Archives of Clinical Infectious Diseases
Volume:17 Issue: 4, Aug 2022

Context: 

The current pandemic of COVID-19 affected all people of the world.

Evidence Acquisition:

 Most complications of SARS-CoV-2 are causally related to severe pneumonia due to host immune response in the form of a cytokine storm. The other causes of an increased mortality rate among COVID-19 patients are secondary infections.

 Mucormycosis is a life-threatening infection that gained much attention in the ongoing COVID-19 pandemic. A rise in the frequency of COVID-19-associated mucormycosis (CAM) occurred in 2020 and 2021. Overall, mortality of CAM has been reported as 54% - 75%.

 Although awareness of the disease has increased among treating physicians, disease-associated morbidity and mortality are still high. The guideline is intended to serve as a reference to prevent mucormycosis in COVID-19 patients and help healthcare providers choose diagnostic and treatment methods for the best management of CAM cases.

 The application of methylprednisolone in ARDS patients has led to a sustained reduction in inflammatory plasma cytokines and chemokines and has recently been used in the treatment of patients with SARS-CoV-2 infection.

 In this study, the effect of methylprednisolone on clinical symptoms and antioxidant changes of patients with COVID-19 has been investigated.

 In the present study, patients with moderate to severe COVID-19 who required hospitalization were entered into the study phase. Then, in addition to standard treatment, patients received methylprednisolone at a dose of 250 mg intravenously over three days. Necessary evaluations include analysis of arterial blood gases, pulse oximetry, monitoring of patient clinical signs, examination of inflammatory biomarkers, and also receiving 10 cc of peripheral blood samples to check for antioxidant changes, at the beginning of the study, after 24 hours, and 72 hours after receiving methylprednisolone was on the agenda.

 Changes in fever, superoxide dismutase (SOD, Glutathione-S-Transferase (GST, the ferric reducing ability of plasma (FRAP, malondialdehyde (MDA, Nitric oxide, Ferritin, and TNF-α before treatment and 72 hours after treatment were significantly different between the two stages (P < 0.05).

 The use of methylprednisolone improves the balance of antioxidants and immunological factors in patients with COVID-19 and thus improves some clinical indicators in these patients.

 Fasciolosis as a zoonotic disease is one of the major health and economic problems with worldwide distribution. In some parts of Iran, the prevalence of human fasciolosis has increased over the past decades.

 This study aimed to determine the seroprevalence of human fasciolosis in Qaemshahr, Mazandaran Province, and determine the epidemiological factors associated with the disease.

 In this cross-sectional study, 2,418 serum samples were collected from different parts of Qaemshahr, Mazandaran province, and stored at -20°C until further use. The anti-Fasciola IgG antibodies were evaluated using the ELISA method. The demographic factors of the individuals were collected through questionnaires.

 Anti-Fasciola hepatica antibodies were detected in 60 (2.48%) individuals using ELISA method. Regarding the Fasciola seropositivity, significant differences were observed between age, gender, farmers, consumption of spring water, raw vegetables, anthelminthic drugs, and patients with a history of jaundice (P < 0.05), while no significant correlation were found between anti-Fasciola IgG positivity and consumption of traditional appetizers such as Dalal or processed olive, abdominal pain, patients with gastrointestinal symptoms, in housewives and administrative employees (P > 0.05).

 We found that 2% of people in Qaemshahr are seropositive for Fasciola infection. Integrated prevention and control strategies are the most effective solution for a decrease in the prevalence of fasciolosis in Qaemshahr, Mazandaran Province.

Breast cancer develops due to the combination of external and internal risk factors. Also, the role of viruses is considerable in developing breast cancer.

This study compared the frequency of herpes simplex virus types 1 and 2 (HSV-1 and HSV-2) and the level of IgM and IgG antibodies against HSV between cancer patients and healthy individuals.

Sixty women with breast cancer and 60 healthy women (40 with fibroadenoma and 20 in good health) were selected. Breast tissue and serum samples were taken from all the subjects to evaluate the HSV-1 and HSV-2 genome frequency using real-time PCR. Also, serum levels of IgM HSV and IgG HSV antibodies were assessed using the ELISA technique.

The HSV-1 genome was detected in six cancer specimens and in two fibroadenoma specimens (P = 0.143, OR: 3.22, CI95%: 0.623 - 16.66). Three cancer cases and one fibroadenoma case were positive for HSV-2 (P = 0.309, OR: 3.105, CI95%: 0.314 - 30.73). HSV IgM antibody was positive in three subjects in the control group and six in the case group (P = 0.298, OR: 2.11, CI95%: 0.503 - 8.87). Although the higher mean levels of antibodies were found in the case group (4.01 ± 5.91 U/mL) compared to the control group (2.95 ± 3.51 U/mL), there was no statistically significant difference between them (P = 0.179). The serum of all samples was positive for the HSV IgG antibody, and there was a statistically significant difference in its mean levels between the case (91.22 ± 13.58 U/mL) and control (81.58 ± 17.02 U/mL) groups (P = 0.008).

