scholarly journals Filling the gaps in the characterization of the clinical management of COVID-19: 30-day hospital admission and fatality rates in a cohort of 118 150 cases diagnosed in outpatient settings in Spain

2020 ◽  
Author(s):  
Daniel Prieto-Alhambra ◽  
Elisabet Balló ◽  
Ermengol Coma ◽  
Núria Mora ◽  
María Aragón ◽  
...  
Keyword(s):  
Primary Care ◽  
Polymerase Chain Reaction ◽  
Hospital Admission ◽  
Nursing Home Residents ◽  
Outcome Studies ◽  
Day Hospital ◽  
Chain Reaction ◽  
Co Morbidity ◽  
Polymerase Chain ◽  
Outpatient Settings

Abstract Background Currently, there is a missing link in the natural history of COVID-19, from first (usually milder) symptoms to hospitalization and/or death. To fill in this gap, we characterized COVID-19 patients at the time at which they were diagnosed in outpatient settings and estimated 30-day hospital admission and fatality rates. Methods This was a population-based cohort study.   Data were obtained from Information System for Research in Primary Care (SIDIAP)—a primary-care records database covering >6 million people (>80% of the population of Catalonia), linked to COVID-19 reverse transcriptase polymerase chain reaction (RT-PCR) tests and hospital emergency, inpatient and mortality registers. We included all patients in the database who were ≥15 years old and diagnosed with COVID-19 in outpatient settings between 15 March and 24 April 2020 (10 April for outcome studies). Baseline characteristics included socio-demographics, co-morbidity and previous drug use at the time of diagnosis, and polymerase chain reaction (PCR) testing and results.   Study outcomes included 30-day hospitalization for COVID-19 and all-cause fatality. Results We identified 118 150 and 95 467 COVID-19 patients for characterization and outcome studies, respectively. Most were women (58.7%) and young-to-middle-aged (e.g. 21.1% were 45–54 years old). Of the 44 575 who were tested with PCR, 32 723 (73.4%) tested positive. In the month after diagnosis, 14.8% (14.6–15.0) were hospitalized, with a greater proportion of men and older people, peaking at age 75–84 years. Thirty-day fatality was 3.5% (95% confidence interval: 3.4% to 3.6%), higher in men, increasing with age and highest in those residing in nursing homes [24.5% (23.4% to 25.6%)]. Conclusion COVID-19 infections were widespread in the community, including all age–sex strata. However, severe forms of the disease clustered in older men and nursing-home residents. Although initially managed in outpatient settings, 15% of cases required hospitalization and 4% died within a month of first symptoms. These data are instrumental for designing deconfinement strategies and will inform healthcare planning and hospital-bed allocation in current and future COVID-19 outbreaks.

scholarly journals Antibody response after one and two doses of the BNT162b2 vaccine in nursing home residents: The CONsort-19 study

2021 ◽  
Author(s):  
Jean Bousquet ◽  
Hubert Blain ◽  
Edouard Tuaillon ◽  
Lucie Gamon ◽  
Amandine Pisoni ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Nursing Home ◽  
Antibody Response ◽  
Nursing Home Residents ◽  
Rt Pcr ◽  
Chain Reaction ◽  
S Protein ◽  
N Protein ◽  
Polymerase Chain ◽  
Low Levels

Methods: Twenty-two French nursing homes were included. COVID-19 had been diagnosed with real-time reverse-transcriptase polymerase chain reaction (RT-PCR) for SARS-CoV-2. Blood S-protein IgG and nucleocapsid (N) IgG protein (N-protein IgG) were measured 21-24 days after the first jab (1,004 residents) and 6 weeks after the second (820 residents). Results: Among the 735 residents without prior COVID-19, 41.7% remained seronegative for S-protein IgG after the first jab vs 2.1% of the 270 residents with a previous positive RT-PCR (p<0.001). After the second jab, only 3% of the 586 residents without prior COVID-19 remained seronegative. However, 26.5% of them had low S-protein IgG levels (50-1050 UA/mL) vs 6.4% of the 222 residents with prior COVID-19. Residents with old infection (first wave), or seropositive for N-protein IgG at the time of vaccination, had the highest S-protein IgG levels. Residents with a prior COVID-19 infection had higher S-protein IgG levels after one dose than those without two jabs. Interpretation: A single vaccine jab is sufficient to reach immunity in residents with prior COVID-19. Most residents without prior COVID-19 are seropositive for S-protein IgG after the second jab, but around 30% have low levels of S-protein IgG. Whether residents with no or low post-vaccine immunity are at higher risk of symptomatic COVID-19 requires further analysis.

scholarly journals Analysis of the demand for detection of SARSCoV-2 in a health area of Spain

