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Coronavirus disease 2019 (COVID-19) is frequently associated with thrombo inflammation, which can predispose to developing of life-threatening conditions in children such as the multisystem inflammatory syndrome (MIS-C) and Kawasaki disease. Because of the consistent overlap in pathogenesis and symptoms, identifying laboratory tests that may aid in the differential diagnosis of these pathologies becomes crucial. We performed an electronic search in PubMed, Web of Science and Scopus, without date or language restrictions, to identify all possible studies reporting D-dimer values in separate cohorts of children with MIS-C or Kawasaki disease. Three multicenter cohort studies were included in our analysis, totaling 487 patients (270 with MIS-C and 217 with Kawasaki disease). In this meta-analysis, significantly higher D-dimer values were found in MIS-C compared to Kawasaki disease in all three studies, yielding an SMD of 1.5 (95 % CI, 1.3–1.7) mg/L. Thus, very high D-dimer values early in the course of disease should raise the clinical suspicion of MIS-C rather than Kawasaki disease. Further studies should be planned to identify harmonized D-dimer diagnostic thresholds that may help discriminate these conditions. [ABSTRACT FROM AUTHOR]

We have planned this analysis to provide current statistics on mortality directly caused by Influenza viruses in recent years in the US. We performed an electronic search in the online database CDC WONDER to obtain current statistics on direct mortality caused by Influenza viruses in the US. Mortality data are derived from information on all death certificates issued in the 50 states and the District of Columbia, excluding deaths of nonresidents. Our basic query criteria included Influenza-specific ICD-10 codes. Influenza caused an average of 7,670 deaths per year from 2018 to 2020 based on Influenza-specific ICD-10 codes, with a corresponding mean death rate of 2.3 × 100,000. The death rate increased in parallel with the age of the US resident population, from 0.2 × 100,000 in the 5–24 age group to 37.4 × 100,000 in US residents aged 85 years or older. No substantial differences were observed in males vs. females. The results of this analysis show that Influenza remains a significant clinical burden in the general population, with a cumulative mortality rate of approximately 2.3 × 100,000, but increasing more than tenfold (to over 37 × 100,000) in older persons. [ABSTRACT FROM AUTHOR]

SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; RDT-Ag, rapid diagnostic antigen test; LAB-Ag, laboratory-based antigen test; RT-PCR, real time polymerase chain reaction. SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; RDT-Ag, rapid diagnostic antigen test; LAB-Ag, laboratory-based antigen test; RT-PCR, real time polymerase chain reaction. [Extracted from the article]

The article discusses Mpox (monkeypox), an infectious disease caused by a member of the Orthopoxvirus genus. It explains that there are two major Clades of mpox, with Clade I currently causing a serious outbreak in Central Africa. The World Health Organization has declared mpox a Public Health Emergency of International Concern. The article also provides information on diagnostic methods for mpox, including nucleic acid amplification tests and immunoassays. It highlights the need for more validated diagnostic kits and the importance of differentiating between Clades I and II. [Extracted from the article]

SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) structure and host tropism have changed over time, and so has the involvement of throat structures. This infodemiological analysis is hence aimed at investigating the evolution of throat symptoms during the COVID-19 pandemic in the US. We searched Google Trends using the medical search terms "ageusia", "hoarseness", "dysphonia", "pharyngitis" and "laryngitis", setting geographical location to "United States", within the past 5 years. The weekly Google Trends score for these symptoms, which reflects their national Web popularity, was divided in three parts, as "pre-COVID" (July 2017 to February 2020), COVID-19 "pre-Omicron" (March 2020 to November 2021), and COVID-19 "Omicron" (December 2021 to July 2022), and then compared. The volume of searches for ageusia increased in the pre-Omicron period and remained significantly higher also during Omicron prevalence, though a significant decrease (∼30%) occurred with Omicron lineages compared to previous strains. The Google searches for hoarseness and dysphonia were relatively similar between the pre-COVID and pre-Omicron periods, but then significantly increased during Omicron predominance. The Google searches for pharyngitis and laryngitis decreased in the pre-Omicron period, but then considerably increased following Omicron emergence. Omicron endemic spread could be significantly and independently predicted by the volume of searches for pharyngitis, laryngitis and hoarseness. The epidemiological burden of throat symptoms has considerably changed after Omicron emergence, with a lower likelihood of developing chemosensory dysfunctions and enhanced risk of throat involvement. [ABSTRACT FROM AUTHOR]

