European Journal of Molecular & Clinical Medicine

The COVID-19 pandemic has unfolded as one of the world’s worst health crisis. Viral RT-PCR, CRP, and CT scan thorax are the most common tools used for its diagnosis, prognosis and severity assessment. Hence, a parallel between these parameters can aid in better understanding and management of COVID-19 infection.
Methodology: Demographic data, history, cycle threshold values of RT-PCR from nasopharyngeal and oropharyngeal swabs, CRP and computed tomography score were obtained from 108 adult participants. Statistical analysis was performed using python programming (python 3.7) and inbuilt libraries.
Results: Mean age of the study group was 51.05 years. 63.89% were males. The mean CT score was 15.417 indicating severe disease. Men had a higher CRP. Cycle threshold value of N gene was directly proportional to CT score. Lower cycle threshold values were associated with higher CRP. Of the 37 deaths, 62.16% were males. Cycle threshold in non-survivors was significantly higher than survivors indicating lower nasopharyngeal viral load in non-survivors. Diabetes was the most common comorbidity associated with mortality.
Conclusion: Nasopharyngeal load can be low even with severe radiological CT findings probably due to migration of the virus to lower respiratory tract in later stages of the disease. Low nasopharyngeal viral loads cannot negate the possibility of a severe pulmonary infection. CRP values may not always correlate with CT findings in recovering stages of disease. Comorbidities adversely affect the disease outcome. These parameters should be used in conjunction to assess and veer the progression, management and outcome of patients with COVID-19 infection.

Background: COVID-19 is an acute viral illness caused by severe acute respiratory syndrome corona virus 2(SARS-CoV-2). Since the onset of the SARS-CoV-2 pandemic, multiple new variants of concern have emerged which are associated with enhanced transmissibility and increased virulence? It also highlights the role of the clinical interprofessional teams, public health agencies, and community participation in improving patientcare. An analysis of genomic sequencing variants of SARS-CoV-2 in symptomatic patients during 2nd and 3rd wave of pandemic by next-generation sequencing (NGS).
Material and Methods: A total of 200 symptomatic patients, throat/nasopharyngeal swab were collected for real-time reverse transcription-polymerase chain reactions (RT-PCR) at tertiary care hospital, Ongole. The specimens were transported under cold chain according to guidelines to Centre for Cellular & Molecular biology (CCMB), Hyderabad, for genome sequence analysis by next generation sequencing (NGS). Study period – 2ndwave i.e., MARCH 2021 –NOVEMBER 2021 & 3rdwave i.e., DECEMBER 2021 –MARCH 2022 according to WHO.
Results: Out of 200 samples analysed, 132 samples of 2nd wave & 68 samples in 3rd wave. Out of 132 samples, 57 Delta (B.1.617.2), 75 Delta sub-lineages. Out of 68 samples 41 Omicron (B.1.1.529), 11 Omicron lineages (BA.1), 16 Omicron (BA.2).
Conclusion: During the 2ndwave the symptomatic patients were detected with more delta and delta sub lineages showing high mortality rate. During 3rdwave omicron and omicron sub lineages were detected more than delta showing very high transmissibility and less mortality. Continuous monitoring and analysis of the sequence variants to understand the genetic heterogenicity.

Background: SARS CoV-2 infection has become a major public health concern. India started Covid-19 vaccination from January 16, 2021, after the approval of two candidate vaccines namely COVISHIELD ™ and COVAXIN ™. The present study was conducted to see the neutralizing antibody response to trimeric S protein of SARS CoV-2 in health care workers (HCWs) with 2 doses of COVISHIELD vaccination in a tertiary care hospital.
Methodology: A prospective cohort study was conducted among 156 healthy adult health care workers in a tertiary care centre, vaccinated during January-March 2021. They were divided into two groups, the first group comprised of individuals who were previously RT-PCR positive (n=36) for SARS CoV-2, and second group comprised of those who were RT-PCR negative (n=120). Blood samples were collected from all participants, the first sample on the day of vaccination, second sample after 4 weeks of vaccination, and third after 8 weeks of vaccination to measure the IgG antibodies against the SARS CoV-2 ‘S’ protein using a chemiluminescent quantitative immunoassay.
Results: The spike protein-specific IgG antibody titre was demonstrated reactive cut-off in 98.3% of the participants after 2 doses of vaccine. The median antibody titre declined from 710.5 (IQR, 338.5-1577.5) to 266 (IQR, 116-557.75) in RT-PCR positive HCWs after 8 weeks of vaccination whereas it increased from 45.1 (IQR, 31.475-76.575) to 83.4 (IQR, 52.075-104) in RT-PCR negative HCWs.
Conclusion: We could demonstrate the development of an adequate spike protein-specific IgG titre against SARS CoV-2 following vaccination with 2 doses of COVISHIELD in HCWs.

