<strong>Background:</strong> Novel corona virus (SARS-Coronavirus-2 SARS-CoV-2) which emerged in China has spread to multiple countries rapidly. Little information is known about delayed viral clearance in...<strong>Background:</strong> Novel corona virus (SARS-Coronavirus-2 SARS-CoV-2) which emerged in China has spread to multiple countries rapidly. Little information is known about delayed viral clearance in mild to moderate COVID-19 pa-tients. As it is highly contagious, health care workers including physicians are high risk of being infected in hospital care. <strong>Case Report:</strong> A 37 years old Bangladeshi physician working in a paediatric unit of a medical college hos-pital with multiple co-morbidities, hypertension, diagnosed axial spondy-loarthropathy (ankylosing spondylitis) taking disease modifying anti rheu-matic drugs— DMARDs (Salfasalazine) from 2016 till now, chronic persis-tent bronchial asthma on medication developed sore throat, increasing breathlessness and cough admitted to his own hospital on 22 April, 2020. He had a history of contact with a relapse nephrotic syndrome (glomerulone-phritis) patient admitted with severe respiratory distress later confirmed as COVID-19 following RT PCR test on 14 April, 2020. After 3 days of contact with the patient, the physician also developed the symptoms mentioned above. The RT PCR test result of the physician came positive on 18 April, 2020. The physician primarily taken only azithromycin 500 mg once daily along with other regular drugs. On 5, 12 and 18 May, 2020, his sample was taken for re-test and came positive subsequently. After that he started Iver-mectin (0.15 mg/kg) once daily for 3 days and doxycycline 100 mg BD for 7 days. He gave samples again on 27 and 29 May, 2020 which were came nega-tive after 39 days. On full recovery he was discharged from hospital on day 40. We choose the patient because presence of co-morbidities may be asso-ciated with delayed viral clearance and physicians with co-morbidities working in a hospital have high risk of being infected.展开更多
With the COVID-19 pandemic, disparities between the infection rate and death rate in different countries become a major concern. In some countries, lower mortality rate compared to others can be explained by better te...With the COVID-19 pandemic, disparities between the infection rate and death rate in different countries become a major concern. In some countries, lower mortality rate compared to others can be explained by better testing capacity and intensive care facilities. Complete SARS-CoV-2 genome sequences from different countries of the world are continually submitted to Global Initiative for Sharing All Influenza Data using Next Generation Sequencing method. A SARS-CoV-2 variant with a D 614G Mutation in the spike (S) protein has become the most dominant form in the global pandemic. There are a number of ongoing studies trying to relate this mutation with the infectivity, mortality, transmissibility of the virus and its impact on vaccine development. This review aims to accumulate the major findings from some of these studies and focus its future implication. Some studies suggested D 614G strain has increased binding capacity, it affects more cells at a faster rate, so has a high transmissibility. Patients infected with this strain were found with high viral load. But still now there is no such evidence that this strain produces more severe disease as well as increased mortality. The structural change of spike protein produced by D 614G mutation was minor and did not hamper the vaccine efficacy. Some studies showed antibodies produced against D614 strain can neutralize G614 strain and <em>vice versa</em>. Whenever a mutation occurs in spike protein there are always chances of affecting the infectivity, transmissibility, vaccine efficacy. Therefore, more studies are required to find out the overall effect of D 614G mutation.展开更多