Keywords: COVID-19; epidemiology; SARS-CoV-2 EN COVID-19 epidemiology SARS-CoV-2 200 202 3 05/18/23 20230501 NES 230501 To the Editor, Public health policies concerning control and prevention of infectious diseases are deeply driven by epidemiologic data, especially when the pathogens have high propensity to spread as local outbreaks or, even worse, as pandemics, like that more recently caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) [[1]]. The use of serological testing cannot help obtain a more accurate picture of COVID-19 epidemiology, since SARS-Cov-2 seropositivity or seronegativity are biased by a variety of confounding factors that make the currently marked anti-SARS-CoV-2 immunoassays outdated and mostly unfit for this purpose [[11]]. [Extracted from the article]

Using body temperature and variables commonly available in the EHR to predict acute infection: a proof-of-concept study showing improved pretest probability estimates for acute COVID-19 infection among discharged emergency department patients. Keywords: coronavirus; COVID-19; fever; screening; temperature EN coronavirus COVID-19 fever screening temperature 195 198 4 05/12/22 20220501 NES 220501 Introduction With the ongoing coronavirus disease 2019 (COVID-19) pandemic continuing to spread all around the world, and resulting in several thousand casualties almost every day, the adoption of reliable measures for widespread (mass) screening of severe acute respiratory distress syndrome coronavirus 2 (SARS-COV-2) infections is a cornerstone of all effective strategies aimed at limiting the viral spread within the community [[1]]. Notably, the use of body temperature to predict acute COVID-19 infection has also been recently challenged by Berdahl and colleagues, who found that its diagnostic accuracy (expressed as area under the curve, AUC) was 0.69 (95% CI, 0.58-0.79) and could be significantly improved by adding covariates known to influence body temperature [[28]]. [Extracted from the article]

Keywords: COVID-19; mutations; SARS-CoV-2; variants EN COVID-19 mutations SARS-CoV-2 variants 11 17 7 02/07/22 20220201 NES 220201 Introduction The worldwide burden of coronavirus disease 2019 (COVID-19) is still unremittingly prosecuting, with nearly 300 million infections and over 5.3 million deaths as of mid December 2021 according to the data from the John Hopkins University Coronavirus Resource Center [[1]]. Although the SARS-CoV-2 genome encodes a specific nonstructural protein 14 (NSP14), which acts by accompanying viral replicases during RNA synthesis, removing misincorporated bases from nascent RNA strands before they extend (i.e., "proofreading") and thus lowering the risk that replication errors will become permanent (thereby ultimately limiting genetic diversity) [[14]], it is undeniable that SARS-CoV-2 evolves I in vivo i , within the infected subject. Considering that the genome of SARS-CoV-2 is more than twice as large as that of Influenza viruses (i.e., ~29.9 vs. ~13.5 Kb, respectively) [[7]], it is hence quite plausible that SARS-CoV-2 will also likely accumulate a large number of mutations over time, despite possessing inherent proofreading capabilities in form of an exonuclease which leads to a 10-fold lower mutation rate compared to influenza [[8]]. SARS-CoV-2 variants The genomic RNA of SARS-CoV-2 encodes four leading structural proteins which are known as Spike (and which also contains the receptor-binding domain [RBD] through which the virus binds to its natural receptor at host cell surface), the envelope (E) protein, the membrane (M) protein and the nucleocapsid (N) protein. [Extracted from the article]