Introduction: The spread of COVID-19 pandemic globally has left us with many unanswered questions about the spread, modality of treatment and preventive measures to be taken to reduce its spread. Lack of sufficient knowledge about the virus and the lack of clarity about preventive measures has led to lot of confusion about healthcare practices. First year medical students although not involved in treatment of COVID-19 patients they can act as information providers and sensitize the community about the pandemic. Hence the present study was taken up among first year medical students.
Aim: To assess the basic knowledge about Novel Corona virus disease and its spread and clear the myths among them regarding COVID-19.
Materials and methods: A cross sectional survey was conducted among first year medical students belonging to 2019-20 batch. Data was tabulated using Microsoft office excel sheet and the response were expressed as total count and percentages distribution. Data was analyzed using EPI INFO (Version 7).
Results: Majority of the study participants have good knowledge about the virus, origin of the first case and mode of spread.92.25% of the study participants knew that elderly and people with comorbidities were more prone for coronavirus disease. 100% of the study participants knew that RT-PCR test has the diagnostic test for COVID-19. The entire study participants knew about non availability of a vaccine to prevent COVID-19 infection and some vaccines were in different stages of clinical trials.
Conclusion: The students of first year MBBS have good background knowledge and awareness about coronavirus disease which will help us to use them as the information providers to sensitize community people about various preventive measures one has to take to prevent the spread of COVID-19 pandemic.

Hepatitis C infection is the main occasional agent of chronic liver disease and might lead to cirrhosis and hepatocellular carcinoma. β-thalassemia and hemodialysis patients are most susceptible to HCV as a result of the continuous blood transfusion. Aim of the study: This study aimed to estimate the quantitative of HCV-RNA in the serum of β- thalassemia patients in Nineveh province using RT-PCR in the GeneXpert system. Methods: We detected anti-HCV using ELISA. Determine the viral RNA using Xpert® HCV viral load technique. Result: The positive detection result of anti-HCV is 48 out of a total of 752 thalassemia patients. Only 12 out of 48 enrolled HCV Ct value with a rate of 1.59% of the total β- thalassemia patients. Conclusions: The prevalence of HCV in thalassemic patients in Nineveh province is less than those found in the other Iraqi provinces or adjacent countries. The routine using of immunobiological and biochemical tests for hepatic enzymes should be the routine pursuit in thalassemia and dialysis clinical centers.

The 2019 novel coronavirus (COVID-19), which originated from China, has been declared a pandemic by the World Health Organization (WHO) as it has surpassed over eighty three million cases worldwide, with nearly two million deaths. The unexpected exponential increase in positive cases and the limited number of ventilators, personal safety equipment and COVID-19 test kits, especially in Low to Middle Income Countries (LMIC), had put undue pressure on medical staff, first responders as well as the overall health care systems. The Real-Time Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR) test is the decisive test for the diagnosis of COVID-19, but a significant percentage of positive tests return a false negative result. For patients in LMICs, the availability and affordability of routine Computerized Tomography (CT) scanning and chest X-rays is better compared to an RT-PCR test, especially in rural areas. Chest X-rays and CT scans can aid in the prognosis and management of COVID-19 positive patients, but are not recommended for diagnostic purposes. Using Deep Convolutional Neural Networks (CNN), three network based pre-trained models (AlexNet, GoogleNet and Resnet50) were used for the automatic classification of positive COVID-19 chest X-Rays and CT scans based on their severity into three classes- normal, mild/moderate, severe. This classification can aid health care workers in performing expeditious analysis of large numbers of thoracic CT scans and chest X-rays of COVID-19 positive patients, and aid in their prognosis and management. The images were obtained from public repositories, and were verified and classified by trained and highly experienced radiologist from Agha Khan University Hospital prior to simulations. The images were augmented and trained, and ResNet50 was concluded to achieve the highest accuracy. This research can be used for other lung infections, and can aid the authorities in the preparations of future pandemics.

Semarang has been reported as an endemic area of dengue hemorrhagic fever (DHF), yet continuous data of molecular epidemiology related to dengue fever is not available. The aim of this study was to analyze the characteristics of virus strains, host suspected dengue, and the dynamics of dengue fever in Semarang City. The design of this study was observational description with cross-sectional design. Seventy three DHF suspected patients from two hospitals and seven health centers in Semarang City were sampled during 2017- 2018. Reverse Transcription Polymerase Chain Reaction (RT-PCR) method was used to examine serum suspected dengue and sequence serotypes and genotypes of dengue virus. The results showed that the highest frequency to be exposed by DHF was infant and children; while, the number of male and female with suspected dengue was relatively the same. The dominant serotype was DENV-3, DENV-1, and mix of DENV-2 and DENV-3; while, the circulation of DENV-1 genotype I and DENV-3 genotype I were identified as Indonesian local endemic strain causing epidemics in Indonesia.