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Diverse COVID-19 severity levels and a spectrum of clinical manifestations underscore the need to comprehend the underlying genetic mechanisms. Such knowledge is essential for improving disease management and therapeutic approaches. This study aims to explore and uncover pivotal genes and pathways linked to distinct COVID-19 conditions, providing insights into potential therapeutic avenues. Gene expression data from COVID-19 patients across different conditions were analyzed using differential gene expression analysis. Significant genes were subjected to pathway analysis and protein–protein interaction network analysis. Gene ontology was used to identify the functions of these genes. The genes ADAMTS2, PCSK9, and OLAH were upregulated across all disease conditions including SARS-CoV-2 bacterial coinfection, potentially serving as therapeutic targets. The proteins, including RPL and CEACAM, could serve as a potential therapeutic target. The deregulated genes were majorly involved in inflammation, lipid metabolism, and immune regulation. The study's findings reveal significant gene expression differences among COVID-19 disease conditions. These insights guide future research toward targeted therapies and an improved understanding of disease progression and long-term consequences.

Diverse COVID-19 severity levels and a spectrum of clinical manifestations underscore the need to comprehend the underlying genetic mechanisms. Such knowledge is essential for improving disease management and therapeutic approaches. This study aims to explore and uncover pivotal genes and pathways linked to distinct COVID-19 conditions, providing insights into potential therapeutic avenues. Gene expression data from COVID-19 patients across different conditions were analyzed using differential gene expression analysis. Significant genes were subjected to pathway analysis and protein-protein interaction network analysis. Gene ontology was used to identify the functions of these genes. The genes ADAMTS2, PCSK9, and OLAH were upregulated across all disease conditions including SARS-CoV-2 bacterial coinfection, potentially serving as therapeutic targets. The proteins, including RPL and CEACAM, could serve as a potential therapeutic target. The deregulated genes were majorly involved in inflammation, lipid metabolism, and immune regulation. The study's findings reveal significant gene expression differences among COVID-19 disease conditions. These insights guide future research toward targeted therapies and an improved understanding of disease progression and long-term consequences. [ABSTRACT FROM AUTHOR]

Although the knowledge on SARS-CoV-2 infection in pregnancy has greatly improved, there is still a lack of information on its role in the later stages of gestation. The aim of this study is to investigate whether SARS-CoV-2 discovered at delivery is associated with any obstetric or neonatal complications. A retrospective case-control study was conducted at Department of Obstetrics, University Hospital Maggiore della Carità, Novara, Italy, from March 2020 to March 2023. Pregnant women admitted were tested for SARS-CoV-2. 168 women resulted positive at the time of delivery; the women were asymptomatic or paucisymptomatic. 170 negative women were selected as controls, selecting, for each SARS-CoV-2 positive patient, the patient who gave birth right before, if negative. Demographic and anamnestic characteristics, pregnancy, labor, and neonatal outcomes were evaluated. SARS-CoV-2 positive patients were more likely to have gestational diabetes (13.7 vs. 5.3 %) and required less frequently intrapartum analgesia (11.3 vs. 27 %) and labor augmentation (7.3 vs. 16.5 %). Post-partum hemorrhage rate was lower (13.7 vs. 22.9 %) and a shorter length of first and second stage of labor occurred. There were no statistically significant differences between the two groups regarding the mode of delivery and neonatal outcomes. SARS-CoV-2 positive patients have shorter labor length and a lower incidence of postpartum hemorrhage. Fewer obstetric interventions, as well as less use of intrapartum analgesia and oxytocin, could explain these findings. Moreover, gestational diabetes could increase susceptibility to infection. SARS-CoV-2 infection discovered at the time of delivery in asymptomatic or paucisymptomatic patients does not appear to increase the rate of cesarean delivery or other obstetric complications, and neonatal outcomes have not worsened. [ABSTRACT FROM AUTHOR]

