This disease is initiated by severe acute respiratory syndrome coronavirus-2 ...(SARS-CoV-2) and uncontrolled cytokine storm, but it remains unknown as to whether a robust antibody response is related to clinical deterioration and poor outcome in COVID-19 patients.
Anti-SARS-CoV-2 IgG and IgM antibodies were determined by chemiluminescence analysis (CLIA) in COVID-19 patients at a single center in Wuhan. Median IgG and IgM levels in acute and convalescent-phase sera (within 35 days) for all included patients were calculated and compared between severe and non-severe patients. Immune response phenotyping based on the late IgG levels and neutrophil-to-lymphocyte ratio (NLR) was characterized to stratified patients into different disease severities and outcomes.
A total of 222 patients were included in this study. IgG was first detected on day 4 of illness, and its peak levels occurred in the fourth week. Severe cases were more frequently found in patients with high IgG levels, compared to those with low IgG levels (51.8 vs. 32.3%;
= 0.008). Severity rates for patients with NLR
IgG
, NLR
IgG
, NLR
IgG
, and NLR
IgG
phenotype were 72.3, 48.5, 33.3, and 15.6%, respectively (
< 0.0001). Furthermore, severe patients with NLR
IgG
, NLR
IgG
had higher inflammatory cytokines levels including IL-2, IL-6 and IL-10, and decreased CD4+ T cell count compared to those with NLR
IgG
phenotype (
< 0.05). Recovery rates for severe patients with NLR
IgG
, NLR
IgG
, NLR
IgG
, and NLR
IgG
phenotype were 58.8% (20/34), 68.8% (11/16), 80.0% (4/5), and 100% (12/12), respectively (
= 0.0592). Dead cases only occurred in NLR
IgG
and NLR
IgG
phenotypes.
COVID-19 severity is associated with increased IgG response, and an immune response phenotyping based on the late IgG response and NLR could act as a simple complementary tool to discriminate between severe and non-severe COVID-19 patients, and further predict their clinical outcome.
Mortality prediction is important for intensivists and conventional disease severity scores may fail to predict mortality in patients with coronavirus disease-19 (COVID-19) consistently. We aimed to ...develop a model using machine learning technology to predict mortality in patients with COVID-19 admitted to the intensive care unit (ICU).
A total of 436 patients with COVID-19 who were followed up in the ICU between March 15, 2020, and December 31, 2021, were screened retrospectively. The worst laboratory results and vital signs of the patients were recorded in the first 24 h in the ICU. We selected a total of 29 inputs for develop a model by machine learning. A total 108 patients who were followed up between January 1, 2022, and March 31, 2022, were used for the testing model prospectively.
Our model predicted mortality with 88% sensitivity and 88% specificity. Conventional disease severity scores predicted mortality with lower sensitivity and specificity than our model (71% sensitivity and 70% specificity for APACHE-2, 75% sensitivity and 75% specificity for SAPS-2 and APACHE−4). Our model had better discriminative power for mortality with area under curve, (AUC) 0.93 (95%CI, 0.87–0.98) than conventional disease severity scores (Fig. 1). Respiratory support on the first day of ICU admission was found to be the most important factors affecting mortality.
Our model can predict ICU mortality with higher predictive power than the three conventional disease severity scores in patients with COVID-19. Conventional disease severity scores, such as APACHE-2 and SAPS-2, have been used for many decades for mortality prediction in ICU. Although conventional disease severity scores have good discriminative power for mortality, they seem to underestimate mortality (1). This situation may stem from the unique clinical course of COVID-19, increased patient load in intensive care units, or a lack of equipment and trained personnel resources in the ICU. In cases such as epidemics, where conventional disease scores are insufficient to predict mortality, models that can reliably predict disease outcomes can be developed with machine learning.
