Memory CD8 T cells play an important role in the protection against breakthrough infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Whether the route of antigen exposure ...impacts these cells at a functional level is incompletely characterized. Here, we compare the memory CD8 T cell response against a common SARS-CoV-2 epitope after vaccination, infection, or both. CD8 T cells demonstrate comparable functional capacity when restimulated directly ex vivo, independent of the antigenic history. However, analysis of T cell receptor usage shows that vaccination results in a narrower scope than infection alone or in combination with vaccination. Importantly, in an in vivo recall model, memory CD8 T cells from infected individuals show equal proliferation but secrete less tumor necrosis factor (TNF) compared with those from vaccinated people. This difference is negated when infected individuals have also been vaccinated. Our findings shed more light on the differences in susceptibility to re-infection after different routes of SARS-CoV-2 antigen exposure.
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•Infection and vaccination against SARS-CoV-2 both favor CD8 TEMRA differentiation•Ex vivo functionality of memory T cells is similar after infection and vaccination•The scope of memory CD8 T cells is larger after infection than after vaccination•Vaccination-induced memory generates secondary effectors with superior functionality
Kavazović et al. compare SARS-CoV-2-specific memory CD8 T cells from people after infection, vaccination, or both. Infection induces a more clonally diverse memory pool than vaccination, but these cells produce less TNF after in vivo recall. Subsequent vaccination negates differences, stressing the importance of boosting irrespective of antigenic history.
•Assessed SARS-CoV-2 immunoassays have diagnostic accuracy from 99 % to 100 %.•Sensitivity of IgG assays is greater than 95 %, specificity greater than 99 %.•Longevity of SARS-CoV-2 IgG in ...symptomatic COVID patients is at least eight months.•Severe disease is associated with higher IgG titers and neutralizing activity.•IgG assays showed strong positive correlation to neutralizing activity.
Evidence is currently insufficient to know whether SARS-CoV-2 antibodies (Abs) protect from future infection and how long immunity will last. The kinetics of the immune response to SARS-CoV-2 infection and role of serology in estimating individual protective immunity is yet to be established. We evaluated diagnostic performances of three serological assays - Abbott Architect CMIA IgG, bioMerieux VIDAS ELFA IgG/IgM, and Diesse Chorus ELISA IgG/IgM, and analyzed longevity and potential neutralizing effect of SARS-CoV-2 Abs in COVID-19 patients. Clinical sensitivities of assessed IgG tests two to three weeks post symptom onset (PSO) were very high: 96.77 % for Architect, 96.77 % for Chorus, and 100.00 % for VIDAS. Sensitivities of two assessed IgM assays were moderate: 74.07 % for Chorus, and 76.92 % for VIDAS. Specificities were excellent for all assessed IgG assays: 99.01 % for Architect and 100 % for Chorus and VIDAS. Chorus and VIDAS IgM assays also achieved excellent specificity of 99.01 % and 100 %, respectively. In most cases IgG Abs were still present eight months PSO. Neutralizing antibodies were detected in majority of serum samples from convalescent patients. Serum samples from severe COVID-19 patients had higher antibody titers and higher neutralizing activity. We observed a strong positive correlation among SARS-CoV-2 IgG antibody titer and neutralizing activity. The strongest positive correlation to neutralizing activity was found for VIDAS IgG assay.
The aim of our study was to establish and compare the diagnostic accuracy and clinical applicability of published chest CT severity scoring systems used for COVID-19 pneumonia assessment and to ...propose the most efficient CT scoring system with the highest diagnostic performance and the most accurate prediction of disease severity. This retrospective study included 218 patients with PCR-confirmed SARS-CoV-2 infection and chest CT. Two radiologists blindly evaluated CT scans and calculated nine different CT severity scores (CT SSs). The diagnostic validity of CT SSs was tested by ROC analysis. Interobserver agreement was excellent (intraclass correlation coefficient: 0.982-0.995). The predominance of either consolidations or a combination of consolidations and ground-glass opacities (GGOs) was a predictor of more severe disease (both
< 0.005), while GGO prevalence alone was not. Correlation between all CT SSs was high, ranging from 0.848 to 0.971. CT SS 30 had the highest diagnostic accuracy (AUC = 0.805) in discriminating mild from severe COVID-19 disease compared to all the other proposed scoring systems (AUC range 0.755-0.788). In conclusion, CT SS 30 achieved the highest diagnostic accuracy in predicting the severity of COVID-19 disease while maintaining simplicity, reproducibility, and applicability in complex clinical settings.
