Perianal Crohn’s disease:Still more questions than answers

In this editorial we comment on the article by Pacheco et al published in a recent issue of the World Journal of Gastroenterology.We focus specifically on the burden of illness associated with perianal fistulizing Crohn’s disease(PFCD)and the diagnostic and therapeutic challenges in the management of this condition.Evol-ving evidence has shifted the diagnostic framework for PFCD from anatomical classification systems,to one that is more nuanced and patient-focused to drive ongoing decision making.This editorial aims to reflect on these aspects to help clinicians face the challenge of PFCD in day-to-day clinical practice.

Impact of interleukin 6 levels on acute lung injury risk and disease severity in critically ill sepsis patients

BACKGROUND Sepsis is a life-threatening condition characterized by a dysregulation of the host response to infection that can lead to acute lung injury(ALI)and multiple organ dysfunction syndrome(MODS).Interleukin 6(IL-6)is a pro-inflammatory cytokine that plays a crucial role in the pathogenesis of sepsis and its complications.AIM To investigate the relationship among plasma IL-6 levels,risk of ALI,and disease severity in critically ill patients with sepsis.METHODS This prospective and observational study was conducted in the intensive care unit of a tertiary care hospital between January 2021 and December 2022.A total of 83 septic patients were enrolled.Plasma IL-6 levels were measured upon admission using an enzyme-linked immunosorbent assay.The development of ALI and MODS was monitored during hospitalization.Disease severity was evaluated by Acute Physiology and Chronic Health Evaluation II(APACHE II)and Sequential Organ Failure Assessment(SOFA)scores.RESULTS Among the 83 patients with sepsis,38(45.8%)developed ALI and 29(34.9%)developed MODS.Plasma IL-6 levels were significantly higher in patients who developed ALI than in those without ALI(median:125.6 pg/mL vs 48.3 pg/mL;P<0.001).Similarly,patients with MODS had higher IL-6 levels than those without MODS(median:142.9 pg/mL vs 58.7 pg/mL;P<0.001).Plasma IL-6 levels were strongly and positively correlated with APACHE II(r=0.72;P<0.001)and SOFA scores(r=0.68;P<0.001).CONCLUSIONElevated plasma IL-6 levels in critically ill patients with sepsis were associated with an increased risk of ALI andMODS.Higher IL-6 levels were correlated with greater disease severity,as reflected by higher APACHE II andSOFA scores.These findings suggest that IL-6 may serve as a biomarker for predicting the development of ALI anddisease severity in patients with sepsis.

Relationship between nutritional therapy and beneficial bacteria ratio in severe disease

Objective:To evaluate relationship between changes in the beneficial bacteria in intensive care unit(ICU)patients and nutritional therapy type.Methods:Ten patients aged≥18 years admitted to the ICU between January and December 2020,were included.Good enteral nutrition was defined as early achievement of target calorie intake through enteral feeding.The ratio of beneficial bacteria at the first and second bowel movements after each patient’s admission was calculated and the patients were classified into the increase or decrease group.Among all patients,five each were in the increase and decrease groups.We investigated patient background,changes in sequential organ failure assessment(SOFA)and acute physiology and chronic health evaluation(APACHE)Ⅱscores,nutritional doses or methods,and clinical outcomes.Results:No relationship was found between changes in the ratio of beneficial bacteria and changes in SOFA/APACHEⅡscores at the time of admission.The rate of good enteral nutrition was significantly higher in the increase group than in the decrease group(4/5 vs.0/5,P=0.01).Conclusions:An increase in beneficial bacteria may be significantly related to the early establishment of enteral nutrition.In the future,accumulating cases may make it possible to establish a new nutritional strategy for critically ill patients from an intestinal microbiota perspective.