Background The impact of previous SARS-CoV-2 infection on the systemic immune response during tuberculosis (TB) disease has not been explored. Methods An observational, cross-sectional cohort was ...established to evaluate the systemic immune response in persons with pulmonary tuberculosis with or without previous SARS-CoV-2 infection. Those participants were recruited in an outpatient referral clinic in Rio de Janeiro, Brazil. TB was defined as a positive Xpert-MTB/RIF Ultra and/or a positive culture of Mycobacterium tuberculosis from sputum. Stored plasma was used to perform specific serology to identify previous SARS-CoV-2 infection (TB/Prex-SCoV-2 group) and confirm the non- infection of the tuberculosis group (TB group). Plasmatic cytokine/chemokine/growth factor profiling was performed using Luminex technology. Tuberculosis severity was assessed by clinical and laboratory parameters. Participants from TB group (4.55%) and TB/Prex-SCoV-2 (0.00%) received the complete COVID-19 vaccination. Results Among 35 participants with pulmonary TB, 22 were classified as TB/Prex-SCoV-2. The parameters associated with TB severity, together with hematologic and biochemical data were similar between the TB and TB/Prex-SCoV-2 groups. Among the signs and symptoms, fever and dyspnea were significantly more frequent in the TB group than the TB/Prex-SCoV-2 group (p < 0,05). A signature based on lower amount of plasma EGF, G-CSF, GM-CSF, IFN-α2, IL-12(p70), IL-13, IL-15, IL-17, IL-1β, IL-5, IL-7, and TNF-β was observed in the TB/Prex-SCoV-2 group. In contrast, MIP-1β was significantly higher in the TB/Prex-SCoV-2 group than the TB group. Conclusion TB patients previously infected with SARS-CoV-2 had an immunomodulation that was associated with lower plasma concentrations of soluble factors associated with systemic inflammation. This signature was associated with a lower frequency of symptoms such as fever and dyspnea but did not reflect significant differences in TB severity parameters observed at baseline.
The study explores anaerobic soil disinfection as an alternative to soil fumigants for controlling Verticillium wilt in strawberry crops. For this purpose, two agrowastes close to the ...strawberry-growing areas of Huelva province were tested as potential amendments for the control of Verticillium wilt: rice bran and residual strawberry extrudate. Furthermore, two application rates were evaluated: 13.50 and 20.00 t/ha for the rice bran and 16.89 and 25.02 t/ha for residual strawberry extrudate. Amended and anaerobically disinfested soils were compared with a non-amended soil under anaerobic conditions, a soil treated with the chemical fungicide metam sodium and an untreated soil. One week before the start of disinfection treatment, these soils were artificially inoculated with 250 microsclerotia/g dry soil of Verticillium dahliae . After disinfestation treatments, pathogens were quantified, and strawberry plants were cropped in a growth chamber to further evaluate Verticillium wilt severity, which was measured with a symptom scale in the same potting soils. Measurements of the anaerobic condition, pH and microbial population densities were performed, and the results showed significant differences between the different amendments. In addition, the treatment with rice bran at 20 t/ha recorded the lowest population density of V. dahliae . Likewise, it was possible to achieve a reduction in foliar disease severity in all amended treatments in similar percentage to those obtained by chemical treatment. These results suggest potential application of this technique for the control of Verticillium wilt in the strawberry-growing area of Huelva, reducing the use of chemical fumigants.
Acne vulgaris (AV) is a common inflammatory skin disease affecting adolescents and young adults. It affects one's self-esteem and social relationship. In addition, poor adherence to treatment can ...cause poor treatment response and disease recurrence. This study aims to determine the effectiveness of medical education and counselling on treatment adherence and disease severity.
This is a non-randomised interventional study with age- and treatment- matched control conducted in a tertiary dermatology clinic from July 2021 to June 2022. Patients in the intervention group received a 10 min video presentation on acne, followed by treatment counselling. The adherence rate was determined objectively (pill counting and tube weighing) and subjectively (ECOB questionnaire). The disease severity was assessed using the Comprehensive Acne Severity Scale (CASS) and Global Acne Grading System (GAGS).
