Objective: To assess the utility of a test-based approach to shorten isolation of healthcare workers with COVID-19 in the setting of the highly transmissible omicron variant Methods: Between December 24th, 2021, to January 5th, 2022 HCWs who tested positive for SARS-CoV-2 were re-tested at least five days since onset of symptoms. Results: 46 sequential fully COVID-19 vaccinated HCWs who had tested positive for SARS-CoV-2 underwent follow up testing. All the isolates were confirmed as omicron variants and only 4 (8.7%) were negative 5 days or more since onset of symptoms., Conclusions: Implementation of a test-based strategy is logistically challenging, increases costs and did not lead to shorter isolation in our institution.

Anti-glutamic acid decarboxylase(Anti-GAD) are associated with various neurologic condition; but, no meningitis has been reported with it, so far. Evidence demonstrates the associated of autoimmune meningoencephalitis with Covid-19 infection. Here we report a 44-year-old female with progressive loss of consciousness with anti-GAD65 meningoencephalitis after Covid-19 infection.

Background Household studies are crucial for understanding the transmission of SARS-CoV-2 infection, which may be underestimated from PCR testing of respiratory samples alone. We aim to combine assessment of household mitigation measures; nasopharyngeal, saliva and stool PCR testing; along with mucosal and systemic SARS-CoV-2 specific antibodies, to comprehensively characterise SARS-CoV-2 infection and transmission in households. Methods Between March and September 2020, we obtained samples from 92 participants in 26 households in Melbourne, Australia, in a 4-week period following onset of infection with ancestral SARS-CoV-2 variants. Results The secondary attack rate was 36% (24/66) when using nasopharyngeal swab (NPS) PCR positivity alone. However, when respiratory and non-respiratory samples were combined with antibody responses in blood and saliva, the secondary attack rate was 76% (50/66). SARS-CoV-2 viral load of the index case and household isolation measures were key factors that determine secondary transmission. In 27% (7/26) of households, all family members tested positive by NPS for SARS-CoV-2 and were characterised by lower respiratory Ct-values than low transmission families (Median 22.62 vs 32.91; IQR 17.06 to 28.67 vs 30.37 to 34.24). High transmission families were associated with enhanced plasma antibody responses to multiple SARS-CoV-2 antigens and the presence of neutralising antibodies. Three distinguishing saliva SARS-CoV-2 antibody features were identified according to age (IgA1 to Spike 1, IgA1 to nucleocapsid protein (NP), suggesting that adults and children generate distinct mucosal antibody responses during the acute phase of infection. Conclusion Utilising respiratory and non-respiratory PCR testing, along with measurement of SARS-CoV-2 specific local and systemic antibodies, provides a more accurate assessment of infection within households and highlights some of the immunological differences in response between children and adults.

A document by Luise Erpenbeck. Click on the document to view its contents.

Objective. To compare the estimates of preterm birth (PTB; 22-36 weeks gestational age, GA) and stillbirth rates during COVID-19 pandemic in Italy with those recorded in the three previous years. Design. A population-based cohort study of liveborn and stillborn infants was conducted using data from Regional Health Systems and comparing the pandemic period (March 1st, 2020-March 31st, 2021, N= 362,129) to an historical period (January 2017- February 2020, N=1,117,172). The cohort covered 84.3% of the births in Italy. Methods. Logistic regressions were run in each Region and meta-analyses were performed centrally. We used an interrupted time series regression analysis to study the trend of preterm births from 2017 to 2021. Main Outcome Measures. The primary outcomes were PTB and stillbirths. Secondary outcomes were late PTB (32-36 weeks’ GA), very PTB (<32 weeks’ GA), and extreme PTB (<28 weeks’ GA), overall and stratified into singleton and multiples. Results. The pandemic period compared with the historical one was associated with a reduced risk for PTB (Odds Ratio: 0.90; 95% Confidence Interval, CI: 0.87, 0.93), late PTB (0.91; 0.87, 0.94), very PTB (0.87; 0.84, 0.91), and extreme PTB (0.88; 0.82, 0.94). In multiples, point estimates were not very different, but had wider CIs. No association was found for stillbirths (1.01; 0.90, 1.13). A linear decreasing trend in PTB rate was present in the historical period, with a further reduction after the lockdown. Conclusions We demonstrated a decrease in PTB rate after the introduction of COVID-19 restriction measures, without an increase in stillbirths.

During the COVID-19 pandemic, multiple skin manifestations have been described. These include an urticarial rash, morbilliform rash, maculopapular rash, vascular lesions, and varicella-like eruptions. A 30-year-old woman presented with a mild cough, then hives and pruritic rash for 3 days, followed by fever, dyspepsia, and throat pain for one day.

After a suspected allergic reactions to first dose of mRNA COVID-19 vaccine, given the PEG skin tests negativity and tolerance in vivo to PEG containing drugs, five patients were vaccinated with the second dose of Pfizer-Biontech undergoing a fractional protocol, with antihistamine premedication, without presenting immediate or delayed reactions.

A growing number of studies indicate a broad range of neurological manifestations, including seizures, occur in patients with COVID-19 infection. We report a 29-yers old female with status epilepticus and positive SARS-CoV-2 in the cerebrospinal fluid. Our findings support previous reports suggesting seizure as a possible symptom of COVID-19 infection.