Viral and Antibody Kinetics of COVID-19 Patients with Different Disease Severities in Acute and Convalescent Phases:A 6-Month Follow-Up Study

Coronavirus disease 2019(COVID-19),caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),has spread rapidly around the world,posing a major threat to human health and the economy.Currently,long-term data on viral shedding and the serum antibody responses in COVID-19 patients are still limited.Herein,we report the clinical features,viral RNA loads,and serum antibody levels in a cohort of 112 COVID-19 patients admitted to the Honghu People’s Hospital,Hubei Province,China.Overall,5.36%(6/112)of patients showed persistent viral RNA shedding(>45 days).The peak viral load was higher in the severe disease group than in the mild group(median cycle threshold value,36.4 versus 31.5;P=0.002).For most patients the disappearance of IgM antibodies occurred approximately 4–6 weeks after symptoms onset,while IgG persisted for over 194 days after the onset of symptoms,although patients showed a 46%reduction in antibodies titres against SARS-CoV-2 nucleocapsid protein compared with the acute phase.We also studied18 asymptomatic individuals with RT-qPCR confirmed SARS-CoV-2 infection together with 17 symptomatic patients,and the asymptomatic individuals were the close contacts of these symptomatic cases.Delayed IgG seroconversion and lower IgM seropositive rates were observed in asymptomatic individuals.These data indicate that higher viral loads and stronger antibody responses are related to more severe disease status in patients with SARS-CoV-2 infection,and the antibodies persisted in the recovered patient for more than 6 months so that the vaccine may provide protection against SARS-CoV-2 infection.

Effect of Pre-Existing Chronic Medical Conditions on Clinical Features and Disease Outcomes of COVID-19 Infection in Jordanian Children

Background: The COVID-19 pandemic emerged unexpectedly, impacting millions worldwide and, though waning in many regions, remains a significant concern. This study focused on understanding COVID-19’s clinical presentation, disease progression, and outcomes among hospitalized pediatric patients. Additionally, it sought to investigate the impact of concurrent chronic medical conditions on disease severity. Methods: Conducted retrospectively between September 2020 and December 2021, this study observed pediatric patients (below 18 years) hospitalized with confirmed COVID-19 at an Irbid, Jordan tertiary healthcare center. Patients meeting inclusion criteria, including a positive nasal swab PCR test and hospitalization need, were analyzed. Epidemiological and clinical data were collected and segregated into two groups (A and B) based on the presence of chronic conditions. Comparative analysis encompassed presentation, disease trajectory, and outcomes between these groups. Results: Among 451 tested positive patients, 112 were included in the study. Significant differences emerged between the two pediatric groups hospitalized for COVID-19. Those with concurrent chronic illnesses exhibited heightened symptom severity—fever, dyspnea, fatigue—and a higher incidence of abnormal chest radiographs, often requiring intensive care and experiencing elevated mortality rates. Conclusion: This study underscores the criticality of prioritizing COVID-19 management strategies for pediatric patients with pre-existing chronic medical conditions. The findings highlight the increased vulnerability and poorer outcomes experienced by this subgroup, emphasizing the necessity for tailored interventions and focused care approaches.

Systemic immune-inflammation index combined with pediatric appendicitis score in assessing the severity and prognosis for paediatric appendicitis

BACKGROUND Pediatric appendicitis is a common cause of abdominal pain in children and is recognized as a significant surgical emergency.A prompt and accurate diagnosis is essential to prevent complications such as perforation and peritonitis.AIM To investigate the predictive value of the systemic immune-inflammation index(SII)combined with the pediatric appendicitis score(PAS)for the assessment of disease severity and surgical outcomes in children aged 5 years and older with appendicitis.METHODS Clinical data of 104 children diagnosed with acute appendicitis were analyzed.The participants were categorized into the acute appendicitis group and chronic appendicitis group based on disease presentation and further stratified into the good prognosis group and poor prognosis group based on prognosis.The SII and PAS were measured,and a joint model using the combined SII and PAS was constructed to predict disease severity and surgical outcomes.RESULTS Significant differences were observed in the SII and PAS parameters between the acute appendicitis group and chronic appendicitis group.Correlation analysis showed associations among the SII,PAS,and disease severity,with the combined SII and PAS model demonstrating significant predictive value for assessing disease severity[aera under the curve(AUC)=0.914]and predicting surgical outcomes(AUC=0.857)in children aged 5 years and older with appendicitis.CONCLUSION The study findings support the potential of integrating the SII with the PAS for assessing disease severity and predicting surgical outcomes in pediatric appendicitis,indicating the clinical utility of the combined SII and PAS model in guiding clinical decision-making and optimizing surgical management strategies for pediatric patients with appendicitis.

