Objective: Vaccinating people can be an effective way of controlling the ongoing COVID-19 pandemic because vaccines have shown high efficacy in preventing serious illness and hospitalization. ...However, the long-term effectiveness of the vaccines is still unknown. Vaccines are not fully effective as evidenced by the reports of fully vaccinated people who developed COVID-19 infection. The aim of the study was to compare the clinical profile and outcomes of the COVID 19 infection among vaccinated and unvaccinated patients. Methods: The observational study was conducted from March to May 2023 at tertiary care center, Kakinada, India. Results: In this study out of 56 COVID-19 infected patients, frequency of COPVID-19 according to age distribution was higher in 41 to 50 years of age population. There was no significant sex preponderance. Out of 56, most common presenting symptoms were breathlessness 37 (66%). Out of 56, 51 (91%) patients were vaccinated (Covisheild, Serum Institute India PVT LTD, India), remaining were not vaccinated. Out of 56, 35 {62%) patients had comorbidities. Out of 56, 44(79 %) patients presented with bilateral multiple opacities on chest X- Ray. Out of 56, 36 patients` saturation was maintained on room air which constitutes (64%). Out of 56, 36(64%) patients presented with mild disease severity. Out of 56, 10 patients succumbed to death of whom 7 (70%) patients were vaccinated , 3 (30%) patients were unvaccinated (p>0.05). Conclusion: Although the vaccination does not restrict/avoid infections, it appears to protect the vaccinated people from severe forms of COVID 19 infections.
•Patients with COVID-19 show a prominent Th1 and Th17 cytokine profile.•COVID-19 induces the expression of TGF-β.•TGF-β can be used as a predictive factor of disease severity in patients with ...COVID-19.
Cytokine dysregulation is the proposed mechanism for Coronavirus disease 2019 (COVID-19). The aim of this study was to evaluate the serum levels of interferon (IFN)-γ, interleukin (IL)-5, IL-8, Il-9, IL-17, TGF-β and IFN-γ in patients infected with SARS-CoV-2. The study was conducted between 63 adult patients with COVID‐19 and compared with 33 age and gender-matched healthy subjects as controls. The age range in both groups was 50–70 years. The patients were classified into mild group (33 patients) and severe group (30 patients). Serum samples were collected from all participants and tested for the cytokine levels by ELISA (enzyme-linked immunosorbent assay) method. Statistical analysis was performed using the one-way ANOVA. The mean serum levels of IFN-γ, TGF-β, IL-17 and IL-8 in the COVID‐19 patients were significantly higher than those observed in the control group. A comparison of between the mild and severe groups showed significant differences in TGF-β levels. The mean concentration of serum IL-5 and IL-9 in patients with COVID‐19 did not differ from those in the control group. Systemic IL-17 levels correlated positively and significantly with TGF-β in patients with COVID‐19. Th1 (IFN-γ), Treg (TGF-β), and Th17 (IL-17) cytokines concentration were increased in COVID-19 patients. Interferon-γ and IL-17 are involved in inducing and mediating proinflammatory responses. Our data suggest that TGF-β can be used as a predictive factor of disease severity in patients with COVID-19.
Abstract
Background
The longitudinal antigen-specific immunity in COVID-19 convalescents is crucial for long-term protection upon individual re-exposure to SARS-CoV-2, and even more pivotal for ...ultimately achieving population-level immunity. We conducted this cohort study to better understand the features of immune memory in individuals with different disease severities at 1 year post–disease onset.
Methods
We conducted a systematic antigen-specific immune evaluation in 101 COVID-19 convalescents, who had asymptomatic, mild, moderate, or severe disease, through 2 visits at months 6 and 12 after disease onset. The SARS-CoV-2–specific antibodies, comprising neutralizing antibody (NAb), immunoglobulin (Ig) G, and IgM, were assessed by mutually corroborated assays (ie, neutralization, enzyme-linked immunosorbent assay ELISA, and microparticle chemiluminescence immunoassay MCLIA). Meanwhile, T-cell memory against SARS-CoV-2 spike, membrane, and nucleocapsid proteins was tested through enzyme-linked immunospot assay (ELISpot), intracellular cytokine staining, and tetramer staining-based flow cytometry, respectively.