2000 ◽  
Vol 33 (6) ◽  
pp. 422-429
Author(s):  
Jesús García-Cruces ◽  
Raúl López Izquierdo ◽  
Marta Domínguez-Gil ◽  
Luis López-Urrutia ◽  
Mónica de Frutos ◽  
...  
Keyword(s):  
Primary Care ◽  
Polymerase Chain Reaction ◽  
Positive Result ◽  
Diagnostic Performance ◽  
Descriptive Analysis ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Health Area ◽  
Reference Hospital ◽  
Polymerase Chain

Introduction. Since the discovery of the SARS-CoV-2 virus, the polymerase chain reaction technique (RT-PCR) has become the fundamental method for diagnosing the disease in its acute phase. The objective is to describe the demand-based series of RT-PCR determinations received at a Microbiology Service at a third-level reference hospital for a health area for three months spanning from the onset of the epidemic by SARS-CoV-2. Methods. A retrospective analysis of the total of the RT-PCR requested in the Microbiology Service analyzed from 02/25/2020 to 05/26/2020 (90 days) has been carried out. They have been grouped by epidemiological weeks and by the petitioner service. A descriptive analysis was carried out by age, gender and number of requests for each patient. In the tests carried out, a confidence level of 95% (p <0.05) was considered significant. Results. A total of 27,106 requests was received corresponding to 22,037 patients. Median age 53.7 (RIC 40.9-71.7) years, women: 61.3%. Proportion of patients with any positive RT-PCR: 14%. Of the total requests for RT-PCR, positive 3,710. Week 13 had the highest diagnosis performance (39.0%). The primary care has been the service thar has made the most requests (15,953). Patients with 3 or more RT-PCR: 565, of them, 19 patients had a positive result after previously having a negative one. Conclusions. Requests have been increasing depending on the evolution of the epidemic. The RT-PCR has a high diagnostic performance in the phases of highest contagiousness and / or transmissibility of the virus.

scholarly journals Electronic Consults for Infectious Diseases in a United States Multisite Academic Health System

2020 ◽  
Vol 7 (4) ◽  
Author(s):  
Brian R Wood ◽  
Jessica A Bender ◽  
Sara Jackson ◽  
Leah Rosengaus ◽  
Paul S Pottinger ◽  
...  
Keyword(s):  
Infectious Disease ◽  
United States ◽  
Primary Care ◽  
Polymerase Chain Reaction ◽  
Latent Tuberculosis ◽  
Positive Culture ◽  
Chain Reaction ◽  
Academic Health ◽  
Polymerase Chain ◽  
Primary Care Practitioners

Abstract We launched Infectious Disease electronic consultations (eConsults) in 2018. During the first 15.5 months, primary care practitioners submitted 328 eConsults; the most frequent reasons were a positive culture or polymerase chain reaction (PCR) result, syphilis, and latent tuberculosis. Practitioners commonly requested advice on antimicrobial choice, clinical evaluation, and indications for treatment. Internal phone consultations decreased after eConsult implementation.

Occurrence of Skin and Environmental Contamination with Methicillin-ResistantStaphylococcus aureusbefore Results of Polymerase Chain Reaction at Hospital Admission Become Available

2010 ◽  
Vol 31 (6) ◽  
pp. 607-612 ◽  
Author(s):  
Shelley Chang ◽  
Ajay K. Sethi ◽  
Usha Stiefel ◽  
Jennifer L. Cadnum ◽  
Curtis J. Donskey
Keyword(s):  
Polymerase Chain Reaction ◽  
Hospital Admission ◽  
Active Surveillance ◽  
Environmental Contamination ◽  
Chain Reaction ◽  
Pcr Screening ◽  
Healthcare Settings ◽  
Polymerase Chain ◽  
Mrsa Colonization ◽  
Median Interval

Background.Active surveillance to detect patients colonized with methicillin-resistantStaphylococcus aureus(MRSA) is increasingly practiced in healthcare settings. However, inpatients may already become sources of transmission before appropriate precautions are implemented.Objective.To examine the frequency of MRSA contamination of commonly touched skin and environmental surfaces before patient carriage status became known.Methods.We conducted a 6-week prospective study of patients who were identified by use of polymerase chain reaction (PCR) at hospital admission as having nasal MRSA colonization. Skin and environmental contamination was assessed within hours of completion of PCR screening.Results.There were 116 patients identified by PCR screening as having nasal MRSA colonization during the period from mid-April to May 2008, of whom 83 (72%) were enrolled in our study. Overall, MRSA was detected on the skin of 38 (51%) of 74 patients and in the environment of 37 (45%) of 83 patients Of 83 environmental culture samples, 63 (76%) were obtained within 7 hours after PSR results became available, and 73 (88%) were obtained before wards were notified of PCR Results. Of the 83 MRSA-colonized patients, 15 (18%) had contaminated their environment 25 hours after admission, and 29 (35%) had contaminated their environment 33 hours after admission. Thirty-two (39%) of the 83 patients had roommates, 13 (41%) of whom contaminated their environment. The median interval from admission to PCR result was 20 hours, and the median interval from PCR result to notification was 23 hours. An increased quantity of MRSA cultured from a nasal sample was significantly associated with contamination.Conclusions.Before any contact precautions can be implemented, newly identified MRSA carriers frequently have contaminated their environment with MRSA and have contamination of commonly examined skin sites. In hospitals that perform active surveillance, strategies are needed to minimize delays in screening or to preemptively identify patients at high risk for disseminating MRSA.