Insights from respiratory virus co-infections

Respiratory viral co-infections present significant challenges in clinical settings due to their impact on disease severity and patient outcomes.Current diagnostic methods often miss these co-infections,complicating the epidemiology and management of these cases.Research,primarily conducted in vitro and in vivo,suggests that co-infections can lead to more severe illnesses,increased hospitalization rates,and greater healthcare utilization,especially in high-risk groups such as children,the elderly,and immunocompromised individuals.Common coinfection patterns,risk factors,and their impact on disease dynamics highlight the need for advanced diagnostic techniques and tailored therapeutic strategies.Understanding the virological interactions and immune response modulation during co-infections is crucial for developing effective public health interventions and improving patient outcomes.Future research should focus on the molecular mechanisms of co-infection and the development of specific therapies to mitigate the adverse effects of these complex infections.

Circulating miR-125a but not miR-125b is decreased in active disease status and negatively correlates with disease severity as well as inflammatory cytokines in patients with Crohn's disease

AIM To determine the association of circulating mi R-125 a/b expression with the risk and disease severity of Crohn's disease(CD), and with inflammatory cytokines.METHODS Plasma samples were collected from patients with active CD(A-CD), or CD in remission(R-CD) and from healthy controls(HCs). The levels of the inflammatory cytokines interleukin-17(IL-17), tumour necrosis factor-α(TNF-α), and interferon-γ(IFN-γ) were measured by enzyme-linked immunosorbent assay. The expression of mi R-125 a/b was assessed by quantitative polymerase chain reaction(q PCR).RESULTS Twenty-nine A-CD patients, 37 R-CD patients, and 37 HCs were included in the study. Plasma mi R-125 a expression was decreased in A-CD patients comparedwith that in R-CD patients(P < 0.001) and HCs(P < 0.001). mi R-125 a expression levels enabled the differentiation of A-CD from R-CD patients [area under curve(AUC) = 0.854] and from HCs(AUC = 0.780), whereas mi R-125 b expression did not. mi R-125 a was negatively correlated with C-reaction protein(CRP)(P = 0.017), erythrocyte sedimentation rate(ESR)(P = 0.026), Crohn's disease activity index(CDAI)(P = 0.003), IL-17(P = 0.015), and TNF-α(P = 0.004) in A-CD patients. Furthermore, mi R-125 a was negatively associated with CRP(P = 0.038) and CDAI(P = 0.021) in R-CD patients. Regarding mi R-125 b, no association with CRP, CDAI, IL-17, TNF-α, or IFN-γ was found in A-CD or in R-CD patients. mi R-125 a levels gradually increased in A-CD patients who achieved clinical remission(P = 0.009) after 3-mo treatment, whereas they remained unchanged among patients who failed to achieve remission. No changes in mi R-125 b expression were detected in remission or non-remission patients after treatment. CONCLUSION Circulating mi R-125 a but not mi R-125 b is decreased in patients with active disease status and negatively correlates with disease severity and inflammatory cytokines in patients with CD.

Predictors of disease severity in ulcerative colitis patients from Southwestern Ontario

