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Rapid identification of SARS-CoV-2-infected individuals is a cornerstone for the control of virus spread. The sensitivity of SARS-CoV-2 RNA detection by RT-PCR is similar in saliva and nasopharyngeal swabs. Rapid molecular point-of-care tests in saliva could facilitate, broaden and speed up the diagnosis. We conducted a prospective study in two community COVID-19 screening centers to evaluate the performances of a CE-marked RT-LAMP assay (EasyCoV) designed for the detection of SARS-CoV2 RNA from fresh saliva samples, compared to nasopharyngeal RT-PCR, to saliva RT-PCR and to nasopharyngeal antigen testing. Overall, 117 of the 1718 participants (7%) tested positive with nasopharyngeal RT-PCR. Compared to nasopharyngeal RT-PCR, the sensitivity and specificity of the RT-LAMP assay in saliva were 34% and 97%, respectively. The Ct values of nasopharyngeal RT-PCR were significantly lower in the 40 true positive subjects with saliva RT-LAMP (Ct 25.9) than in the 48 false negative subjects with saliva RT-LAMP (Ct 28.4) (p = 0.028). Considering six alternate criteria for reference tests, including saliva RT-PCR and nasopharyngeal antigen, the sensitivity of saliva RT-LAMP ranged between 27 and 44%. The detection of SARS-CoV-2 in crude saliva samples with an RT-LAMP assay had a lower sensitivity than nasopharyngeal RT-PCR, saliva RT-PCR and nasopharyngeal antigen testing. Registration number: NCT04578509. [ABSTRACT FROM AUTHOR]

IFN-gamma treatment led to a fast increase in HLA-DR SP high sp monocytes in all but one patient with rapidly fatal septic shock (patient #3). Patients were assessed for mHLA-DR expression and were then administered interferon (IFN)-gamma to restore activated monocytes and thereby improve lung defense. IFN-gamma treatment was based on mHLA-DR expression, a reliable biomarker of post-aggressive immune suppression, thereby accounting for a good example of personalized medicine in critically ill patients. [Extracted from the article]

According to ADQI criteria, AKI was defined as rapidly reversed in 42 patients (25.3% of AKI patients), persistent AKI in 16 patients (9.7%) and as acute kidney disease (AKD) in 64 patients (38.6%), remaining patients couldn't be classified (n = 44). 108 (61.0%) patients died in intensive care, 76 (43.4%) patients had a hemorrhagic complication, 46 patients (26%) had a severe hemorrhagic complication defined by death or/and massive transfusion or/and hemostatic procedure (surgery or endoscopy), 87 (49.1%) patients had thrombopenia < 100 G/L, 50 (28.2%) patients had thrombopenia < 50 G/L, 53 patients (30.1%) and 43 patients (24.6%) required antiaggregation and anticoagulation withdrawal. Tracheal disorders patterns were: tracheal ring fractures (15 patients), granulomas (11 patients), tracheomalacia (7 patients), subglottic edema (4 patients), tracheal stenosis (2 patients). Concerning the other 31 patients, antibiotics prescribed were: amoxicillin/clavulanic acid in 17 patients (47.2%), carbapenems in 17 patients (47.2%), aminosids in 13 patients (36.1%), glycopeptides in 10 patients (27.8%), colistin in 9 patients (25%), fluoroquinolones in 7 patients (19.4%), cephalosporins in 6 patients (16.6%), tigecycline in 4 patients (11.1%). For the modalities of BT: the cross match was done for 7 patients in ICU (18% of cases), and for 2 patients of CVS in block A2 (7% of patients), we had 2 anti-B agglutinations (2.34%): one in ICU patient AB+, and one in patient block A+, for each one blood bags have been changed. [Extracted from the article]