Despite inter-individual variations in their diagnostic efficiency, dogs have been trained to investigate many human pathologies, especially cancer, diabetes, migraine, seizures and even infectious diseases. To this end, we performed a critical review and pooled analysis of current scientific literature on the performance of dogs trained for identifying severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive human specimens. We carried out an electronic search in PubMed, Scopus and Web of Science with the keywords "dog(s)" AND "sniffer" OR "scent" OR "smell" AND "SARS-CoV-2" OR "severe acute respiratory syndrome coronavirus 2" OR "coronavirus disease 2019" OR "COVID-19" within all fields, without date or language restrictions, to identify studies describing dogs' performance for identifying SARS-CoV-2 infected material. Three studies could be finally included in pooled analysis, totaling 17 dogs (47% females), aged between 0.5 and 12 years. The pooled diagnostic sensitivity was 0.88 (95% CI, 0.84–0.91; I2, 85.3%), the diagnostic specificity 0.99 (95% CI, 0.99–0.99; I2, 97.4%), whilst the area under the summary receiver operating characteristic curve (SROC) was 0.979 (standard error, 0.003). The notable performance observed in this pooled analysis would persuade us to suggest that adequately trained dogs could represent an intriguing and sustainable resource for purposes of rapid SARS-CoV-2 mass screening. [ABSTRACT FROM AUTHOR]

Although the most effective strategy for preventing or containing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreaks relies on early diagnosis, the paramount and unprecedented number of tests needed to fully achieve this target is overwhelming worldwide testing supply and capacity. Molecular detection of SARS-CoV-2 RNA in nasopharyngeal swabs is still considered the reference diagnostic approach. Nonetheless, identification of SARS-CoV-2 proteins in upper respiratory tract specimens and/or saliva by means of rapid (antigen) immunoassays is emerging as a promising screening approach. These tests have some advantages compared to molecular analysis, such as point of care availability, no need of skilled personnel and dedicated instrumentation, lower costs and short turnaround time. However, these advantages are counterbalanced by lower diagnostic sensitivity compared to molecular testing, which would only enable to identifying patients with higher SARS-CoV-2 viral load. The evidence accumulated to-date has hence persuaded us to develop a tentative algorithm, which would magnify the potential benefits of rapid antigen testing in SARS-CoV-2 diagnostics. [ABSTRACT FROM AUTHOR]

The new generation of clinical chemistry and coagulation analyzers is equipped with technical features allowing a systematic check of sample quality, including an assessment of the so-called HIL (“hemolysis”, “icterus”, “lipemia”) indices. These measures enable an accurate and reproducible assessment of sample hemolysis in serum or plasma, hence the hemolysis index (H-index) is now also increasingly used for monitoring and benchmarking phlebotomy performance. Reliable evidence attests that intravascular hemolysis is not such a rare phenomenon, and its prevalence may be especially higher in geographical areas where congenital hemolytic diseases are endemic, as well as in healthcare settings where patients with acquired hemolytic disorders are more frequently visited or hospitalized. It is hence conceivable that monitoring phlebotomy performance based on the rate of hemolyzed specimens received by the laboratory may not be so straightforward, provided that specimens drawn from patients with intravascular hemolysis can be identified and excluded from the analysis. The aim of this article is to provide an overview of potential drawbacks in using the H-index alone for monitoring phlebotomy performance, and to offer potential solutions to improve its efficiency for this scope. We therefore suggest that the H-index may only be used for purposes of benchmarking phlebotomy performance when the overall number of diagnoses of hemolytic diseases or the haptoglobin values measured by the laboratories are comparable across different healthcare settings or geographic areas. [ABSTRACT FROM AUTHOR]

The authors reflect on the restrictive measures that clinical laboratories should adopt in order to prevent Ebola virus contamination. They discuss the documents released by the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) about infection prevention and control guidance for patients under investigation for the Ebola disease. They highlight suggestions on how to eliminate or minimize occupational exposure to the virus in clinical laboratories.