AIM:To understand the demographic characteristics of patients in Southwestern Ontario,Canada with ulcerative colitis(UC)in order to predict disease severity. METHODS:Records from 1996 to 2001 were exam- ined to create a database of UC patients seen in the London Health Sciences Centre South Street Hospital Inflammatory Bowel Disease Clinic.To be included, patients'charts were required to have information of their disease presentation and a minimum of 5 years of follow-up.Charts were reviewed using standardized data collection forms.Disease severity was generated during the chart review process,and non-endoscopic Mayo Score criteria were collected into a composite. RESULTS:One hundred and two consecutive patients'data were entered into the database.Demographic analyses revealed that 51%of the patients were male, the mean age at diagnosis was 39 years,13.7%had a first degree relative with inflammatory bowel disease (IBD),61.8%were nonsmokers and 24.5%were ex-smokers.In 22.5%of patients the disease was limited to the rectum,in 21.6%disease was limited to the sigmoid colon,in 22.5%disease was limited to the left colon,and 32.4%of patients had pancolitis. Standard multiple regression analysis which regressed a composite of physician global assessment of disease severity,average number of bowel movements,and average amount of blood in bowel movements on year of diagnosis and age at time of diagnosis was significant,R 2=0.306,F(7,74)=4.66,P<0.01. Delay from symptoms to diagnosis of UC,gender, family history of IBD,smoking status and disease severity at the time of diagnosis didnot significantly predict the composite measure. CONCLUSION:UC severity is associated with younger age at diagnosis and year of diagnosis in a longitudinal cohort of UC patients,and may identify prognostic UC indicators.

Characterizing and Estimating Fungal Disease Severity of Rice Brown Spot with Hyperspectral Reflectance Data

Large-scale farming of agriculture crops requires real-time detection of disease for field pest management. Hyperspectral remote sensing data generally have high spectral resolution, which could be very useful for detecting disease stress in green vegetation at the leaf and canopy levels. In this study, hyperspectral reflectances of rice in the laboratory and field were measured to characterize the spectral regions and wavebands, which were the most sensitive to rice brown spot infected by Bipolaris oryzae （Helminthosporium oryzae Breda. de Hann）. Leaf reflectance increased at the ranges of 450 to 500 nm and 630 to 680 nm with the increasing percentage of infected leaf surface, and decreased at the ranges of 520 to 580 nm, 760 to 790 nm, 1550 to 1750 nm, and 2080 to 2350 nm with the increasing percentage of infected leaf surface respectively. The sensitivity analysis and derivative technique were used to select the sensitive wavebands for the detection of rice brown spot infected by B. oryzae. Ratios of rice leaf reflectance were evaluated as indicators of brown spot. R669/R746 （the reflectance at 669 nm divided by the reflectance at 746 nm, the following ratios may be deduced by analogy）, R702/R718, R692/R530, R692/R732, R535/R746, R521/R718, and R569/R718 increased significantly as the incidence of rice brown spot increased regardless of whether it＇s at the leaf or canopy level. R702/R718, R692/R530, R692/R732 were the best three ratios for estimating the disease severity of rice brown spot at the leaf and canopy levels. This result not only confirms the capability of hyperspectral remote sensing data in characterizing crop disease for precision pest management in the real world, but also testifies that the ratios of crop reflectance is a useful method to estimate crop disease severity.

Cardiovascular Cast Model Fabrication and Casting Effectiveness Evaluation in Fetus with Severe Congenital Heart Disease or Normal Heart

To investigate the application and effectiveness of vascular corrosion technique in preparing fetal cardiovascular cast models, 10 normal fetal heart specimens with other congenital disease（control group） and 18 specimens with severe congenital heart disease（case group） from induced abortions were enrolled in this study from March 2013 to June 2015 in our hospital. Cast models were prepared by injecting casting material into vascular lumen to demonstrate real geometries of fetal cardiovascular system. Casting effectiveness was analyzed in terms of local anatomic structures and different anatomical levels（including overall level, atrioventricular and great vascular system, left-sided and right-sided heart）, as well as different trimesters of pregnancy. In our study, all specimens were successfully casted. Casting effectiveness analysis of local anatomic structures showed a mean score from 1.90±1.45 to 3.60±0.52, without significant differences between case and control groups in most local anatomic structures except left ventricle, which had a higher score in control group（P=0.027）. Inter-group comparison of casting effectiveness in different anatomical levels showed no significant differences between the two groups. Intra-group comparison also revealed undifferentiated casting effectiveness between atrioventricular and great vascular system, or left-sided and right-sided heart in corresponding group. Third-trimester group had a significantly higher perfusion score in great vascular system than second-trimester group（P=0.046）, while the other anatomical levels displayed no such difference. Vascular corrosion technique can be successfully used in fabrication of fetal cardiovascular cast model. It is also a reliable method to demonstrate three-dimensional anatomy of severe congenital heart disease and normal heart in fetus.