<b><span style="font-family:Verdana;">Background</span></b><b><span style="font-family:Verdana;">:</span></b><span style="font-family:Verdana...<b><span style="font-family:Verdana;">Background</span></b><b><span style="font-family:Verdana;">:</span></b><span style="font-family:Verdana;"></span><span style="font-family:Verdana;"> Since 2019, the pandemic of Coronavirus disease 2019</span><span style="font-family:Verdana;"> (COVID-</span><span style="font-family:Verdana;">19) has spread very rapidly in China and Worldwide. COVID-19 is a highly contagious, infectious and rapidly spreading viral disease with an alarming case fatality rate up to 5%. </span><span style="font-family:Verdana;"></span><b><span style="font-family:Verdana;">Case</span></b><span style="font-family:Verdana;"></span><b><span style="font-family:;" "=""> </span></b><span style="font-family:Verdana;"></span><b><span style="font-family:Verdana;">Report</span></b><b><span style="font-family:Verdana;">:</span></b><span style="font-family:Verdana;"></span><span style="font-family:;" "=""><span style="font-family:Verdana;"> In this article, we report a case of 60 years old non diabetic, hypertensive woman infected with COVID-19 who </span><span style="font-family:Verdana;">has end stage renal disease (ESRD) on hemodialysis for last 18 months.</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">COVID-</span><span style="font-family:;" "=""><span style="font-family:Verdana;">19 patients with ESRD need isolation dialysis but most of them cannot be handled properly due to limited hemodialysis machine. With these unavailability and risk, we continue the treatment along with hemodialysis for controlling uraemia and fluid balance. With all effort this patient ended with an uneventful course with clinical improvement, improvement of all laboratory </span><span style="font-family:Verdana;">parameters and resolution of radiological findings but follow up RT-PCR</span><span style="font-family:Verdana;"> cannot done due to changing guideline of discharge criteria of COVID-19 patient in Bangladesh.</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">He positively responded to meropenem, clarithromycin, favi</span><span style="font-family:Verdana;">piravir, thromboprophylaxis with enoxaparin along with supplemental oxygen therapy. After that she was discharged with an advice of 14 days home isolation with regular hemodialysis and a follow up visit after 14 days in the outpatient department. </span><span style="font-family:Verdana;"></span><b><span style="font-family:Verdana;">Conclusion</span></b><b><span style="font-family:Verdana;">:</span></b><span style="font-family:Verdana;"></span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">An ESRD patient on regular hemodialysis suffering from severe pneumonia has high risk of mortality. Combined </span><span style="font-family:Verdana;">effort from the health care workers are needed to decrease the mortality of</span><span style="font-family:Verdana;"> COVID-19 infected ESRD patients.</span></span>展开更多
文摘<strong>Background:</strong> Novel corona virus (SARS-Coronavirus-2 SARS-CoV-2) which emerged in China has spread to multiple countries rapidly. Little information is known about delayed viral clearance in mild to moderate COVID-19 pa-tients. As it is highly contagious, health care workers including physicians are high risk of being infected in hospital care. <strong>Case Report:</strong> A 37 years old Bangladeshi physician working in a paediatric unit of a medical college hos-pital with multiple co-morbidities, hypertension, diagnosed axial spondy-loarthropathy (ankylosing spondylitis) taking disease modifying anti rheu-matic drugs— DMARDs (Salfasalazine) from 2016 till now, chronic persis-tent bronchial asthma on medication developed sore throat, increasing breathlessness and cough admitted to his own hospital on 22 April, 2020. He had a history of contact with a relapse nephrotic syndrome (glomerulone-phritis) patient admitted with severe respiratory distress later confirmed as COVID-19 following RT PCR test on 14 April, 2020. After 3 days of contact with the patient, the physician also developed the symptoms mentioned above. The RT PCR test result of the physician came positive on 18 April, 2020. The physician primarily taken only azithromycin 500 mg once daily along with other regular drugs. On 5, 12 and 18 May, 2020, his sample was taken for re-test and came positive subsequently. After that he started Iver-mectin (0.15 mg/kg) once daily for 3 days and doxycycline 100 mg BD for 7 days. He gave samples again on 27 and 29 May, 2020 which were came nega-tive after 39 days. On full recovery he was discharged from hospital on day 40. We choose the patient because presence of co-morbidities may be asso-ciated with delayed viral clearance and physicians with co-morbidities working in a hospital have high risk of being infected.
