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SARS-CoV-2 and COVID-19
Published in Patricia G. Melloy, Viruses and Society, 2023
Like with other viruses, one can either perform a nucleic acid–based test to detect the viral genome, look for the viral antigen itself, or look for the presence of antibodies against the virus in the patient’s blood (Christakis 2020; Daley 2020). The initial tests used by the CDC and WHO were known as reverse transcriptase polymerase chain reaction (RT-PCR) tests (Daley 2020). As mentioned in other chapters, PCR allows for rapid amplification of a DNA sequence of interest, like a gene copier machine. Because the SARS-CoV-2 genome is RNA-based, the reverse transcriptase is needed to make a DNA copy of the genome to use as a template in the PCR reaction. Rapid PCR tests are now available, as are ones that detect viral antigens (Daley 2020). When comparing rapid tests, rapid PCR tests are said to be more sensitive than rapid antigen tests because they can pick up the virus earlier (Guglielmi 2021). Another way of testing is to look for the presence of antibodies in the person’s blood, indicating that they had been exposed to SARS-CoV-2 (Daley 2020; Guglielmi 2021).
Rocket Science
Published in Norman Begg, The Remarkable Story of Vaccines, 2023
Over the last few years, gene-based science has created platforms that enable new vaccines to be made to order. The success of gene-based COVID-19 vaccines has paved the way for vaccines not just for pandemics, but for other diseases that have hitherto eluded conventional approaches, such as HIV. Gene-based vaccines are in development for Lassa fever (a viral disease that causes internal bleeding, like Ebola, which has caused outbreaks in West Africa since the 1950s) and for Zika virus, the mosquito-borne disease which has recently spread from Africa to many regions, especially South America. Zika virus causes devastating damage to the unborn baby if caught in pregnancy; the baby is born with a small head (microcephaly) and severe mental retardation. Gene-based vaccines are being pursued for respiratory syncytial virus (RSV), which causes a serious respiratory illness in young children and the elderly, and for cytomegalovirus (CMV), anther illness which causes damage to the developing fetus in pregnant women; one in 200 pregnancies are affected by CMV. A trial of an RNA vaccine against Epstein-Barr virus (EBV) has started. EBV is the cause of infectious mononucleosis (better known as glandular fever) but has also been linked to multiple sclerosis. Influenza vaccines will likely be improved by using gene-based technology. The world of viral vaccines is being revolutionised as the genomes of these tiny organisms are laid bare.
Infectious Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Susanna J. Dunachie, Hanif Esmail, Ruth Corrigan, Maria Dudareva
Congenital infection with Zika virus is associated with miscarriage as well as CNS and joint problems in the new born. Most severely, this can manifest as microcephaly and even anencephaly, as well as severe deformities of the hands and feet.
Mechanical filtration of the cerebrospinal fluid: procedures, systems, and applications
Published in Expert Review of Medical Devices, 2023
Viral encephalitis (VE) and viral myelitis (VM) are inflammations of the brain and spinal cord respectively, caused by viruses. The virus most commonly involved in CNS infections is herpes simplex virus, but other viruses of the herpesviridae family (e.g. varicella-zoster or Epstein–Barr), along with enterovirus, mumps, measles, and viruses associated with respiratory tract infections (adenovirus and influenza B), varicella-zoster virus, rubella, measles, VIH, JC, and SARS-CoV-2 may also cause VE or VM. VM and VE may present with a variety of syndromes depending on the precise location of the inflammatory focus including rapidly progressive encephalopathy. Some cases develop an increase in ICP, seizures, and depression of the level of consciousness, which requires tracheal intubation for airway protection and ventilatory support, control of raised ICP, and the effective treatment of seizures [16]. Treatment options include medication to relieve the symptoms and antiviral medications for some particular types of viruses (few antivirals are indicated and just some types of viruses, i.e. herpesvirus). More antivirals and adjunctive therapies are needed for better outcomes of VE and VM. To our knowledge, the only case with VE/VM treated with CSF filtration to date is a patient with psychotic symptoms related to Borna disease VE with rapid clinical improvement after CSF filtration [17].
Value of combined detection of serum amyloid A, C-reactive protein and procalcitonin in differential diagnosis of respiratory tract infection in children of China
Published in Annals of Medicine, 2022
Respiratory tract infections are a common respiratory illness, occurring at the turn of the season, especially in children. The clinical features of respiratory infections in children often include cough, runny nose and fever, which if left untreated may prone to develop into lower respiratory tract infection, even causing nephritis, myocarditis, sepsis, rheumatic fever, etc [8]. If the disease cannot be a timely and effective control, the continuous progress of the disease may lead to sepsis, multiple organ failure and septic shock, and even endanger the lives of children [9]. Therefore, timely diagnosis and appropriate treatment are essential for the management of respiratory tract infections. However, conventional culture tests for respiratory tract infections are long, have a low positive diagnosis rate and are of low clinical value. Hence, the search for more accurate and specific tests is of great clinical importance for early and accurate and effective treatment of the disease. In addition, in China, antibiotics are the mainstay of treatment for respiratory tract infections in children. However, antibiotic therapy is not effective for non-bacterial infections and respiratory infections caused by viruses. If antibiotic treatment is applied blindly without a clear diagnosis of the pathogen, it is more likely to increase the risk of dual infection. Therefore, early diagnosis of the disease also plays an important role in determining the type of infection, avoiding the misuse of antibiotics and reducing the incidence of drug resistance.
Comparative efficacy and safety of antiviral traditional Chinese medicine injections for viral pneumonia: a systematic review and network meta-analysis
Published in Expert Review of Anti-infective Therapy, 2022
Meng-Ting Li, Jia Wang, Jia Hu, Han-Biao Wu, Wei-Shang Deng, Zhi-Kun Qiu, Ji-Sheng Chen
Antiviral therapy should be the key to treatment, but due to the high variability of most viruses, it brings difficulties to the development of therapeutic drugs. At present, the treatment for most respiratory viral infections lacks specificity, and clinically specific antiviral therapy is also limited to influenza virus, and the drugs mainly include abidol, oseltamivir, zanamivir, and peramivir. Traditional Chinese medicine (TCM) has the characteristics of systematic regulation and multi-target therapy, which can improve human immune function while reducing fever, reducing inflammation, and anti-virus, and has more advantages than single antiviral drugs in reducing upper respiratory tract symptoms. TCMIs are the product of the modernization of TCM dosage forms, which change the traditional model of administration of TCM, with rapid absorption and rapid action. The new coronavirus diagnosis and treatment plan recommends 7 kinds of traditional Chinese medicine injections according to the severity of the disease [3]. Although, TCM in being applied for COVID-19 pneumonia, its effectiveness remains uncertainly [4]. Therefore, integrating more clinical data becomes urgently needed. Furthermore, many RCTs of TCMIs in patients with VP have been completed. A reassessment of the available evidence to support clinical decision-making is urgently needed.