Key Points 1. During the COVID-19 pandemic, NHS cancer referral guidance recommended a move from face-to-face clinics to telephone appointment. In this study, we reviewed the safety of telephone clinic for urgent 2-week wait cancer referrals. 2. In the 7 months study period during the COVID-19 pandemic, 1062 urgent 2-week wait cancer referrals were received in our regional head and neck specialist unit, reflecting a 7.3% decline compared to pre-pandemic data. 3. At 6-months follow-up, 98 (9.2%) patients received a new diagnosis of malignancy. 95 of them received their diagnoses promptly after their initial telephone clinic, whereas 3 patients received a delayed diagnosis. 4. There is a late diagnosis rate of 0.28% but we discussed in our cases that late diagnosis does not inevitably lead to worse clinical outcome or harm. 5. Telephone clinics will likely remain in some capacity after the pandemic, while telephone clinics are pragmatic means to maintain patient flow during the pandemic, they could result in risk of late diagnosis.

An 89-year-old male case was hospitalized in the COVID-19 department. His computerized chest tomography scan showed nodular opacities with glass halo including peripheral distribution. The patient showed active brucellosis.Finally, his respiratory symptoms and the radiologic images had got better and the second SARS-COV-2 test and the serologic tests were negative

ECMO is a selectively available therapeutic option, generally at a large-size referral healthcare system. In a single-center experience of use of veno-venous ECMO for COVID-19 ARDS in a medium-size healthcare system during the pandemic, West and colleagues in their study have convincingly demonstrated that ECMO can become a broadly available therapeutic option without compromising quality.

Title: Posterior Reversible Encephalopathy Syndrome and Necrotizing Enterocolitis in a Pediatric Patient with Medulloblastoma Infected with COVID-19

Critical illness-associated cerebral microbleeds and leukoencephalopathy related to COVID-19 infection are increasingly being recognized in the literature. We report seven cases of COVID-19 with microbleeds in the juxtacortical white matter and corpus callosum and one case of leukoencephalopathy.

We reported an association between SARS-CoV-2 infection and Guillain-Barre´ syndrome (GBS). From 37 patients with GBS, Previous SARS-CoV-2 infection clues, including fever, cough, and diarrhea were recorded in 18 patients. Among them, SARS-CoV-2 IgG was detected in 7 patients, considered confirmed cases. SARS-CoV-2 PCR was positive in just 1 patient.

Fluvoxamine is a selective-serotonin reuptake inhibitor (SSRI), well-tolerated and widely available, usually used in the management of mental-health conditions. Fluvoxamine is also a sigma-1 agonist with high affinity to this receptor and this pharmacodynamical effect has been being portrayed as the main explanation in emerging evidence about the potential of using fluvoxamine in COVID-19 patients. This systematic review was conducted according to the PRISMA guidelines. The search was run in MEDLINE, Web of Science, and CENTRAL from the Cochrane databases. The study protocol was registered in PROSPERO (CRD42022302025). Our aim was to assess the present evidence for therapeutic role of fluvoxamine in COVID-19 patients, the review included studies which evaluate the effect of fluvoxamine in COVID-19 patients. The main outcomes evaluated in the review were: mortality, need for hospitalization (outpatients) and clinical deterioration. The quality control of the selected articles was made using Cochrane’s Risk of Bias tool for the randomized controlled trials (RCTs) and the ROBINS-I criteria for non-randomized studies. A total of 4 studies were included in the final qualitative analysis of the review, 2 of which were RCTs, and the others were open-label prospective cohorts. 3 studies assessed outpatient population and 1 evaluated ICU population. Overall, the 4 studies included a total of 1864 participants. In conclusion, 3 studies with outpatients showed that fluvoxamine treatment can prevent clinical deterioration, hospitalisation, or proxy-hospitalisation. The only study with patients hospitalized in the ICU also demonstrated a therapeutic benefit reducing overall mortality.

It is important to increase the awareness of head and neck surgeons about the recent surge of craniofacial mucormycosis in COVID-19 patients, because early diagnosis and treatment are essential to improve the outcomes. Here, we describe clinical features, treatment protocols, and outcomes of treatment in 8 patients with COVID-19-associated mucormycosis

Myositis is one of the uncommon adverse events following COVID--19 vaccination, and its mechanism is still unclear. In the hope of aiding in its better understanding, we present a case of myositis following the first dose of the ChAdOx1 nCoV-19 Corona Virus Vaccine, evidenced by serology and MRI.

COVID-19 showed different characteristics and many cases showed clinical manifestations that could not be attributed to other conditions. We present a 22-year-old female had an uneventful recovery from COVID-19 and after that, she developed a cytokine storm and a worsening clinical condition two days after dental root canal therapy.

Length of anticoagulation for thrombotic events related to COVID-19 is unknown. We present a patient with COVID-19 complicated by a thrombotic anterior STEMI and multiple left ventricular (LV) thrombi that resolved after 8 weeks of anticoagulation. We suggest a shorter length of anticoagulation with COVID-19 related LV thrombus.

Re letter to British Journal of Clinical Pharmacology

Joint involvement in COVID-19 may occur at different stages of the disease and maybe represented by acute arthritis.We report Two cases of COVID-19.Both of our cases are consistent with what has been reported in the literature strengthen the necessity of wider studies to identify rheumatologic manifestations after surviving COVID-19.

COVID-19, TB and HIV are infectious diseases of global public health concern. Triple Co-infection with these diseases can create a diagnostic and therapeutic dilemma. We present a case of a young Cameroonian woman with SARS-CoV-2 -- HIV-TB triple co-infection. Early diagnosis and appropriate management yielded an excellent outcome.

Asthma 17q21 Polymorphism Associates with COVID-19 in Children

A potential immunological silver bullet for COVID-19: the trivalent chimpanzee adenoviral serotype-68 vector (Tri:ChAd)