scholarly journals Long-Term Carriage of Ciprofloxacin-Resistant Escherichia coli Isolates in High-Risk Nursing Home Residents

2016 ◽  
Vol 37 (4) ◽  
pp. 440-447 ◽  
Author(s):  
Miriam D. Ismail ◽  
Ting Luo ◽  
Sara McNamara ◽  
Bonnie Lansing ◽  
Evonne Koo ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Polymerase Chain Reaction ◽  
High Risk ◽  
Polymerase Chain Reaction Amplification ◽  
Nursing Home Residents ◽  
Multidrug Resistant ◽  
Chain Reaction ◽  
E Coli ◽  
Polymerase Chain ◽  
Gram Negative Organisms

BACKGROUNDRates of multidrug-resistant gram-negative organisms are surpassing those of methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci in nursing homes (NHs).OBJECTIVETo characterize the incidence and duration of carriage of ciprofloxacin-resistant Escherichia coli (CipREc) in NHs and identify those in the O25b-ST131 lineage.METHODSWe collected 227 CipREc isolates obtained by routine and regular surveillance of high-risk NH residents with indwelling devices. Repetitive element palindromic (REP)–polymerase chain reaction assay and multiplex polymerase chain reaction amplification for O25b-ST131 E. coli detection were performed using (GTG)5-primers and O25pabBspe and trpA2 primer pairs, respectively.RESULTSWe found a high period prevalence of CipREc colonization (21.5%), high rates of recolonization with the same strain following clearing (0.46 recolonizations/ person/ year), and an acquisition incidence of 1.05 cases/1,000 person-days. Almost three-quarters of colonized residents carried strains in the O25b-ST131 E. coli lineage. Compared with isolates not in the lineage, O25b-ST131 isolates were carried significantly longer (10 vs 3 months). We identified 18 different REP-types; 2 occurred in 55% of the residents colonized with CipREc, and in more than 1 NH. Duration of CipREc carriage varied by REP-type and averaged 6 months.CONCLUSIONCipREc occurred frequently in NH residents and is carried for long durations, and reacquisition following clearance is commonTrial registration. ClinicalTrials.gov identifier: NCT01062841.Infect. Control Hosp. Epidemiol. 2016;37(4):440–447

High performance Nanogold™-in situ hybridzation and its use in the detection of hybridized and PCR-amplified microscopical preparations

1996 ◽  
Vol 54 ◽  
pp. 896-897
Author(s):  
G. W. Hacker ◽  
I. Zehbe ◽  
J. Hainfeld ◽  
A.-H. Graf ◽  
C. Hauser-Kronberger ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Messenger Rna ◽  
High Performance ◽  
Detection System ◽  
Direct Methods ◽  
Genetic Alterations ◽  
Chain Reaction ◽  
Protein Encoding ◽  
Polymerase Chain

In situ hybridization (ISH) with biotin-labeled probes is increasingly used in histology, histopathology and molecular biology, to detect genetic nucleic acid sequences of interest, such as viruses, genetic alterations and peptide-/protein-encoding messenger RNA (mRNA). In situ polymerase chain reaction (PCR) (PCR in situ hybridization = PISH) and the new in situ self-sustained sequence replication-based amplification (3SR) method even allow the detection of single copies of DNA or RNA in cytological and histological material. However, there is a number of considerable problems with the in situ PCR methods available today: False positives due to mis-priming of DNA breakdown products contained in several types of cells causing non-specific incorporation of label in direct methods, and re-diffusion artefacts of amplicons into previously negative cells have been observed. To avoid these problems, super-sensitive ISH procedures can be used, and it is well known that the sensitivity and outcome of these methods partially depend on the detection system used.

1504: Molecular Diagnosis and Staging of Prostate Cancer Using Clusterin in Real Time Reverse Transcription Polymerase Chain Reaction (RT-PCR)

2006 ◽  
Vol 175 (4S) ◽  
pp. 485-486
Author(s):  
Sabarinath B. Nair ◽  
Christodoulos Pipinikas ◽  
Roger Kirby ◽  
Nick Carter ◽  
Christiane Fenske
Keyword(s):  
Prostate Cancer ◽  
Polymerase Chain Reaction ◽  
Real Time ◽  
Molecular Diagnosis ◽  
Reverse Transcription ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Polymerase Chain
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