Quantification of Tc-99m-ethyl cysteinate dimer brain single photon emission computed tomography images using statistical probabilistic brain atlas in depressive end-stage renal disease patients:Correlation with disease severity and symptom factors

This study adapted a statistical probabilistic anatomical map of the brain for single photon emission computed tomography images of depressive end-stage renal disease patients. This research aimed to investigate the relationship between symptom clusters, disease severity, and cerebral blood flow. Twenty-seven patients （16 males, 11 females） with stages 4 and 5 end-stage renal disease were enrolled, along with 25 healthy controls. All patients underwent depressive mood assessment and brain single photon emission computed tomography. The statistical probabilistic anatomical map images were used to calculate the brain single photon emission computed tomography counts. Asymmetric index was acquired and Pearson correlation analysis was performed to analyze the correlation between symptom factors, severity, and regional cerebral blood flow. The depression factors of the Hamilton Depression Rating Scale showed a negative correlation with cerebral blood flow in the left amygdale. The insomnia factor showed negative correlations with cerebral blood flow in the left amygdala, right superior frontal gyrus, right middle frontal gyrus, and left middle frontal gyrus. The anxiety factor showed a positive correlation with cerebral glucose metabolism in the cerebellar vermis and a negative correlation with cerebral glucose metabolism in the left globus pailidus, right inferior frontal gyrus, both temporal poles, and left parahippocampus. The overall depression severity （total scores of Hamilton Depression Rating Scale） was negatively correlated with the statistical probabilistic anatomical map results in the left amygdala and right inferior frontal gyrus. In conclusion, our results demonstrated that the disease severity and extent of cerebral blood flow quantified by a probabilistic brain atlas was related to various brain areas in terms of the overall severity and symptom factors in end-stage renal disease patients.

Intestinal dysbiosis in pediatric Crohn's disease patients with IL10RA mutations

BACKGROUND Several studies have employed animal models to explore the association between microbiota and interleukin(IL) 10 signaling;however,limited information is available about the human microbiome.AIM To characterize the microbiome in patients with IL10 RA mutations and to explore the association between gut dysbiosis and disease severity.METHODS Fecal samples were collected from patients who were diagnosed with loss-offunction mutations in the IL10 RA gene between January 2017 and July 2018 at the Children’s Hospital of Fudan University.Age-matched volunteer children were recruited as healthy controls.Patients with Crohn’s disease(CD) were used as disease controls to standardize the antibiotic exposure.Microbial DNA was extracted from the fecal samples.All analyses were based on the 16 S rRNA gene sequencing data.RESULTS Seventeen patients with IL10 RA mutations(IL10 RA group),17 patients with pediatric CD, and 26 healthy children were included.Both patients with IL10 RA mutations and those with CD exhibited a reduced diversity of gut microbiome with increased variability.The relative abundance of Firmicutes was substantially increased in the IL10 RA group(P=0.02).On further comparison of the relative abundance of taxa between patients with IL10 RA mutations and healthy children,13 taxa showed significant differences.The IL10 RA-specific dysbiosis indices exhibited a significant positive correlation with weighted pediatric CD activity index and simple endoscopic score for CD.CONCLUSION In patients with IL10 RA mutations and early onset inflammatory bowel disease,gut dysbiosis shows a moderate association with disease severity.

Disease Grading Criterion and Assessment of Yield Loss Caused by Maize Rough Dwarf Disease

[Objective] The paper was to study the disease grading criterion and assess the yield loss caused by maize rough dwarf disease. [Method] The ear lengths and yields of each healthy and infected plant of 5 cultivars were measured during 2009 and 2010. The severity grading criterion was deduced according to the ear length ratios. [Result]When the ratios were 0.92-1.00, 0.67-0.91, 0.41-0.66, 0.10-0.40 and 0, its corresponding disease grading criterions were 0, 1, 3, 5 and 7, respectively. The severity grading criterion was closely correlated to the yield loss. By analyzing the data of disease indexes and yield loss rates of 27 cultivars with DPS （Data Processing System）, the regression equations were established respectively. According to the comparison with each other, the Weibull Model was proved to have the highest fitting degree. Validating with the disease indexes of 27 cultivars in 2010, the equation supported the feasibility of the equation to predict the yield loss caused by maize rough dwarf disease. [Conclusion] The paper provided theoretical basis for further study on maize rough dwarf disease.