The present study showed that HSV-1 and HSV-2 were not directly related to breast tissue carcinogenesis and may act as co-factors.

 The COVID-19 pandemic affected different aspects of human life seriously, including health issues. Unfortunately, the process of RNA extraction using commercial kits is highly expensive. Replacement of this technique with a cheaper one may help us catch a more affordable approach.

 This study aims to introduce a simple and cost-benefit procedure to extract nucleic acid from swab samples of patients infected with SARS-COV-2.

 All 41 positive extracted samples were extracted with three methods separately. The first method was based on the commercial kit using a silica filter column. The second method was made of ammonium acetate, sodium acetate, and alcohol as an extraction solution, and the last method was applied using only the sodium acetate and alcohol solution.

 All samples extracted with a commercial kit based on a silica column were positive (100%) with Cts 21 ± 4.9, 21.4 ± 4.8, and 28.1 ± 1.8 for RNA-dependent RNA polymerase (RdRp), N, and RNase P genes, respectively. In the precipitation method using ammonium acetate, 40 samples were detected positive (97.5%), and the Cts were 26.3 ± 4.5, 23.6 ± 5.3, and 25.7 ± 3.5 for the above three genes, respectively. Similar to the conventional extraction method, the third method also showed positive results (97.5%) significantly. The mean CTs were 26 ± 4.3, 23 ± 5.4, and 23.7 ± 2.3, respectively.

 Our results indicated that the precipitation method using ammonium acetate, sodium acetate, and ethanol could be an alternative extraction method instead of the column-based method for SARS-COV-2 by swab samples.

 Otomycosis is defined as a superficial fungal infection, accounting for about 10% of infectious otitis externa cases.

 This study investigated patients with suspicious symptoms through the examination of their demographic information, isolate etiological agents, and in vitro antifungal susceptibility patterns.

 The samples of 170 patients with otitis externa symptoms were collected and confirmed for otomycosis by mycological examination (e.g., potassium hydroxide, methylene blue staining, and fungal culture) and molecular sequencing. In vitro antifungal susceptibility tests against miconazole, fluconazole, itraconazole, voriconazole, posaconazole, amphotericin B, and caspofungin were performed according to the Clinical and Laboratory Standards Institute (M27-A3/S4 and M38-A2).

 Out of 170 patients, 145 subjects (85.29%) showed positive mycological findings. In this study, 55.8% of the patients were male, and the most common age group affected was 50 - 59 years (26.2%). Hearing loss and pruritus were the most common clinical manifestations. The most common occupation was being a housewife (47.5%), and most cases occurred during the winter (40%). Aspergillus niger was the most common species, followed by Aspergillus fumigatus, Candida albicans, and Candida glabrata. Caspofungin showed the highest activity against Aspergillus and Candida isolates; nevertheless, itraconazole demonstrated the lowest activity against Aspergillus isolates. Fluconazole showed the weakest power against Candida species.

 Due to climatic conditions, humidity, and dust, otomycosis has a high occurrence in Iran. Although otomycosis needs long-term antifungal therapy and recurrence is high in some cases, it is rarely life-threatening, and eardrop antifungals are usually enough to eradicate the infection. Local information about the antifungal pattern is useful for the control, prevention, and treatment of otomycosis.

 Magnesium (Mg) deficiency is a common clinical electrolyte abnormality in critically ill patients, which is related to higher mortality and is easily ignored.

 We aimed to investigate the association of Mg levels with mortality and comorbidity in patients admitted to the intensive care unit (ICU) based on COVID-19 infection classification.

 A total of 69 patients admitted to the ICU of Shahid Mohammadi Hospital, Bandar Abbas, Iran, from June to December 2021were included in the present study. The serum Mg was measured in these patients. Data from sequential organ failure assessment (SOFA), acute physiologic assessment and chronic health evaluation (APACHE), ICU stay length, mechanical ventilation duration, mortality, and comorbidity were determined. Moreover, the COVID-19 infection was detected by PCR.

 The mean ± SD age of patients (34.8% male) was 52.56 ± 16.43 years. Out of 69 patients, 18 (26.1%) died during hospitalization, and 24 (34.8%) required mechanical ventilation. The prevalence of COVID-19 was 39.1% (27 patients). Our results showed no difference in serum Mg between patients based on mortality and comorbidity status. However, the Mg level of patients with kidney failure was significantly higher than patients without kidney failure (P < 0.05). Based on the COVID-19 classification, there was only a positive correlation between hypomagnesemia and the length of ICU hospitalization in patients without COVID-19 (P < 0.05).

 Our findings showed no difference in the Mg levels of patients based on mortality status. Patients with kidney failure had higher serum Mg than those without kidney failure. Furthermore, our results showed no difference in the Mg levels of critically ill patients based on COVID-19 infection status.