Objective: In this study, we aim to assess the relationship between laboratory results and pregnancy outcomes of the asymptomatic preripartum women who have been diagnosed incidentally by universal COVID-19 screening upon admission for delivery. Methods: This is a case-control study conducted between January 2021 and March 2022. The study group consisted of the peripartum women with positive PCR result for SARS CoV-2 without the COVID-19 symptoms. Age and gestational age-matched peripartum women were included as the control group (1:3). The primary outcomes measures are inflammatory laboratory parameters (lymphocyte, neuthrophyl, eosinophyl, aspartate aminotransferase, alanin aminotransferase, lactate dehydrognase, neuthrophyl lymphocyte ratio, platelet lymphocte ratio, eosinophyl lymphocyte ratio, monocyte eosinophyl ratio) and their association with a positive PCR result for SARS CoV-2. Additional outcome measures were the associations between asymptomatic COVID-19 and pregnancy, maternal and neonatal outcomes. Results: A total of 369 (95 in study, 274 in control group) women were analyzed. The ROC curve and multivariate logistic regression analysis have shown that increased monocyte-to-eosinophile ratio (MER, ≥14.7, aOR: 3.49 (95% CI 1.893-6.435)) and lactate dehydrogenase (LDH≥214 U/L, aOR: 15.869 (95% CI 8.529-29.524)) levels; and decreased lymphocyte count (≤1.7 103/mm3, aOR:1.8 (95% CI1.27-3.437)) were associated with COVID-19 in asymptomatic peripartum woman. Asymptomatic COVID-19 was associated with an increase in late preterm delivery (p<0.001). Conclusion: Asymptomatic COVID-19 do not cause an increase in maternal and neonatal mortality and major morbidity in peripartum women. Increased monocyte-to-eosinophile ratio (MER, ≥14.7) and LDH (≥214) levels; and decreased lymphocyte count (≤1.7) are associated with COVID-19 in asymptomatic peripartum woman. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has significantly affected societies worldwide, including the medical healthcare system and trauma care. This study explores the impact of COVID-19 infection on trauma patients in South Korea, a country with effective pandemic management. Methods: A retrospective cohort study of 4206 trauma patients from June 2020 to May 2022 was conducted. Patients were categorized into COVID-19-positive and COVID-19-negative groups. Various clinical parameters, complications, and mortality rates were analyzed. Results: COVID-19-positive patients exhibited higher rates of complications, such as pressure sores (8.8% vs. 2.3%, p < 0.001), surgical site infections (2.4% vs. 0.8%, p = 0.044), and pneumonia (8.8% vs. 4.1%, p = 0.007). There was no significant difference in mortality between COVID-19-positive and -negative groups (4% vs. 5.6%, p = 0.439). Factors influencing mortality included COVID-19 status, age, Glasgow Coma Scale, Injury Severity Score, and transfusion status. Conclusion: COVID-19 positivity may have adverse clinical effects on trauma patients, but the impact varies based on public health factors. Additional studies in different contexts are crucial to elucidate these complexities. [ABSTRACT FROM AUTHOR]

Introduction: Recent coronavirus disease 2019 (COVID-19) infection may pose increased risk of post-operative complications after total joint arthroplasty (TJA). Current recommendations suggest waiting four-weeks before elective surgery in asymptomatic patients. The purpose of this study was to propensity-score-match patients who had positive COVID-19-test between (1) 0–2 weeks and (2) 2–4 weeks before TJA with a matching group without COVID-19 history to determine rates of complications at 90-days and 1-year post-operatively. Materials and methods: We queried a national-database for patients who tested positively for COVID-19 within 1-month (n = 1749) before TJA. A propensity-score-match analysis was conducted to limit influence of confounders. They were separated into mutually exclusive asymptomatic cohorts based on time of positive COVID-19-test before TJA: within 2-weeks (n = 1749) and between 2-to-4 weeks (n = 599). Asymptomatic patients were patients with positive test without symptoms of fever, shortness of breath, nausea, vomiting, diarrhea, loss of taste or smell, cough, bronchitis, pneumonia, lung infections, septic shock, and multiple-organ-dysfunction. Complications analyzed: 90-day and 1-year periprosthetic-joint infections (PJIs), surgical-site infections(SSIs), wound complications, cardiac complications, transfusions, and venous thromboembolisms. Results: Asymptomatic patients who have COVID-19 demonstrated increased incidence of PJI in patients who had TJA performed within two weeks from positive test at 90-days compared to patients who did not test positive for COVID-19 (3.0 vs. 1.5%; p = 0.023). Upon totaling all 90-day post-operative complications, no significant difference was found amongst asymptomatic patients who tested positive for COVID-19 for total complications at 90-days (p = 0.936). Conclusions: Asymptomatic patients who test positive for COVID-19 don't have increased risk for post-operative complications after TJA. However, two-fold increased risk in PJI for patients who tested positive for COVID-19 in first 2-weeks cannot be ignored. These results should be taken into consideration when surgeons consider performing TJA. We recommend asymptomatic patients consider waiting two-weeks before TJA to mitigate risk of PJI. Nevertheless, there's reassurance these patients are not at increased total complication risk. [ABSTRACT FROM AUTHOR]

Abstract Objective Children infected with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) are less clinically affected than adults, with most cases presenting as asymptomatic or mildly symptomatic. However, true rates of asymptomatic SARS‐CoV‐2 infection in children remain unclear. We sought to examine rates of SARS‐CoV‐2 in asymptomatic children and the role of children in transmission. Methods We performed a retrospective review of patients between 6 months and 17 years of age who underwent elective or semi‐elective otolaryngologic surgery with physicians affiliated with Weill Cornell Medicine between May 15, 2020 and March 31, 2022. Patients were included if they received molecular assay testing for SARS‐CoV‐2 without SARS‐CoV‐2 symptoms within 5 days of scheduled surgery. SARS‐CoV‐2 infection status, exposure, clinical symptoms, demographic data, and insurance status were recorded. Results 1047 patients met inclusion criteria. Thirteen positive cases (1.24%) were identified in the study population. Six cases occurred between December 2021 and February 2022 following the classification of the omicron variant as a variant of concern in November 2021. Five of the 13 cases occurred in children under 2 years of age. Seven patients were male, and five were female. Residences spanned all five boroughs of New York City and the surrounding metropolitan area. Conclusion Throughout the pandemic, children have had a low rate of asymptomatic disease and likely pose a low risk of transmission of SARS‐CoV‐2 to the general population. Our results suggest that testing of asymptomatic children is a low‐yield practice that is unlikely to influence rates of SARS‐CoV‐2 in the general population. Level of Evidence 3.