We developed a next-generation SARS-CoV-2 sequencing platform and obtained the first SARS-CoV-2 sequences from patients in Croatia at the beginning of the COVID-19 outbreak in the spring of 2020. ...Integrating the sequencing and the epidemiological data, we show that patients were infected with different SARS-CoV-2 variants belonging to different clades (mostly G and GH). This result confirms that there was widespread virus transmission early in 2020. Interestingly, we identified a unique mutation resulting in a V13I substitution in Nsp5A, the main viral protease, in a patient who had not received antiviral therapy.
Virus krpeljnog meningoencefalitisa (KME) najčešći je uzročnik infekcija središnjeg živčanog sustava u endemskim područjima srednje Europe. Radi se o prirodno žarišnoj zoonozi, čiji rezervoar čine ...šumski glodavci, domaće i divlje životinje, a čovjek se zarazi prigodno, ubodom inficiranog krpelja. U posljednje je vrijeme sve više izvješća o epidemijama KME povezanih s konzumacijom svježeg mlijeka i mliječnih proizvoda. Cilj je rada prikazati kliničke značajke i tijek bolesti kod oboljelih od KME u tijeku grupiranja u Primorsko- goranskoj županiji (lipanj 2019. godine), povezanog s konzumacijom nepasteriziranog kozjeg mlijeka iz istog izvora. Tri su bolesnika hospitalizirana s kliničkom slikom meningitisa, a kod dvoje se infekcija prezentirala kao febrilna bolest s mijalgijama i općom slabošću. Kod svih je bolesnika infekcija potvrđena serološkom obradom. Niti jedan bolesnik nije bio cijepljen protiv KME niti je imao podatak o ugrizu krpelja. Ovim radom želimo ukazati na zdravstvene opasnosti prehrambenih navika konzumiranja sirovog mlijeka koje u današnje vrijeme postaje sve popularnije, osobito među zagovornicima „zdrave hrane“.
Structural changes in the rat placenta during the last third of gestation were for the first time assessed by stereology. Fischer female rats were euthanized on the day 16 or day 19 of gestation, and ...35 placentas were collected. Three randomly selected placentas from each group were stereologically analyzed for the absolute volume. The proportion of the glycogenic cells and the trophoblast giant cells (TGC) in the basal part of the placenta was calculated using volume density. The absolute volume of the rat placenta on the day 16 of gestation was determined as 0.0638 cm3. The labyrinth comprised 0.0274 cm3, the basal plate 0.0271 cm3 and the decidua 0.0093 cm3. On the day 19 of gestation, the absolute volume of the placenta was 0.1627 cm3, the labyrinth occupied 0.0922 cm3, the basal plate 0.0596 cm3 and the decidua 0.0109 cm3. The volume density of trophoblast giant cells was 0.174 cm0 on the day 16 and 0.107 cm0 on the day 19 of gestation. The glycogenic cells comprised 0.379 percentage of the basal plate on the day 16 and 0.236 on the day 19 of gestation. We conclude that the absolute volume of the whole placenta and the labyrinth has increased from day 16 to the day 19 of gestation. In contrast, the volume density of glycogenic cells and trophoblast giant cells was higher on the day 16 than on the day 19 of gestation, probably due to the intensive trophoblast invasion during that time.
