Infectious Diseases

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Infectious Diseases

Resources for managing ID patients

20  articles in this collection
Written by Mathias Castonguay, Laurie-Anne Duquette, Noémie Desgagnés, Michael Hnaris, 

Overview of Liver Injuries

Clinical parameters and known mechanisms:     The main viral entry receptor of COVID19 is angiotensin converting enzyme 2 (ACE2). Because this receptor is expressed in different organs, like the liver, SARS-CoV-2 causes a systemic disease1.     14% to 53%of hospitalized patients with COVID-19 show elevated serum liver biochemistries such as ALT, AST and […]

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03/29/2020

Is Diarrhea a Frequent Symptom?

The incidence of diarrhea is varying from 2% to 33% and may be underestimated in clinical publications ACE2, a known receptor used by SARS-CoV2 to enter cells, is more expressed in proximal and distal enterocytes SARS-CoV2 appears to invade mucosal cells of the stomach, small intestine and colon where it multiplies and creates virions.2 SARS-CoV […]

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04/06/2020

Blood or Digestive RNA Test Predicting Severity of Disease

There is a significant difference in the ratio of severe symptoms between the RNA blood positive group (100%) and the RNA blood negative group (23,5%). There is a significant difference in the ratio of severe symptoms between the RNA anal swab positive group (72,7%) and the RNA blood negative group (23,5%). Both tests could be […]

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04/16/2020

Vaccine Development Landscape

This list shows candidate vaccines and their research stage on May 20th, 2020.  Candidate vaccines in clinical evaluation: 9 Vaccine  Platform Developer/ Location Stage Ad5-nCoV Non- Replicating Viral Vector CanSinoBiological Inc./ Beijing Institute of Biotechnology (China) Phase II ChiCTR2000031781  Phase I ChiCTR2000030906  mRNA-1273 RNA Moderna/NIAID (U.S.) Phase 2 (IND accepted) Phase 1 NCT04283461 ChAdOx1 nCoV-19 […]

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04/26/2020

Recovered Patients Still Potential Carriers?

A proportion of recovered patients, defined as asymptomatic with 2 negative RT-PCR tests, may still be asymptomatic carrier. This study was done in Wuhan, China at Zhongnan Hospital of Wuhan University. The data comes from 4 patients, one hospitalized patient, and three medical personnel that tested positive for SARS-Cov-2 from January 1, 2020, to February […]

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04/07/2020

Summary of Emerging Treatment Options

Investigational Drugs Results in favor of the use* Results not in favor of the use** Efficacy proven Antiviral agents Chloroquine∆,1-3 ✓ ✓ Hydroxychloroquine∆,4-11 ✓ ✓ Hydroxychloroquine + Azithromycin∆,5,7,8,10 ✓ ✓ Ivermectin12 N/A N/A Favipivir13,14 ✓ Lopinavir-Ritonavir15,16 ✓ Oseltamivir17 ✓ Remdesivir18,19 ✓ ✓ Convalescent plasma20 ✓ Supporting agents Anakinra (IL-1 receptor antagonist) N/A N/A Baricitinib (JAK […]

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04/26/2020

Influenza Virus Co-Infection

Key Points Influenza virus and COVID-19 co-infection clinical diagnostic may be difficult as they appear to have similar transmission patterns, clinical manifestations and radiological aspect1. Nasal congestion (Nasal tampon) and pharyngalgia, which are not common symptoms of COVID-19, were more prone to appear with co-infected patients1. Co-infected patients seemed to have similar outcomes1. There is no significant […]

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03/28/2020

Rationale Behind Coronaviruses’ Vaccines

What we know about SARS-CoV: Caused an outbreak in 2002; Immune responses are mediated by both humoral and cellular immunity; S protein is responsible for 3 important mechanisms:  attachment of the virus by binding to the ACE2; entry in the host cells and membrane fusion; allowing release of the viral RNA. This makes S protein the […]

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04/06/2020

Origin of SARS-CoV-2

The evidence strongly suggests that SARS-CoV-2 is not a laboratory creation nor an intentionally manipulated virus. The RBD (receptor-binding domain) sequence of the SARS-CoV-2 spike protein appears to bind with high affinity to human ACE2, but this sequence is different than those predicted to be optimal for receptor binding based on previous computational analyses on […]

