Temporal pattern of humoral immune response in mild cases of COVID-19

BACKGROUND Understanding the humoral response pattern of coronavirus disease 2019(COVID-19)is one of the essential factors to better characterize the immune memory of patients,which allows understanding the temporality of reinfection,provides answers about the efficacy and durability of protection against severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),and consequently helps in global public health and vaccination strategy.Among the patients who became infected with SARS-CoV-2,the majority who did not progress to death were those who developed the mild COVID-19,so understanding the pattern and temporality of the antibody response of these patients is certainly relevant.AIM To investigate the temporal pattern of humoral response of specific immunoglobulin G(IgG)in mild cases of COVID-19.METHODS Blood samples from 191 COVID-19 real-time reverse transcriptase-polymerase chain reaction(RT-qPCR)-positive volunteers from the municipality of Toledo/Paraná/Brazil,underwent two distinct serological tests,enzyme-linked immunosorbent assay,and detection of anti-nucleocapsid IgG.Blood samples and clinicoepidemiological data of the volunteers were collected between November 2020 and February 2021.All assays were performed in duplicate and the manufacturers'recommendations were strictly followed.The data were statistically analyzed using multiple logistic regression;the variables were selected by applying the P<0.05 criterion.RESULTS Serological tests to detect specific IgG were performed on serum samples from volunteers who were diagnosed as being positive by RT-qPCR for COVID-19 or had disease onset in the time interval from less than 1 mo to 7 mo.The time periods when the highest number of participants with detectable IgG was observed were 1,2 and 3 mo.It was observed that 9.42%of participants no longer had detectable IgG antibodies 1 mo only after being infected with SARS-CoV-2 and 1.57%were also IgG negative at less than 1 mo.At 5 mo,3.14%of volunteers were IgG negative,and at 6 or 7 mo,1 volunteer(0.52%)had no detectable IgG.During the period between diagnosis by RT-qPCR/symptoms onset and the date of collection for the study,no statistical significance was observed for any association analyzed.Moreover,considering the age category between 31 and 59 years as the exposed group,the P value was 0.11 for the category 31 to 59 years and 0.32 for the category 60 years or older,showing that in both age categories there was no association between the pair of variables analyzed.Regarding chronic disease,the exposure group consisted of the participants without any comorbidity,so the P value of 0.07 for the category of those with at least one chronic disease showed no association between the two variables.CONCLUSION A temporal pattern of IgG response was not observed,but it is suggested that immunological memory is weak and there is no association between IgG production and age or chronic disease in mild COVID-19.

87 CASES OF FACIAL SPASM TREATED WITH MILD ACUPUNCTURE

Facial spasm is clinically a commonly en-countered and obstinate disease. This diseasewas treated by mild acupuncture with a satisfac-tory therapeutic effect, as summarized in thefollowing.GENERAL DATAThere were 87 cases in total in this series,52 males. and 35 females. The oldest and theyoungest patients were 60 and 28 years old re-spectively. The longest and the shortest

Liver test abnormalities in asymptomatic and mild COVID-19 patients and their association with viral shedding time

BACKGROUND Asymptomatic infections and mild symptoms are common in patients infected with the Omicron variant,and data on liver test abnormalities are rare.AIM To evaluated the clinical characteristics of asymptomatic and mild coronavirus disease 2019(COVID-19)patients with abnormal liver test results.METHODS This retrospective study included 661 laboratory-confirmed asymptomatic and mild COVID-19 patients who were treated in two makeshift hospitals in Ningbo from April 5,2022 to April 29,2022.Clinical information and viral shedding time were collected,and univariate and multivariate logistic regression models were performed in statistical analyses.RESULTS Of the 661 patients,83(12.6%)had liver test abnormalities,and 6(0.9%)had liver injuries.Abnormal liver tests revealed a reliable correlation with a history of liver disease(P<0.001)and a potential correlation with male sex and obesity(P<0.05).Elevated alanine aminotransferase was reliably associated with obesity(P<0.05)and a history of liver disease(P<0.001).Elevated aspartate transaminase(AST)was reliably correlated with a history of liver disease(P<0.001),and potentially correlated with age over 30 years(P<0.05).There was a reliable correlation between AST≥2×the upper limit of normal and a longer viral shedding time,especially in mild cases.CONCLUSION Obesity and a history of liver disease are risk factors for liver test abnormalities.Being male and an older age are potential risk factors.Attention should be given to liver tests in asymptomatic and mild COVID-19 patients,which has crucial clinical significance for evaluating the viral shedding time.

Simple Simulation for COVID-19 in Wuhan, Hubei, China to Predict Outbreak in Wuhan, the Initial Case in Wuhan, and the Epidemic in Japan as of 11 February, 2020

Object: Prediction of the COVID-19 epidemic represents a matter of concern not only for public health or medicine but also for Earth’s general population. This study predicts outbreaks in Wuhan and in Japan as of 11 February, 2020.Method: We applied a simple SIR model to data published by Hubei public health authorities. Moreover, into the model, we incorporate mild and asymptomatic cases from experiences of Japanese residents of Wuhan up to the outbreak. Finally, we predict an outbreak in Japan based on 10,000 iterations of a simulation conducted under the assumption of infected people including mild cases visiting Japan according to the estimated distribution of patients in Wuhan since the date on which the initial case occurred to the date when travel from Wuhan to Japan was suspended. Results: Results suggest the basic reproduction number, R0, as 2.84;its 95% confidence interval (CI) was [2.35, 3.33]. The peak is estimated to be reached on March 11. Its 95% CI peak date is 29 February to 27 March. The 95% CI peak date in Japan is 26 April to 2 May. The greatest number of patients at the peak with severe symptoms was estimated as 858.3 thousand. Discussion and Conclusion: Our obtained R0 of 2.84 approximates an earlier estimate. We predicted the greatest number of patients at the peak with severe symptoms as 858.3 thousand in Japan. This number is 63% greater than the highest daily peak of influenza.