A total of 100 patients completed the 12-week study. With intervention, patients have better adherence to topical medication (5% benzoyl peroxide gel: 71% vs 57.9%, p= 0.031; 0.05% tretinoin cream: 58.7% vs 45.4%, p= 0.044) at week 12. However, the intervention program did not improve adherence to oral medication. Overall, with intervention, a significantly higher percentage of improvement in disease severity was noted (47.3% vs. 39.1%, p=0.044). Nonadherence to treatment was attributed mostly to forgetfulness in 54% of the patients, followed by a busy lifestyle (41%) and little knowledge of acne (26%).
Patients have significantly better adherence to topical medication with education and counselling. Better adherence to treatment leads to more remarkable disease improvement.
Coronavirus disease 2019 (COVID-19) exhibits variable symptom severity ranging from asymptomatic to life-threatening, yet the relationship between severity and the humoral immune response is poorly ...understood. We examined antibody responses in 113 COVID-19 patients and found that severe cases resulting in intubation or death exhibited increased inflammatory markers, lymphopenia, pro-inflammatory cytokines, and high anti-receptor binding domain (RBD) antibody levels. Although anti-RBD immunoglobulin G (IgG) levels generally correlated with neutralization titer, quantitation of neutralization potency revealed that high potency was a predictor of survival. In addition to neutralization of wild-type SARS-CoV-2, patient sera were also able to neutralize the recently emerged SARS-CoV-2 mutant D614G, suggesting cross-protection from reinfection by either strain. However, SARS-CoV-2 sera generally lacked cross-neutralization to a highly homologous pre-emergent bat coronavirus, WIV1-CoV, which has not yet crossed the species barrier. These results highlight the importance of neutralizing humoral immunity on disease progression and the need to develop broadly protective interventions to prevent future coronavirus pandemics.
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•Severe COVID-19 associates with higher antibody production and neutralization titers•Neutralization potency of anti-RBD antibodies predicts disease severity and survival•Immunomodulatory COVID-19-directed therapies modulate antibody responses•COVID-19 sera neutralize D614 and G614 variants, but not pre-emergent WIV1-CoV
Garcia-Beltran et al. show that the development of more potent neutralizing antibodies during SARS-CoV-2 infection predicts COVID-19 survival. Protective antibody responses exhibit potent neutralization against the currently circulating SARS-CoV-2 D614G spike variant but lack significant activity against pre-emergent WIV1-CoV spike, suggesting that convalescent patients are likely to remain susceptible to future pandemics.
Yellow mosaic and leaf curl diseases caused by whitefly‐transmitted begomo virus genera are important problems in tomato (Solanum lycopersicon L.) production in Indonesia, particularly on Java ...Island. The aims of this survey are to assess the percentages of disease incidence (DI) and disease severity index (DSI), evaluate the spread and complexity of begomovirus and crinivirus infections responsible for yellow mosaic and leaf curl diseases in tomato plants, and identify the species of whitefly insect vectors and their cryptic biotypes in tomato production centers located on Java Island, Indonesia. A total of 43 locations in East, Central, and West Java were surveyed during the dry season from July 2022 to September 2022. Disease incidence and severity were determined by observing 200 samples of tomato plants from five points at each location, with 40 plants per point of land. A total of 116 whitefly samples in microtubes and 215 symptomatic leaf samples were collected. The genus begomovirus and crinivirus infecting tomato were identified by PCR and RT‐PCR using genus‐specific primers. Similarly, whitefly species and their cryptic biotypes were identified by PCR using MCoI gene‐specific primers. Results showed that DI and DSI remarkably differed between the lowlands (66%–89%) and highlands (33%–62%) in the provinces of Central Java and West Java. Furthermore, PCR analysis of 215 infected tomato showing the symptoms of yellow mosaic and curly leaf revealed that three begomoviruses, one crinivirus and their mixed combination both begomoviruses, one crinivirus has been detected in all the samples. Similarly, the whitefly insect vector Bemisia tabaci biotype Q was identified in all areas, whereas Trialeurodes vaporariorum was found only in the East Java and Java highlands, respectively.