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04/02/2020

Insights About Reinfection and Immunization

How long does the immunity last after infections with coronaviruses? Is it possible to get reinfected?  As of now, one of the hospital discharge criterias for COVID-19 infection is that with at least a one-day interval, two repetitive RT-PCR tests done on throat swabs have turned up negative. This method of testing is currently questioned […]

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05/02/2020

Viral Load in Upper Respiratory Tracts

Viral loads seems to be higher soon after the symptom onset, with higher viral loads detected in the nose than in the throat. The results suggest a potential transmission potential by asymptomatic or minimally symptomatic patients, as the viral load in the asymptomatic patient was similar to the symptomatic ones.   These data come from […]

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04/03/2020

The Attack on Hemoglobin: a Distraction or a Virulence?

This study suggests that structural and transcribed proteins of the virus may attack the β1-chain of hemoglobin leading it to release its porphyrin (just like the heme oxidase)1, 2. It also suggests that the virus can capture the free porphyrin and use it to enter the human cells, rather than only using the ACE2 and […]

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04/07/2020

The Use of Remdesivir in Severe Cases

What is Remdesivir? Remdesivir (or GS-5734) is a nucleoside analogue with antiviral activity developed by Gilead Sciences. It inhibits viral RNA replication by incorporating itself in the nascent viral RNA chain. It was originally developed for the treatment of Ebola virus infection, for which it was judged to be less effective than the monoclonal antibody […]

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04/06/2020

Can Rapid IgM-IgG Ab Testing Replace RT-PCR?

Reverse Transcription Polymerase chain reaction (RT-PCR) and serologic testing for IgM-IgG antibodies are the dominant ways that global healthcare authorities are using to test for COVID-19. What is RT-PCR testing?    RT-PCR is currently the main testing method used to detect COVID-19. It consists of, first, reverse transcription of RNA into DNA and then amplifying […]

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04/16/2020

Tocilizumab for Cytokine Storm

What is Tocilizumab? Tocilizumab is a humanized monoclonal antibody directed against the interleukin-6 receptor, initially indicated only for use in patients with moderate and severe rheumatoid arthritis, but has now been FDA approved for other conditions including cytokine release syndrome, a notable side effect of CAR-T cell therapy.    Cytokine storm in Covid-19 ? The […]

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04/14/2020

Is a Symptom-Based Screening Process Effective?

A symptom-based and epidemiology-based screening process was ineffective in detecting all SARS-CoV-2 cases. Persons who have no fever and no signs or symptoms of respiratory infection can potentially shed SARS-CoV-2. The proportion of asymptomatic cases among individuals who tested positive for SARS-CoV-2 is around 17.9%. Since the viral loads between asymptomatic and symptomatic patients are […]

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04/04/2020

What Is the Efficacy of Masks in Preventing Transmission?

Aerosol is a potential mode of transmission from asymptomatic individuals. Surgical masks could reduce the emission of virus particles into the environment in droplets and aerosols. Therefore, they have the potential to reduce onward transmission if worn by symptomatic individuals. Only a minority (35%) of infected participants shed detectable virus in droplets or aerosols, and […]

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04/10/2020

Rationale of Old Antimalarial Drugs Against New Pandemic

Before COVID-19: Chloroquine has demonstrated its antiviral properties in vitro in the past against SARS-CoV-1 and MERS-CoV.1,2,3 It inhibits replication of several viruses in pH-dependent steps including members of the flaviviruses, retroviruses and coronaviruses.2 Immunomodulatory effects of chloroquine suppress the production/release of TNF-α and IL-6, which mediate the inflammatory responses in several viral diseases.2 Hydroxychloroquine […]

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04/01/2020

Lopinavir-Ritonavir in Severe Cases

No benefit was observed with lopinavir-ritonavir treatment in addition to standard of care in hospitalized adult patients with severe COVID-19. No significant difference in the time to clinical improvement or mortality at 28 days was shown between the lopinavir-ritonavir group and the standard of care group.  Viral RNA was detectable in similar percentages of patients […]

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04/01/2020

Dengue Fever as a Differential Diagnosis

Initial dengue IgG and IgM serology results might be falsely positive in the early-onset presentation of COVID-19 Dengue fever and early onset of SARs-COV-2 infection may present with similar symptoms. Thrombocytopenia and lymphopenia are laboratory findings presented in two patients who tested positive for COVID-19 after having a false positive dengue serology result.    This […]

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03/28/2020