Results
SARS-CoV-2–specific IgG antibodies, and NAb, can persist among >95% of COVID-19 convalescents from 6 to 12 months after disease onset. At least 19/71 (26%) of COVID-19 convalescents (double positive in ELISA and MCLIA) had detectable circulating IgM antibody against SARS-CoV-2 at 12 months post–disease onset. Notably, numbers of convalescents with positive SARS-CoV-2–specific T-cell responses (≥1 of the SARS-CoV-2 antigen S1, S2, M, and N proteins) were 71/76 (93%) and 67/73 (92%) at 6 and 12 months, respectively. Furthermore, both antibody and T-cell memory levels in the convalescents were positively associated with disease severity.
Conclusions
SARS-CoV-2–specific cellular and humoral immunities are durable at least until 1 year after disease onset.
SARS-CoV-2–specific humoral and T-cell immune memory are present within ~95% and ~90% of convalescents, respectively, until 1 year, with durable neutralizing antibodies and CD8+and CD4+T cells, but decreased IgG and IgM from 6 to 12 months.
Background: The complete blood count (CBC) profile has been found extremely useful in monitoring the growth of SARS-CoV-2 infection; however, predictive CBC parameters that could be used in the ...management of the disease may vary in different populations. Methods: This study comparatively analyzed the CBC profile of SARS-CoV-2 patients (N = 75; confirmed positive by real-time polymerase chain reaction PCR) and healthy individuals (confirmed negative by real-time PCR) from Kashmir (north India). Results: Compared with healthy individuals, most of the CBC parameters (hemoglobin levels 13.43 vs 10.9 g/dL; P = 0.0001, lymphocytes 16.04% vs 30.8%; P = 0.00001, monocytes 5.53% vs 7.53%; P = 0.009, and platelet count 150 vs 186 ×103 µL; P = 0.037) were significantly low in SARS-CoV-2 infected patients, while neutrophilia was more common in infected patients (76.77% vs 59.26%). Among derived parameters, the neutrophil-to-lymphocyte ratio (NLR; 7.31 vs 2.04; P = 0.001) and derived NLR (d-NLR; 4.43 vs 1.5; P = 0.0002) were significantly high in SARS-CoV-2 patients. Further correlation analysis revealed a significant association of neutrophilia with the severity of the disease in SARS-CoV-2 infected patients. Moreover, receiver operating characteristic (ROC) analysis of derived CBC parameters (NLR, d-NLR, and platelet‐to-lymphocyte ratio PLR with disease severity and disease outcome) revealed d-NLR as better predictive marker of disease severity (area under the curve AUC = 0.658) and disease outcome (AUC = 0.766) compared to PLR with disease severity (AUC = 0.645) and disease outcome (AUC = 0.693). Conclusion: We therefore conclude, of the CBC parameters neutrophilia as the marker of disease severity and among derived parameters, d-NLR as an early predictive biomarker of both disease severity and poor disease outcome in SARS-CoV-2 patients.
Background
Atopic dermatitis (AD) is a multifactorial inflammatory skin disease and an altered skin microbiota with an increase of Staphylococcus aureus has been reported. However, the role of fungi ...remains poorly investigated.
Objectives
We aimed to improve the understanding of the fungal skin microbiota, the mycobiota, in AD in relation to the bacterial colonization.
Methods
Skin swabs of 16 AD patients and 16 healthy controls (HC) from four different skin sites, that is antecubital crease, dorsal neck, glabella and vertex from multiple time points were analysed by DNA sequencing of the internal transcribed spacer region 1 (ITS1) and 16S rRNA gene for fungi and bacteria, respectively.
Results
Malassezia spp. were the predominant fungi in all subjects but with a decreased dominance in severe AD patients in favour of non‐Malassezia fungi, for example Candida spp. For bacteria, a decrease of Cutibacterium spp. in AD patients in favour of Staphylococcus spp., particularly S. aureus, was observed. Further, both bacterial and fungal community compositions of severe AD patients significantly differed from mild‐to‐moderate AD patients and HC with the latter two having overall similar microbiota showing some distinctions in bacterial communities.
Conclusions
We conclude that severe AD is associated with a pronounced dysbiosis of the microbiota with increased fungal diversity. Potentially infectious agents, for example Staphylococcus and Candida, were increased in severe AD.