Purpose: The coronavirus disease 2019 (COVID-19) pandemic is posing unprecedented challenges for patient care, especially for cancer patients. This study looks at asymptomatic (AS) COVID-19 positivity in cancer patients and its effects on their care. Methods: We conducted a retrospective chart review of AS patients testing positive for COVID-19 upon screening at Fox Chase Cancer Center between January 2020 and September 2020. Relationships between positive tests and demographics, clinical characteristics, and treatment delays were investigated using conditional logistic regression or Mantel–Haenszel tests. Results: Among 4143 AS patients who underwent COVID-19 testing, 25 (0.6%) were COVID-19 positive (cases) and these were matched to 50 controls. The median age was lower in the cases compared to that of the controls (64 vs 70 years old, p = 0.04). Of the cases, 10 patients (40%) never underwent their planned oncologic intervention [6/10 (60%) did not require the planned intervention once deemed okay to proceed]. Of the controls, only 1 patient (2%) did not undergo the planned intervention. Of these 15 COVID-19 positive patients who underwent the planned intervention, 11 (73.3%) had a delay related to COVID-19, with a mean delay duration of 18 days (range: 0–49, SD: 16.72). Conclusion: Cancer patients had lower incidence of AS COVID-19 than general population. Delays that occur due to AS COVID screening are not very long and serve as a tool to limit spread of virus. Further studies will be important in addressing delays in cancer care and concerns of patient safety as the pandemic continues. [ABSTRACT FROM AUTHOR]

Objective: Children infected with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) are less clinically affected than adults, with most cases presenting as asymptomatic or mildly symptomatic. However, true rates of asymptomatic SARS‐CoV‐2 infection in children remain unclear. We sought to examine rates of SARS‐CoV‐2 in asymptomatic children and the role of children in transmission. Methods: We performed a retrospective review of patients between 6 months and 17 years of age who underwent elective or semi‐elective otolaryngologic surgery with physicians affiliated with Weill Cornell Medicine between May 15, 2020 and March 31, 2022. Patients were included if they received molecular assay testing for SARS‐CoV‐2 without SARS‐CoV‐2 symptoms within 5 days of scheduled surgery. SARS‐CoV‐2 infection status, exposure, clinical symptoms, demographic data, and insurance status were recorded. Results: 1047 patients met inclusion criteria. Thirteen positive cases (1.24%) were identified in the study population. Six cases occurred between December 2021 and February 2022 following the classification of the omicron variant as a variant of concern in November 2021. Five of the 13 cases occurred in children under 2 years of age. Seven patients were male, and five were female. Residences spanned all five boroughs of New York City and the surrounding metropolitan area. Conclusion: Throughout the pandemic, children have had a low rate of asymptomatic disease and likely pose a low risk of transmission of SARS‐CoV‐2 to the general population. Our results suggest that testing of asymptomatic children is a low‐yield practice that is unlikely to influence rates of SARS‐CoV‐2 in the general population. Level of Evidence: 3. [ABSTRACT FROM AUTHOR]

Abstract We present two cases of acute myocardial infarction in young patients with asymptomatic COVID‐19 infection and ST‐elevation myocardial infarction (STEMI), complicated by severe acute heart failure and ventricular fibrillation, resulting cardiopulmonary resuscitation and mechanical ventilatory support. Urgent primary percutaneous coronary intervention with further complex treatment was effective in both cases with critical cardiovascular state and co‐morbid COVID‐19 infection. This report illustrates the challenges in clinical severity of STEMI with COVID‐19 infection, despite of young age and absence of clinical symptoms and chronic co‐morbidities. STEMI patients with even asymptomatic COVID‐19 infection may be presented with significantly higher rates of severe acute heart failure.