Although most treatment algorithms in inflammatory bowel disease (IBD) begin with classifying patients according to disease severity, no formal validated or consensus definitions of mild, moderate, ...or severe IBD currently exist. There are 3 main domains relevant to the evaluation of disease severity in IBD: impact of the disease on the patient, disease burden, and disease course. These measures are not mutually exclusive and the correlations and interactions between them are not necessarily proportionate. A comprehensive literature search was performed regarding current definitions of disease severity in both Crohn’s disease and ulcerative colitis, and the ability to categorize disease severity in a particular patient. Although numerous assessment tools for symptoms, quality of life, patient-reported outcomes, fatigue, endoscopy, cross-sectional imaging, and histology (in ulcerative colitis) were identified, few have validated thresholds for categorizing disease activity or severity. Moving forward, we propose a preliminary set of criteria that could be used to classify IBD disease severity. These are grouped by the 3 domains of disease severity: impact of the disease on the patient (clinical symptoms, quality of life, fatigue, and disability); measurable inflammatory burden (C-reactive protein, mucosal lesions, upper gastrointestinal involvement, and disease extent), and disease course (including structural damage, history/extension of intestinal resection, perianal disease, number of flares, and extraintestinal manifestations). We further suggest that a disease severity classification should be developed and validated by an international group to develop a pragmatic means of identifying patients with severe disease. This is increasingly important to guide current therapeutic strategies for IBD and to develop treatment algorithms for clinical practice.
•Aloe vera gel is a promising bio-preservatives due to its health benefit and antimicrobial properties.•Packaging with polythene bag also increases the shelf life of papaya but not as much as Aloe ...vera gel.•Aloe vera gel-coated papaya fruits in polythene bag must be avoided during postharvest storage.•Aloe vera gel could be used commercially for extending the shelf life of climacteric fruits.•Aloe vera gel is the best alternative of non-recycled plastic material.
The edible coating is one of the promising aspects in the preservation of climacteric fruits like papaya. Among the various edible coating, Aloe vera gel has drawn serious attention to the scientific community as one of the promising bio-preservatives due to its human health benefit and antimicrobial properties. The packaging of fruits using polythene bag is already a common practice. Thus, this study was conducted to evaluate the effect of no packaging and packaging with both perforated and unperforated polythene, together with Aloe vera gel coated and uncoated papaya fruits on post-harvest ripening behaviour and physicochemical properties when stored at room condition (25 ± 2 °C temperature and 80–85 % relative humidity). The results showed that Aloe vera gel coating alone delayed colour development during storage compared to the control (no packaging without Aloe vera gel). After 12 days of storage (DAS), the weight loss and moisture content of fruits treated with only Aloe vera gel were 11.7% and 89.9% respectively, whereas in control, the weight loss was 25.2% and moisture content was 87.1%. Moreover, soluble solids concentration (SSC) and disease severity were reduced as around 3% and 29% respectively, for coated compared to uncoated fruits. Similar to Aloe vera gel coating, packaging of papaya fruits with only both types of polythene bag showed better performance compared to control but not as much as Aloe vera gel coating alone. In addition, if the fruits are coated with Aloe vera gel as well as packed with polythene bag their edible quality drastically reduces once the fruits reach their peak climacteric or ripening stage, although these results were more severe with unperforated polythene compared to perforated polythene bags. These findings also suggest that Aloe vera gel as an edible coating could be used commercially for extending the storage life of papaya fruits for up to 14 days, while packaging of Aloe vera gel-coated papaya fruits in polythene bags must be avoided during, storage, transportation, and marketing. In addition, this is in accordance with the need to avoid the use of non-recycled plastic material due to its pollution effects on ecosystems worldwide.
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