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Background Finding reliable clinical predictors for severity of COVID-19 has been challenging. Interferon gamma (IFNG) plays an important role in viral replication. QuantiFERON-TB (QFT) test relies on IFNG release in response to antigens. A positive or negative test signifies adequate IFNG response, whereas an indeterminate result is obtained when such a response is lacking. In this study, we have attempted to see if an indeterminate QFT result can provide prognostic information on patients with COVID–19. Survival Probability in patients with Covid - 19 and an indeterminate TB Quantiferon test result Methods This is a retrospective study of patients who were admitted at our institute with COVID–19 and had a QFT done within one month of the positive SARS-CoV-2 nucleic acid amplification test result. Patient charts were analyzed for clinical course and outcomes, including in-hospital mortality (primary outcome), 90-day mortality, respiratory failure, requirement for intubation and other complications that would portend a more severe disease course. Results A total of 120 patient charts were analyzed, out of which 43 (35.8%) had an indeterminate QFT. All the indeterminate results were due to an inadequate mitogen response. The indeterminate QFT group had a 41.86% (18/43) in-hospital mortality vs. 9.09% (7/77) in the negative or positive QFT group (p-value of < 0.001). The 90-day mortality was similar between the two groups. Patients with indeterminate QFT also had a higher incidence of respiratory failure (97.7% vs. 75.3%; p-value = 0.020), requirement for mechanical ventilation (55.8% vs. 23.4%; p-value < 0.001), requirement of ECMO (25.58% vs. 0%; p-vale < 0.001), requirement of pressor (48.83% vs. 14.28%; p-value < 0.001) and requirement for renal replacement therapy (32.5% vs. 1.3%; p-value < 0.001), when compared to patients with a negative or positive QFT. Patients in indeterminate group had a higher hospital length of stay than the other group (p-value = 0.035). Conclusion Our study indicates that patients with COVID-19 who fail to mount an adequate IFNG mitogen response in QFT assay have worse clinical outcomes and a more complicated and protracted clinical course. Evaluating cell-mediated immune responses through commercially available IFNG release assays may yield a promising strategy to predict COVID-19 clinical outcomes. Disclosures All Authors: No reported disclosures

The Middle East Respiratory Syndrome Coronavirus (MERS-CoV) was isolated in 2012 and is well known to cause the respiratory syndrome. The orf1ab gene is known to mediate MERS-CoV replication. In this study, we have discussed the in silico prediction of potential siRNAs targeting MERS-CoV-orf1ab gene for antiviral therapeutics. To identify the potential siRNAs, various factors were considered. We have excluded the siRNAs with off-target effects and potential binding with human mRNAs. By using available softwares, total twenty-one functional, off-target reduced potential siRNA were selected from four hundred and sixty-two siRNAs based on greater potency and specificity. We have tested only seven siRNAs initially to evaluate their performance by reverse transfection approach by lipofectamine mediated delivery in Vero cells. The evaluation results showed no cytotoxicity at various concentrations of siRNAs used. The results obtained in this study provided preliminary information about the cytotoxicity which will help us to further evaluate siRNAs in other cell cultures to find out the replication inhibition efficiency of MERS-CoV. Finally, it is concluded that the in silico prediction and designing resulted in filtration and selection of potential siRNAs with high accuracy, efficiency, and strength which can be further utilized for the development of oligonucleotide-based therapeutics.

Volatile solvent abuse (VSA) is defined at the "intentional inhalation of a volatile substance for the purpose of achieving a euphoric state". The lifetime prevalence of VSA in the UK remains steady at around 15%, the fourth highest rate in Europe, and VSA is the most common form of drug abuse in the 11-15 year age group in England and Wales. A 13 year old girl presented to the accident and emergency unit following inhalation of butane based deodorant, which resulted in a prolonged semiconscious state with encephalopathic symptoms.