Background  Asymptomatic COVID-19 subjects can transmit the infection for as many as 14 days and are regarded as a significant factor in the rapid spread of the COVID-19 pandemic. This exploratory study aimed to determine any additional benefits of selected homeopathic medicines compared with placebo in asymptomatic COVID-19 individuals receiving standard care. Methods  This open-label, randomized, placebo-controlled, exploratory trial was undertaken at a COVID Care Centre (CCC) in Madhya Pradesh, India. Patients (n  = 200, 18–65 years, both sexes) having a positive RT-PCR and asymptomatic during admission were enrolled. They were randomly assigned to one of four groups (each n  = 50): Arsenicum album 30C (Ars. alb.), Camphora 1M (Camph.), Bryonia alba 30C (Bry. alb.) and placebo (Pl.). All the patients were given standard care. The primary outcome was the number of patients becoming RT-PCR negative for SARS-CoV-2 at days 5, 10 and 15. Results  In total, 200 asymptomatic COVID-19 patients were enrolled. One hundred and seventy-seven patients became RT-PCR negative by day 15; 88%, 80%, 98% and 88% from Ars. alb., Camph., Bry. alb. and Pl. respectively. A Chi-square test of association for the total patients who became RT-PCR negative for SARS-Cov-2 in each group showed a marginal statistical significance (Chi-square: 8.1, p  = 0.04). A two-proportion Z -test comparing each pre-identified homeopathic medicine with placebo showed marginal statistical significance (p  = 0.05) for Bry alb. only. Median time in days to RT-PCR negative (Kaplan Meier analysis) was 10 days in each of the groups. Conclusion  There was some evidence that, compared with Ars alb., Camph. or Pl. , Bry. alb. was associated with an increased number of patients who became RT-PCR negative for COVID-19 by day 15. The possible effect exerted needs to be investigated in additional research. [ABSTRACT FROM AUTHOR]

The coronavirus, COVID-19 pandemic spread across the globe in 2020, with an initial high case mortality in those requiring intensive care treatment due to serious complication. A vaccine programme was quickly developed and currently the UK is one of highest double vaccinated and boosted countries in the world. Despite tremendous efforts by the UK, new cases of COVID-19 are still occurring, due to viral mutation. A major problem associated with COVID-19 is the large a-symptomatic spread within the population. Little investigation into the a-symptomatic population has been carried out and therefore we pose that the residual effects of a-symptomatic infection is still largely unknown. Prior to mass vaccination, a multi-phased single cohort study of IgM and IgG COVID-19 antibody prevalence and the associated haemostatic changes were assessed in a Welsh cohort of 739 participants, at three time points. Positive antibody participants with age and gender matched negative antibody controls were assessed at 0, 3 and 6 months. Antibody positive females appeared to have lower antibody responses in comparison to their a-symptomatic male counterparts. Despite this initial testing showed a unique significant increase in TRAP-6-induced platelet aggregation, prothrombin time (PT) and clot initiation time. Despite coagulation parameters beginning to return to normal at 3 months, significant decreases are observed in both haemoglobin and haematocrit levels. The production of extracellular vesicles (EV) was also determined in this study. Although the overall number of EV does not change throughout the study, at the initial 0 months' time point a significant increase in the percentage of circulating pro-coagulant platelet derived EV is seen, which does not appear to be related to the extent of platelet activation in the subject. We conclude that early, but reversible changes in haemostatic pathways within the a-symptomatic, female, antibody positive COVID-19 individuals are present. These changes may be key in identifying a period of pro-coagulative risk for a-symptomatic female patients. [ABSTRACT FROM AUTHOR]

Limiting transmission of SARS-CoV-2 from asymptomatic people assumes the paramount importance of keeping fragile subjects protected. We evaluated the utility of rapid SARS-CoV-2 antigen testing in asymptomatic subjects attending emergency departments in non-COVID-19 areas, using a single nasopharyngeal swab specimen collected in universal transport medium to perform both rapid antigen testing and rRT-PCR (used as reference standard) in a cohort of 899 patients. In the overall sample, the rapid antigen test had 43.9% sensitivity, 100% specificity, 100% positive predictive value, 93.6% negative predictive value. Considering subjects with rRT-PCR cycle threshold ≤30, the test had 80.4% sensitivity, 100% specificity, 100% positive predictive value, 98.8% negative predictive value. Considering subjects with rRT-PCR cycle threshold ≤25, the test had 94.7% sensitivity, 100% specificity, 100% positive predictive value and 99.7% negative predictive value. Despite low sensitivity, routine application of rapid antigen testing in the emergency department can lead to isolation in less than 30 min of about a half of asymptomatic COVID-19 subjects assigned to non-COVID-19 areas by clinical triage. The rapid test correctly identified 94.7% of asymptomatic patients with cycle threshold ≤ 25 that are supposed to be more infective; thus, it could be a useful measure to contain viral transmission in non-COVID-19 areas. [ABSTRACT FROM AUTHOR]

We present two cases of acute myocardial infarction in young patients with asymptomatic COVID‐19 infection and ST‐elevation myocardial infarction (STEMI), complicated by severe acute heart failure and ventricular fibrillation, resulting cardiopulmonary resuscitation and mechanical ventilatory support. Urgent primary percutaneous coronary intervention with further complex treatment was effective in both cases with critical cardiovascular state and co‐morbid COVID‐19 infection. This report illustrates the challenges in clinical severity of STEMI with COVID‐19 infection, despite of young age and absence of clinical symptoms and chronic co‐morbidities. STEMI patients with even asymptomatic COVID‐19 infection may be presented with significantly higher rates of severe acute heart failure. [ABSTRACT FROM AUTHOR]