Background: Hantaviruses remain an important case of emerging and re-emerging infections in human medicine. This study aimed to analyse the epidemiology, clinical presentation, and outcome of ...hantavirus infections in the western part of Republic of Croatia, a new geographical area for hantavirus infections. Methods: Retrospective analysis of medical records of patients treated for hemorrhagic fever with renal syndrome (HFRS) at the infectious diseases Clinic of the Clinical Hospital Center in Rijeka, Croatia, from 1 January 2014, to 31 December 2021. Results: During the eight-year period, 251 patients were hospitalized and treated for HFRS, with epidemic outbreaks in years 2014 and 2021. Most patients had a typical clinical course of HFRS and received supportive care. Serological analysis revealed the Puumala Virus (PUUV) as the predominant etiology of the disease. Epidemiological analysis revealed clustering of infections in the region of Gorski Kotar and spread to the area on the Mediterranean coast (Adriatic Sea), which was previously considered an area free from hantavirus infections. Conclusions: The presented results indicate the spread of hantavirus infections in Croatia from the central low-lying parts of the country to the tourist-attractive western area adjacent to the Mediterranean coast, which was previously considered free of hantavirus infections.
Lajmska borelioza i krpeljni meningoencefalitis (KME) najčešće su bolesti prenosive krpeljima u Republici Hrvatskoj. Isti vektor, krpelj roda Ixodes ricinus, odgovoran je i za prijenos humane ...granulocitne anaplazmoze (HGA) koja se u našoj zemlji rijetko dokazuje, a prvi slučajevi su potvrđeni 1998. godine u Koprivničko-križevačkoj županiji. HGA se najčešće klinički prezentira vrućicom s leukopenijom, trombocitopenijom, povišenim aminotransferazama i CRP-om, a potvrđuje se serološki, pri čemu se povremeno dokaže koinfekcija s virusom KME i/ili bakterijom Borrelia burgdorferi.
Prikazujemo slučaj 44-godišnje bolesnice koja je ambulantno liječena u Klinici za infektivne bolesti Kliničkog bolničkog centra Rijeka zbog vrućice s bicitopenijom (leukopenija, trombocitopenija) i akutnog perikarditisa. Serološkom je obradom dokazana akutna koinfekcija uzročnicima Anaplasma phagocytophilum i Borrelia burgdorferi. Liječenje je provedeno doksiciklinom i nesteroidnim antireumaticima, čime je postignut povoljan klinički odgovor.
Cilj: Prikazati slučaj bolesnika s atipičnom kliničkom slikom toksokaroze, koja se manifestirala izoliranom afekcijom središnjeg živčanog sustava. Prikaz slučaja: Bolesnik u dobi od 55 godina liječen ...je u Klinici za infektivne bolesti KBC-a Rijeka zbog cerebralne toksokaroze koja se prezentirala inicijalno aneozinofilnim aseptičnim meningitisom. Klinički tijek bolesti u početku nije ukazivao na parazitarnu infekciju, već je dijagnoza postavljena nakon ponavljajućih citološko-biokemijskih i seroloških analiza cerebrospinalnog likvora i seruma. Zaključci: Cerebralna toksokaroza je rijetka bolest, a može se prezentirati i kao teški meningitis, encefalitis ili mijelitis. Prikaz slučaja bolesnika s dokazanom cerebralnom toksokarozom koja se inicijalno prezentirala kao aneozinofilni aseptični meningitis ukazuje na važnost uključivanja neurotoksokaroze u diferencijalnu dijagnozu sindroma aseptičnog meningitisa bez drugog dokazanog uzročnika.
Aim: To present a case of a patient with an atypical clinical course of toxocariasis, which was manifested by isolated affection of the central nervous system. Case report: A 55-year-old patient was hospitalized at the Clinic for Infectious Diseases of the University Hospital Center Rijeka due to cerebral toxocariasis, which was initially presented as aneosinophilic aseptic meningitis. Since the clinical course of the disease did not initially indicate a parasitic infection, the diagnosis was established after repeated cytological-biochemical and serological analyzes of the cerebrospinal fluid and serum. Conclusions: Cerebral toxocariasis is a rare disease and can also present as severe meningitis, encephalitis, or myelitis. This case report of a patient with proven cerebral toxocariasis initially presented as aneosinophilic aseptic meningitis indicates the importance of including neurotoxocariasis in the differential diagnosis of aseptic meningitis syndrome with no other proven causative agent.
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