Effect of Varieties and Fungicide Rate on Chocolate Spot (Botrytis fabae) Disease of Faba Bean (Vicia faba L.) at Tach Gayint District in South Gondar Zone, Amhara Region, Ethiopia

Faba bean is suffered with many biotic and abiotic factors. Chocolate spot disease, caused by Botrytis fabae is one of the biotic factors limiting yields of this crop resulting in yield losses up to 68% in Ethiopia. The experiment was conducted during 2020/2021 cropping season at Tach Gayint district, Ethiopia to determine the integration of faba bean varieties and fungicide rates on reducing chocolate spot disease. The experiment consisted of 12 treatments, viz. three faba bean varieties and four rate of Mancozeb fungicide in factorial arrangement. The experiment was laid out as randomized complete block design (RCBD) with three replications. Data was collected and analyzed. Results indicated that, disease incidence was reached at maximum percentage in all treatments on the last dates of assessment. But treatments were significantly difference in severity level. The least disease severity was recorded from varieties treated by 3.5 kg/ha of Mancozeb 80% WP with mean values Walki (12.7%), and (18.1% and 20.8%) on Gora and local variety respectively at the final dates of disease assessment. Similarly, the reduced AUDPC was also recorded from varieties treated by 3.5 kg/ha of Mancozeb 80% WP with mean values Walki (371.8% unit/day) and (539% and 686.4% days) on varieties Gora, and Local respectively. Whereas the maximum disease severity and AUDPC were obtained from unsprayed plots. Based on the results obtained, variety Walki treated with Mancozeb 80% WP at rate of 2.5 kg/ha and 3.5 kg/ha were effective to reduce the effect of chocolate spot disease for the study area.

Apolipoprotein E variants correlate with the clinical presentation of paediatric inflammatory bowel disease:A cross-sectional study

BACKGROUND It has been suggested that apolipoprotein E(APOE)polymorphisms are associated with the risk of developing inflammatory bowel disease(IBD)and the early age of disease onset.However,there are no reports regarding the relationship with clinical characteristics and disease severity.AIM To summarise that APOE polymorphisms are associated with the risk of developing IBD and the early age of disease onset.METHODS In total,406 patients aged 3-18 with IBD(192 had ulcerative colitis and 214 had Crohn’s disease)were genotyped using the TaqMan hydrolysis probe assay.Clinical expression was described at diagnosis and the worst flare by disease activity scales,albumin and C-reactive protein levels,localisation and behaviour(Paris classification).Systemic steroid intake with the total number of courses,immunosuppressive,biological,and surgical treatment with the time and age of the first intervention were determined.The total number of exacerbation-caused hospitalisations,the number of days spent in hospital due to exacerbation,the number of relapses,and severe relapses were also estimated.RESULTS Ulcerative colitis patients with the APOEε4 allele had lower C-reactive protein values at diagnosis(P=0.0435)and the worst flare(P=0.0013)compared to patients with the APOEε2 allele and genotype APOEε3/ε3.Crohn’s disease patients with the APOEε2 allele scored lower on the Pediatric Crohn’s Disease Activity Index at diagnosis(P=0.0204).IBD patients with APOEε2 allele spent fewer days in the hospital due to relapse(P=0.0440).CONCLUSION APOE polymorphisms are associated with the risk of developing IBD and the clinical expression of IBD.However,the clinical relevance of the differences identified is rather modest.