Migraine is a highly prevalent and frequently disabling disorder. Since the pathogenesis of this condition has a strong inflammatory component and migraine is significantly associated with cardiovascular disease, we assess whether C-reactive protein (CRP) may be epidemiologically or casually linked with migraine. An electronic search on Medline, Scopus and Web of Science produced 17 studies reporting original data about the epidemiological association between CRP and migraine (1 retrospective, 1 interventional, 14 cross-sectional and 1 both interventional and cross-sectional). When all studies reporting sufficient data about CRP values were pooled (n = 12; 6980 cases and 38,975 controls), the concentration of CRP was found to be significantly higher in patients with migraine than in controls (weighted mean difference 1.12 mg/L; 95% CI 1.01–1.25 mg/L; p < 0.001). In further analysis of studies containing separate data for migraine with and without aura (n = 7), CRP values remained significantly higher in both migraineur patients with aura (n = 1939; weighted mean difference 0.88 mg/L; 95% CI 0.63–1.14 mg/L; p < 0.001) or without aura (n = 2483; weighted mean difference 1.04 mg/L; 95% CI 0.78–1.30 mg/L; p < 0.001) when compared with controls (n = 29,354). Despite a large inter-study heterogeneity (99.3%), our analysis provides evidence of a potential epidemiological association between increased concentration of CRP and migraine, thus paving the way for further clinical investigations about therapeutic agents that may contextually decrease the risk of cardiovascular disease and reduce the burden of migraine. [ABSTRACT FROM AUTHOR]

This article reports on an investigation conducted by the Italian Society of Clinical Biochemistry and Molecular Biology on the volume of urgent testing in clinical laboratories of the country. Topics discussed include the reasons that make stat testing a quandary for clinical laboratories, the median percentage of stat testing referred to the total number of tests and the total number of inpatient tests, and the percentage of stat tests in academic hospitals.

Laboratory diagnostics, a pivotal part of clinical decision making, is no safer than other areas of healthcare, with most errors occurring in the manually intensive preanalytical process. Patient misidentification errors are potentially associated with the worst clinical outcome due to the potential for misdiagnosis and inappropriate therapy. While it is misleadingly assumed that identification errors occur at a low frequency in clinical laboratories, misidentification of general laboratory specimens is around 1% and can produce serious harm to patients, when not promptly detected. This article focuses on this challenging issue, providing an overview on the prevalence and leading causes of identification errors, analyzing the potential adverse consequences, and providing tentative guidelines for detection and prevention based on direct-positive identification, the use of information technology for data entry, automated systems for patient identification and specimen labeling, two or more identifiers during sample collection and delta check technology to identify significant variance of results from historical values. Once misidentification is detected, rejection and recollection is the most suitable approach to manage the specimen. Clin Chem Lab Med 2009;47:143–53. [ABSTRACT FROM AUTHOR]

Remarkable advances in instrument technology, automation and computer science have greatly simplified many aspects of previously tedious tasks in laboratory diagnostics, creating a greater volume of routine work, and significantly improving the quality of results of laboratory testing. Following the development and successful implementation of high-quality analytical standards, analytical errors are no longer the main factor influencing the reliability and clinical utilization of laboratory diagnostics. Therefore, additional sources of variation in the entire laboratory testing process should become the focus for further and necessary quality improvements. Errors occurring within the extra-analytical phases are still the prevailing source of concern. Accordingly, lack of standardized procedures for sample collection, including patient preparation, specimen acquisition, handling and storage, account for up to 93% of the errors currently encountered within the entire diagnostic process. The profound awareness that complete elimination of laboratory testing errors is unrealistic, especially those relating to extra-analytical phases that are harder to control, highlights the importance of good laboratory practice and compliance with the new accreditation standards, which encompass the adoption of suitable strategies for error prevention, tracking and reduction, including process redesign, the use of extra-analytical specifications and improved communication among caregivers. [ABSTRACT FROM AUTHOR]

The article reports on a study which analyzed bibliometric indices of scientific journals in the category "medical laboratory technology." The study revealed the lack of discrepancies that exist among the three most widely used scientific databases, including Journal Citation Reports, SCImago Journal and Country Rank and Google Scholar Metrics. It concluded that the bibliometric information contained in the databases would reveal a journal's prestige in research and academia.

The authors reflect on the aspects that influence the market trend of in vitro diagnostic (IVD). They mention that the negative effect of the economical crisis on employment and wealth is one significant aspect that might influence the market. They say that possible bankruptcy and long payment delays of some countries are additional problems that might influence future trends.

A letter to the editor is presented in response to the article "Thrombophilia testing and diagnostic dilemma: A tertiary centre experience" by Chandrashekar V. in the previous issue.