Introduction: Serum D-dimer is a protein fragment generated during the final phase of clot formation. Increased serum D-dimer levels indicate the hemostatic change in patients, likely related to the ...prothrombotic switch. As the world is battling with the damaging effect of coronavirus disease, it is very important to find out the early and effective predictors of prognosis to improve the management of COVID-19 patients. Thus, our study aims to find out the prevalence of increased D-dimer levels in coronavirus disease patients.
Methods: A descriptive cross-sectional study was conducted on a total of 235 patients admitted in the COVID ward and COVID Intensive Care Units at a tertiary care hospital from July 2020 to August 2021 after getting ethical approval (Reference number: 401/2020) from the Institutional Review Committee. A convenience sampling method was used for sample collection. The highest recorded values for D-dimer during the hospital stay were taken for data collection. The data were entered in Microsoft Excel 2013 and analyzed using Statistical Package for the Social Sciences version 16.0. Point estimate at 95% Confidence Interval was calculated along with frequency, proportion, mean and standard deviation.
Results: Among 235 patients, elevated D- dimer level was in 175 (74.46%) (68.88-80.04 at 95% Confidence Interval). Majority of the patients were males 136 (77.71%) whereas 39 (22.28%) of the patients were females.
Conclusions: The prevalence of raised D-dimer levels was quite higher in our studies compared to other studies done in different parts of the world. Thus, serum D-dimer level may serve as an early marker in improving the management of patients with coronavirus disease.
Examine the association between physical activity and neuromuscular and physical function in patients with multiple sclerosis when also considering disease severity.
91 patients with multiple ...sclerosis were enrolled. Assessments included physical activity by 7-day thigh-worn accelerometry, knee extensor neuromuscular function by dynamometry (maximal isometric muscle strength, rate of force development (0-50 ms)), and physical function by 5× sit-to-stand, 2-min walk test, and timed 25 ft walk test. Physical activity tertile comparisons along with simple and multiple regressions (adjusting for age, gender, EDSS, time since diagnosis) were performed.
Physical activity tertiles revealed differences (p < 0.05) in maximal muscle strength (1.77 ≈ 1.97 < 2.28 Nm/kg), rate of force development (4.66 < 8.03 ≈ 10.55 Nm/kg/s), 5× sit-to-stand (11.4 ≈ 9.7 > 8.5 s), 2-min walk test (153 < 183 < 207 m), and timed 25 ft walk test (6.3 > 4.4 > 4.3 s). Moreover, physical activity was associated (p < 0.05) with maximal muscle strength and rate of force development (r
2
= 0.13-0.15) along with 5× sit-to-stand, 2-min walk test, and timed 25 ft walk test (r
2
= 0.18-0.24), also after adjusting for age + gender + EDSS + time since diagnosis (r
2
= 0.25-0.37 and 0.24-0.52), with physical activity consistently being a strong predictor.
Higher levels of physical activity are associated with greater neuromuscular and physical function in ambulatory patients with multiple sclerosis independent of disease severity. These findings emphasize the importance of performing regular physical activity at all stages of multiple sclerosis.
IMPLICATIONS FOR REHABILITATION
Physical activity is associated with neuromuscular and physical function, independent of disease severity.
Physical activity may be important in improving or preserving neuromuscular and physical function at all stages of ambulatory multiple sclerosis patients, yet longitudinal studies are warranted.
Clinicians and rehabilitation professionals should encourage ambulatory patients at all stages of their disease to be as physically active as possible.
In China, bronchial asthma has emerged as the second most prevalent respiratory disease, with mild asthma constituting 50%-70% of the reported cases. The challenges in diagnosing mild asthma arise ...from the subtle or atypical symptoms exhibited by patients, coupled with the absence of characteristic wheezing sounds. Notably, pulmonary function tests frequently yield normal indices for large airway functions, contributing to a significant misdiagnosis rate exceeding 70%. This high misdiagnosis rate results in patients seeking medical care repeatedly， and some cases receiving inappropriate treatments, with incresed the risk of progressing to moderate or severe asthma, experiencing acute attacks, and facing the potential threat of mortalitydeath. About one-third of asthma deaths occur in mild asthma. Furthermore, the predominant focus on symptom relief rather than the effective control of airway inflammation raises significant concerns regar-ding the diagnosis and treatment of mild asthma in China. In response, t
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