Expanding easily accessible community SARS-CoV-2 screening is essential in the response to the COVID-19 pandemic. In this report, we describe the findings from the initial 25 days of a SARS-CoV-2 drive-up and walk-up testing initiative was organized in Peoria, Illinois. Eighty-seven out of 4,073 individuals (2.1%) tested positive for SARS-CoV-2, and 46% of these were asymptomatic at the time of testing. There were ten frontline workers without symptoms consistent with COVID-19 who tested positive, including six that did not report any known exposure to SARS-CoV-2. These results stress the importance and effectiveness of widely available community SARS-CoV-2 testing and suggest a possible benefit to screening of asymptomatic individuals at higher risk for infection.

This study aims to detect the SARS-CoV-2 infection prevalence in asymptomatic pregnant women. A group of 195 asymptomatic pregnant women who attended the prenatal care outclinic and to the obstetric emergency department was tested concomitantly for SARS-CoV-2 by RT-PCR and serological tests. The virus was detected by RT-PCR in two (1.02%) cases and 17 (8.71%) patients had antibodies detected by immunochromatographic tests. Due to the high risk of this emerging infection in the health of pregnant women, fetuses and newborns, we suggest the universal screening of all pregnant women admitted to hospital through the combined method RT-PCR and serological. [ABSTRACT FROM AUTHOR]

Background: Egypt has reported almost 515,103 confirmed cases of coronavirus disease (COVID-19) with 24,779 deaths from January 3rd, 2020 to May 29th, 2022. To date, the clinical picture of coronavirus infection among Egyptian patients has not been well-characterized. Asymptomatic infection and mild cases make up a large proportion of infections all over the world. According to Ain Shams University guidelines, asymptomatic and mild cases can be isolated at home; however it is unclear to what extent patients adhere to home isolation guidelines, and whether home isolation was in fact effective in reducing infection among the patient's family contacts. Aim of the Work: The aim of this study was: Describe the socio-demographic characteristics of asymptomatic and mild patients eligible for home isolation and measure the adherence of patients isolated at home to the recommended control measures with telemedicine follow up. Patients and Methods: This is a retrospective cohort study conducted in Ain Shams University on 400 patients who were diagnosed as positive for covid-19, classified as asymptomatic or mild cases at presentation and recommended for home isolation. Results: In our cohort, Patients that were adherent to home isolation guidelines had similar household infection rate to those with less compliance except for those who had more than one bathroom, household infection had significant negative correlation to number of bathrooms (p = 0.003) because the patient was able to have personal bathrooms. Regarding family members, 57.8% of cases had members with no symptoms of COVID-19 and 43.2 % had members with symptoms or positive test. Conclusion: Our study was limited with the low number of patients from a single centre. However, our findings showed that self-isolation at home may be an alternative to manage mild cases or asymptomatic patients when applied with careful and close observation. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2, has become a global pandemic. Based on symptoms, COVID-19 cases can be classified as symptomatic or asymptomatic. However, there is limited information about the differences between COVID-19 patients with and without pneumonia. Our study aimed to further discuss the spectrum and clinical characteristics of symptomatic and asymptomatic COVID-19 patients with and without pneumonia.Methods: In China, all COVID-19 cases are hospitalized in designated hospitals until two continuous negative oropharyngeal swabs obtained, which allows the professional monitoring of symptoms and clinical characteristics. We stratified all COVID-19 cases in our database and evaluated clinical characteristics in different COVID-19 subgroups (symptomatic with pneumonia, symptomatic without pneumonia, asymptomatic with pneumonia, and asymptomatic without pneumonia).Results: According to symptoms and laboratory and radiologic findings, COVID-19 cases were defined as symptomatic with pneumonia, symptomatic without pneumonia, asymptomatic with pneumonia, or asymptomatic without pneumonia. There were differences in the clinical characteristics and prognosis among the four groups. Both non-invasive mechanical ventilation (18, 4.2%) and invasive mechanical ventilation (11, 2.6%) were applied in only the symptomatic with pneumonia group. Likewise, extracorporeal membrane oxygenation and continuous renal replacement therapy were applied in only the symptomatic with pneumonia group. There were no differences in viral load, the durations of viral shedding, and hospitalization among the four groups.Conclusion: We have defined a comprehensive spectrum of COVID-19 with and without pneumonia. The symptomatic with pneumonia group consumed more medical resources than the other groups, and extra caution and monitoring should be applied in this group. The asymptomatic COVID-19 group had a similar viral load and viral shedding duration as the symptomatic COVID-19 group.