文摘With the COVID-19 pandemic, disparities between the infection rate and death rate in different countries become a major concern. In some countries, lower mortality rate compared to others can be explained by better testing capacity and intensive care facilities. Complete SARS-CoV-2 genome sequences from different countries of the world are continually submitted to Global Initiative for Sharing All Influenza Data using Next Generation Sequencing method. A SARS-CoV-2 variant with a D 614G Mutation in the spike (S) protein has become the most dominant form in the global pandemic. There are a number of ongoing studies trying to relate this mutation with the infectivity, mortality, transmissibility of the virus and its impact on vaccine development. This review aims to accumulate the major findings from some of these studies and focus its future implication. Some studies suggested D 614G strain has increased binding capacity, it affects more cells at a faster rate, so has a high transmissibility. Patients infected with this strain were found with high viral load. But still now there is no such evidence that this strain produces more severe disease as well as increased mortality. The structural change of spike protein produced by D 614G mutation was minor and did not hamper the vaccine efficacy. Some studies showed antibodies produced against D614 strain can neutralize G614 strain and <em>vice versa</em>. Whenever a mutation occurs in spike protein there are always chances of affecting the infectivity, transmissibility, vaccine efficacy. Therefore, more studies are required to find out the overall effect of D 614G mutation.
文摘<b><span style="font-family:Verdana;">Background</span></b><b><span style="font-family:Verdana;">:</span></b><span style="font-family:Verdana;"></span><span style="font-family:Verdana;"> Since 2019, the pandemic of Coronavirus disease 2019</span><span style="font-family:Verdana;"> (COVID-</span><span style="font-family:Verdana;">19) has spread very rapidly in China and Worldwide. COVID-19 is a highly contagious, infectious and rapidly spreading viral disease with an alarming case fatality rate up to 5%. </span><span style="font-family:Verdana;"></span><b><span style="font-family:Verdana;">Case</span></b><span style="font-family:Verdana;"></span><b><span style="font-family:;" "=""> </span></b><span style="font-family:Verdana;"></span><b><span style="font-family:Verdana;">Report</span></b><b><span style="font-family:Verdana;">:</span></b><span style="font-family:Verdana;"></span><span style="font-family:;" "=""><span style="font-family:Verdana;"> In this article, we report a case of 60 years old non diabetic, hypertensive woman infected with COVID-19 who </span><span style="font-family:Verdana;">has end stage renal disease (ESRD) on hemodialysis for last 18 months.</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">COVID-</span><span style="font-family:;" "=""><span style="font-family:Verdana;">19 patients with ESRD need isolation dialysis but most of them cannot be handled properly due to limited hemodialysis machine. With these unavailability and risk, we continue the treatment along with hemodialysis for controlling uraemia and fluid balance. With all effort this patient ended with an uneventful course with clinical improvement, improvement of all laboratory </span><span style="font-family:Verdana;">parameters and resolution of radiological findings but follow up RT-PCR</span><span style="font-family:Verdana;"> cannot done due to changing guideline of discharge criteria of COVID-19 patient in Bangladesh.</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">He positively responded to meropenem, clarithromycin, favi</span><span style="font-family:Verdana;">piravir, thromboprophylaxis with enoxaparin along with supplemental oxygen therapy. After that she was discharged with an advice of 14 days home isolation with regular hemodialysis and a follow up visit after 14 days in the outpatient department. </span><span style="font-family:Verdana;"></span><b><span style="font-family:Verdana;">Conclusion</span></b><b><span style="font-family:Verdana;">:</span></b><span style="font-family:Verdana;"></span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">An ESRD patient on regular hemodialysis suffering from severe pneumonia has high risk of mortality. Combined </span><span style="font-family:Verdana;">effort from the health care workers are needed to decrease the mortality of</span><span style="font-family:Verdana;"> COVID-19 infected ESRD patients.</span></span>