Typology of the Main Fungal Diseases Affecting Winter Wheat in the Grand Duchy of Luxembourg

Over the 2003-2009 period, field campaigns were carried out in order to identify the main fungal diseases of winter wheat （Triticum aestivum） in the Grand-Duchy of Luxembourg. Four fungal diseases （septoria leaf blotch （SLB）, wheat leaf rust （WLR）, wheat powdery mildew （WPM） and fusarium head blight （FHB）） were observed and a regional-based typology was established according to their severity and prevalence. In the Gutland （South）, SLB severity was strong （about 51% on average） and higher than the severity （about 16%） prevailing in the Oesling （North）. Similar typology was observed with the WLR： high severity in the Gutland （66% and 57% for the years 2003 and 2007, respectively） and low severity （〈 1%） in the Oesling. The FHB was also present in the Eastern part of the Gutland, with a prevalence and severity significantly higher （P = 0.049 and P = 0.012, respectively, Tukey＇s test） compared with their values in the Oesling. On the other hand, the WPM severity was high in the Oesling （15% to 40%） while less than 1% in the Gutland. Such a study is important for the spatial mapping of wheat fungal diseases risk based on agroclimatic parameters and for defining optimal frequencies and dates of chemical treatments.

SARS-CoV-2 viral load in the upper respiratory tract and disease severity in COVID-19 patients

Due to the disease's broad clinical spectrum,it is currently unclear how to predict the future prognosis of patients at the time of diagnosis of coronavirus disease 2019(COVID-19).Real-time reverse transcription-polymerase chain reaction(RTPCR)is the gold standard molecular technique for diagnosing COVID-19.The number of amplification cycles necessary for the target genes to surpass a threshold level is represented by the RT-PCR cycle threshold(Ct)values.Ct values were thought to be an adequate proxy for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)viral load.A body of evidence suggests that SARS-CoV-2 viral load is a possible predictor of COVID-19 severity.The link between SARS-CoV-2 viral load and the likelihood of severe disease development in COVID-19 patients is not clearly elucidated.In this review,we describe the scientific data as well as the important findings from many clinical studies globally,emphasizing how viral load may be related to disease severity in COVID-19 patients.Most of the evidence points to the association of SARS-CoV-2 viral load and disease severity in these patients,and early anti-viral treatment will reduce the severe clinical outcomes.

Fixed-point Monitoring of Vaccine Immune Effects on Severe Animal Diseases in Livestock and Poultry Breeding Fields

In order to reveal the immune antibody levels and immune effect of livestock and poultry in the locality,we performed antibody surveillance on severe animal diseases in 17 livestock and poultry fields in six administrative districts of Wuhan City. The results showed that the vaccines had a good protective efficacy on highly pathogenic avian influenza( HPAI) and Newcastle disease( ND) in Wuhan City. The whole antibody levels kept above the ministerial standard( 】 70%).However,the vaccine immunity of porcine reproductive and respiratory syndrome( PRRS),swine fever( SF) and foot and mouth disease( FMD) was still poorly protective. The data indicated that the vaccines are protecting the severe animal diseases well,but there are still some potential security holes in some administrative districts.

Early Hyperglycemia in Diabetics as a Predictor of Disease Severity in COVID-19

Background: Hyperglycemia is an important predictor of prolonged hospitalization and mortality. The objective of this study was to analyze the role of early hyperglycemia in predicting the severity of COVID-19 illness and mortality. Method: Retrospective study on 259 patients with COVID-19 with measurement of average glucose during 24 hours of admission. Association of Early Hyperglycemia categorized as <180 mg/dl or >180 mg/dl;was studied with mortality, requirement of ICU stay and prognostic markers. Results: Early hyperglycemia (>180 mg/dl) revealed a higher median value for CRP (109 mg/l [IQR;48 - 199]) in comparison to <180 mg/dl group (86 mg/l [IQR;26.3 - 153]) p = 0.03. ICU stay was higher in >180 mg/dl group;24 (15.9%) vs 14 patients (13%) [p = 0.51] in the <180 mg/dl group. Mortality in the group > 180 mg/dl was 8 (5.3%) while <180 mg/dl had a mortality rate of 4 (3.7%) [p = 0.547]. Conclusion: Hyperglycemia in the first 24 hours may anticipate an increased risk of ICU stay and a higher mortality rate. It may be a possible predictor of disease severity.