The objective of this study was to inform public health practitioners who are designing, adapting and implementing testing and tracing strategies for Coronavirus disease (COVID-19) control. The study design is monitoring and evaluation of a national public health protection programme. All close contacts of laboratory-confirmed cases of COVID-19 identified between the 19th May and 2nd August were included; secondary attack rates and numbers needed to test were estimated. Four thousand five hundred eighty six of 7272 (63%) close contacts of cases were tested with at least one test. The secondary attack rate in close contacts who were tested was 7% (95% Confidence Interval [CI]: 6.3 – 7.8%). At the 'day 0' test, 14.6% (95% CI: 11.6–17.6%) of symptomatic close contacts tested positive compared with 5.2% (95% CI: 4.4–5.9%) of asymptomatic close contacts. The application of additional symptom-based criteria for testing in this high-incidence population (close contacts) is of limited utility because of the low negative predictive value of absence of symptoms. • More asymptomatic close contacts were identified than symptomatic close contacts. • Application of symptom-based criteria for testing in this high-incidence population is of limited utility. • The secondary attack rate in close contacts who were tested was 7% (95% CI: 6.3–7.8%). • The number of close contacts needed to test at 'day 0' to identify one case was 15, and 63 at 'day 7'. [ABSTRACT FROM AUTHOR]

COVID‐19 is a novel coronavirus disease with a higher incidence of bilateral pneumonia and pleural effusion. The high pulmonary tropism and contagiousness of the virus, severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), have stimulated new approaches to combat its widespread diffusion. In developing new pharmacological strategies, the chemical characteristic of volatility can add therapeutic value to the hypothetical drug candidate. Volatile molecules are characterized by a high vapor pressure and are consequently easily exhaled by the lungs after ingestion. This feature could be exploited from a pharmacological point of view, reaching the site of action in an uncommon way but allowing for drug delivery. In this way, a hypothetical molecule for COVID‐19 should have a balance between its lung exhalation characteristics and both antiviral and anti‐inflammatory pharmacological action. Here, the feasibility, advantages, and disadvantages of a therapy based on oral administration of possible volatile drugs for COVID‐19 will be discussed. Both aerosolized antiviral therapy and oral intake of volatile molecules are briefly reviewed, and an evaluation of 1,8‐cineole is provided in view of a possible clinical use and also for asymptomatic COVID‐19. [ABSTRACT FROM AUTHOR]

A sizeable proportion of individuals contracting the corona virus disease 2019 (COVID-19) infection remains asymptomatic, while some patients develop mild symptoms and others exhibit severe symptomatology becoming critically ill necessitating admission to intensive care unit exposed to a high mortality risk. The pathophysiological mechanisms underlying this diversity in the clinical picture of COVID-19 are poorly understood. A variety of reasons have been postulated, among which, viral load, age, gender, immune response, blood type, genotypes, polymorphisms, comorbidities and pre-existing immunity are actively explored. Thus, there is a dire need to further elucidate this phenomenon and find ways to identify and discern susceptible from resistant individuals with the ultimate goal to find a cure for the disease. These issues are herein discussed and pertinent recent literature is reviewed. [ABSTRACT FROM AUTHOR]

Data from both New York and London report a high prevalence of the asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection in pregnant patients admitted for delivery, raising questions on the possible correlated dangers (ie, contacts with healthcare workers; the possible creation of an intrahospital outbreak at birth; and conflicting evidence on vertical transmission). For this study, results from SARS‐CoV‐2 screening via nasopharyngeal swab from maternity wards of the four hospitals of Genoa, Italy, were collected during a month of complete lockdown from 1 April to 30 April 2020. Out of 333 tested women, only 9 were symptomatic. Only one symptomatic patient (0.3%) and six asymptomatic ones (1.8%) tested positive. Out of the six positive asymptomatic patients, five were from the most disadvantaged neighborhood of the city (assessed by postal code). In conclusion, even if Italy was badly affected by coronavirus disease 2019 in the studied month, the reported prevalence of SARS‐CoV‐2 infections in asymptomatic pregnant patients at term was lower than the ones reported in the literature. Highlights: An high prevalence of asymptomatic SARS‐CoV‐2 infections in pregnant patients admitted for delivery was reported in literature.The maternity wards of Genoa, Italy, implemented a universal screening among women admitted for delivery.During the month of April, 2020 only one symptomatic patient (0.3%) and 6 asymptomatic ones (1.8%) tested positive, despite an high number of new infections in the general population in the same month.Factors that could have impacted these results are the complete national lockdown during the month and the existence of strong antenatal maternity leave policies. [ABSTRACT FROM AUTHOR]

Expanding easily accessible community SARS-CoV-2 screening is essential in the response to the COVID-19 pandemic. In this report, we describe the findings from the initial 25 days of a SARS-CoV-2 drive-up and walk-up testing initiative was organized in Peoria, Illinois. Eighty-seven out of 4,073 individuals (2.1%) tested positive for SARS-CoV-2, and 46% of these were asymptomatic at the time of testing. There were ten frontline workers without symptoms consistent with COVID-19 who tested positive, including six that did not report any known exposure to SARS-CoV-2. These results stress the importance and effectiveness of widely available community SARS-CoV-2 testing and suggest a possible benefit to screening of asymptomatic individuals at higher risk for infection. [ABSTRACT FROM AUTHOR]

Objectives: Although the knowledge on SARS-CoV-2 infection in pregnancy has greatly improved, there is still a lack of information on its role in the later stages of gestation. The aim of this study is to investigate whether SARS-CoV-2 discovered at delivery is associated with any obstetric or neonatal complications., Methods: A retrospective case-control study was conducted at Department of Obstetrics, University Hospital Maggiore della Carità, Novara, Italy, from March 2020 to March 2023. Pregnant women admitted were tested for SARS-CoV-2. 168 women resulted positive at the time of delivery; the women were asymptomatic or paucisymptomatic. 170 negative women were selected as controls, selecting, for each SARS-CoV-2 positive patient, the patient who gave birth right before, if negative. Demographic and anamnestic characteristics, pregnancy, labor, and neonatal outcomes were evaluated., Results: SARS-CoV-2 positive patients were more likely to have gestational diabetes (13.7 vs. 5.3 %) and required less frequently intrapartum analgesia (11.3 vs. 27 %) and labor augmentation (7.3 vs. 16.5 %). Post-partum hemorrhage rate was lower (13.7 vs. 22.9 %) and a shorter length of first and second stage of labor occurred. There were no statistically significant differences between the two groups regarding the mode of delivery and neonatal outcomes., Conclusions: SARS-CoV-2 positive patients have shorter labor length and a lower incidence of postpartum hemorrhage. Fewer obstetric interventions, as well as less use of intrapartum analgesia and oxytocin, could explain these findings. Moreover, gestational diabetes could increase susceptibility to infection. SARS-CoV-2 infection discovered at the time of delivery in asymptomatic or paucisymptomatic patients does not appear to increase the rate of cesarean delivery or other obstetric complications, and neonatal outcomes have not worsened., (© 2023 Walter de Gruyter GmbH, Berlin/Boston.)

• In section 2, an improved wavelet threshold based on the shrinkage factor is proposed. In this method, the threshold decreases with the increase of decomposition scale. It improves the accuracy of noise detection to a greater extent for asymptomatic COVID-19. • In section 2, we develop the wavelet threshold function based on the adjustment factor integrated with the arc tangent, which overcomes the discontinuity and the constant deviation of the traditional threshold function. It is suitable for noisy signals with different variance. • In section 3, a wavelet transform based on the optimization of parameters combined with improved PSO is proposed, so that the wavelet parameters can change adaptively according to the details of lung lobes and ground-glass shadow with relatively few iterations. • In section 4, aiming at the different kinds of asymptomatic COVID-19 CT images, the simulation experiments prove that the paper method has strong robustness to Gaussian noise, which enhances the ability of image denoising while better protecting the details of the lesion. It reduces the rate of missed and mistake diagnosis for asymptomatic COVID-1. The quality of asymptomatic corona virus disease 2019 (COVID-19) computed tomography (CT) image is reduced due to interference from Gaussian noise, which affects the subsequent image processing. Aiming at the problem that asymptomatic COVID-19 CT image often have small flake ground-glass shadow in the early lesions, and the density is low, which is easily confused with noise. A denoising method of wavelet transform with shrinkage factor is proposed. The threshold decreases with the increase of decomposition scale, and it reduces the misjudgment of signal points. In the advanced stage, the range of lesions increases, with consolidation and fibrosis in different sizes, which have similar gray value to the CT images of suspected cases. Aiming at the problems of low contrast and fuzzy boundary in the traditional wavelet transform, the threshold function based on the optimization of parameters combined with the improved particle swam optimization (PSO) is proposed, so that the parameters of wavelet threshold function can change adaptively according to the lung lobe and ground-glass lesions with fewer iterations. The simulation results show that the paper method is significantly better than other algorithms in peak signal-to-noise ratio (PSNR), signal-to-noise ratio (SNR) and mean absolute error (MSE). For example, aiming at the early asymptomatic COVID-19, compared with the comparison methods, the PSNR under the proposed method has increased by about 5 dB, the MSE has been greatly reduced, and the SNR has increased by about 6.1 dB. It can be seen that the denoising effect under the proposed method is the best. [ABSTRACT FROM AUTHOR]

BACKGROUND: Liver transplant (LT) recipients with COVID-19 have been reported as a high-risk population for severe disease through the COVID-19 pandemic. Recent studies have shown that liver transplantation did not significantly increase the risk of death and severe disease in patients with SARS-CoV-2 infection (1). Also, patients with COVID-19 can be asymptomatic. Here we report the first results of our ongoing SARS-CoV-2 seroprevalence study.. RESULTS: During November 2020, we collected data and serum samples for 30 liver transplant recipients at Ankara City Hospital (median age 54.2 years [IQR 24-68]; 23 (76.7%) men, 7 (23.3%) women). Hypertension was the most common comorbid disease (8/30, 26.6%), followed by type 2 diabetes (3/30, 10%). All study participants were older than 18 years, and they provided informed consent enrolment. Study enrolment was performed when patients pre-sented for scheduled routine follow-up. All participants completed a questionnaire querying information including clinical symptoms in the last three months. In addition to all routine blood sample tests, Anti-SARS-CoV-2 IgM and IgG was determined with enzyme-linked immunosorbent assays (ELISA). All participants with positive results were checked for anti-SARS-CoV-2 PCR by the nasopharyngeal swab. We further collected 30 serum samples, and of these 30 samples, 7 (23.3%) tested positive for anti-SARS-Cov-2 IgM and IgG. Two patients had a known history of symptomatic COVID-19 in the last three months. We evaluated 5 patients for the COVID-19 PCR test, and all of them were negative. Overall, only one patient declared symptoms of flu-like upper respiratory tract infection, while 4 did not (1/5, 20%). The diseases of two participants with apparent COVID-19 (2/7) were mild-moderate.. CONCLUSION: We documented past SARS-CoV-2 infection in 23.3% of our LT recipients during the study, and the majority were asymptomatic. Seroprevalence in the general population are lacking for our country and city. We are planning to include all LT recipients with follow-up in our hospital in our study. [ABSTRACT FROM AUTHOR]

Despite routine screening of patients for coronavirus disease 2019 (COVID-19) symptoms and signs at hospital entrances, patients may slip between the cracks and be incidentally discovered to have lung findings that could indicate COVID-19 infection on imaging obtained for other reasons. Multiple case reports and case series have been published to identify the pattern of this highly infectious disease. This article addresses the radiographic findings in different imaging modalities that may be incidentally seen in asymptomatic patients who carry COVID-19. In general, findings of COVID-19 infection may appear in computed tomography (CT), magnetic resonance imaging, positron emission tomography-CT, ultrasound, or plain X-rays that show lung or only apical or basal cuts. The identification of these characteristics by radiologists and clinicians is crucial because this would help in the early recognition of cases so that a rapid treatment protocol can be established, the immediate isolation to reduce community transmission, and the organization of close monitoring. Thus, it is important to both the patient and the physician that these findings are highlighted and reported., Competing Interests: Conflict-of-interest statement: The authors declares no relevant conflict-of-interest to this work., (©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.)

Background: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2, has become a global pandemic. Based on symptoms, COVID-19 cases can be classified as symptomatic or asymptomatic. However, there is limited information about the differences between COVID-19 patients with and without pneumonia. Our study aimed to further discuss the spectrum and clinical characteristics of symptomatic and asymptomatic COVID-19 patients with and without pneumonia. Methods: In China, all COVID-19 cases are hospitalized in designated hospitals until two continuous negative oropharyngeal swabs obtained, which allows the professional monitoring of symptoms and clinical characteristics. We stratified all COVID-19 cases in our database and evaluated clinical characteristics in different COVID-19 subgroups (symptomatic with pneumonia, symptomatic without pneumonia, asymptomatic with pneumonia, and asymptomatic without pneumonia). Results: According to symptoms and laboratory and radiologic findings, COVID-19 cases were defined as symptomatic with pneumonia, symptomatic without pneumonia, asymptomatic with pneumonia, or asymptomatic without pneumonia. There were differences in the clinical characteristics and prognosis among the four groups. Both non-invasive mechanical ventilation (18, 4.2%) and invasive mechanical ventilation (11, 2.6%) were applied in only the symptomatic with pneumonia group. Likewise, extracorporeal membrane oxygenation and continuous renal replacement therapy were applied in only the symptomatic with pneumonia group. There were no differences in viral load, the durations of viral shedding, and hospitalization among the four groups. Conclusion: We have defined a comprehensive spectrum of COVID-19 with and without pneumonia. The symptomatic with pneumonia group consumed more medical resources than the other groups, and extra caution and monitoring should be applied in this group. The asymptomatic COVID-19 group had a similar viral load and viral shedding duration as the symptomatic COVID-19 group., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Zeng, Ma, Zhou, Liu, Huang, Jiang, Liu, Chen, Luo and Chen.)

Immune thrombocytopenia (ITP) may occur following a viral infection. We report the case of a 30-year-old woman with thrombocytopenia who was subsequently diagnosed with ITP. Although she was asymptomatic, chest computed tomography (CT) showed ground-glass opacities in the lower lung regions. The patient had a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) real-time polymerase chain reaction (RT-PCR) test. She responded well to 400 mg/kg of intravenous immunoglobulin therapy. Coronavirus disease of 2019 or COVID-19 should be considered as a cause of ITP during the pandemic, and chest CT scans and RT-PCR tests should be performed in patients suspected of ITP.