No effect of remdesivir or betamethasone on upper respiratory tract SARS-CoV-2 RNA kinetics in hospitalised COVID-19 patients: a retrospective observational study

Background The viral kinetics of SARS-CoV-2 has been considered clinically important. While remdesivir and corticosteroids are recommended for COVID-19 patients requiring oxygen support, there is a limited number of published reports on viral kinetics in hospitalised patients with COVID-19 treated with remdesivir or corticosteroids. Methods We conducted a retrospective study by collecting longitudinal samples from the nasopharynx/throat of 123 hospitalised patients (median age 55 years, 74% male) with COVID-19, to evaluate the effects of remdesivir and corticosteroid treatment on viral RNA levels. The subjects were divided into four groups: those receiving remdesivir (n = 25), betamethasone (n = 41), both (n = 15), or neither (n = 42). Time to viral RNA clearance was analysed using Kaplan-Meier plots, categorical data were analysed using Fisher\u27s exact test, and Kruskal-Wallis for continuous data. Viral RNA decline rate was analysed using a mixed effect model. Results We found no significant difference in SARS-CoV-2 RNA decline rate or time to SARS-CoV-2 RNA clearance between the groups. Moreover, clinical status at baseline was not correlated with time to viral clearance. Conclusions Since SARS-CoV-2 RNA kinetics was not affected by treatment, repeated sampling from the upper respiratory tract cannot be used to evaluate treatment response

On the epidemiology, clinical presentation and transmission of respiratory viral infections

Respiratory viral infections encompass a large heterogenous group of pathogens that constitute a major burden of disease globally. The various routes of transmission including airborne spread make them difficult to control. The aim of this thesis was to investigate the epidemiology, clinical presentation and transmission of viral airborne pathogens and respiratory viruses affecting the airways. In paper I over 20 000 clinical airway samples, referred for the detection of respiratory viral pathogens over a period of 3 years, were collected retrospectively and analysed for seasonal variation and relationship with meteorological factors. Paper II was a prospective study analysing the prevalence of respiratory viruses, as detected by PCR in nasopharyngeal samples, in 444 adults asymptomatic of respiratory tract infection. In paper III, clinical and laboratory differences of naïve measles infection compared to breakthrough infection, with focus on the risk of onward transmission, were investigated, in a retrospective analysis of a measles outbreak in Gothenburg 2017/2018. In paper IV we prospectively collected airway samples for multiplex real-time PCR in 220 adults hospitalized at the Department of Infectious Diseases with lower respiratory tract infection across three consecutive winter seasons. Conclusions: The incidence of influenza and several other respiratory viruses are strongly associated with low outdoor temperature and low absolute humidity. The onset of the annual influenza epidemic is preceded by a sudden drop in temperature below 0 °C in our region. The prevalence of respiratory viruses in asymptomatic adults is low (<5%), suggesting that a positive detection by PCR is likely of clinical relevance when symptoms of respiratory tract infection are present. Breakthrough measles infection can be identified by history of vaccination and the detection of IgG at rash onset, and onward transmission from these infections is unlikely due to low viral load and mild respiratory symptoms. Viral infections and viral/bacterial coinfections are a common cause of hospitalization in adults with LRTI. Viral infections may have pronounced symptoms at presentation making them difficult to discern from bacterial infections

Development of a Surveillance Camera Web Application

Tässä lopputyössä käydään läpi pientiimissä kehitetyn IP-kameroita ja moderneja webstandardeja käyttävän valvontakamerajärjestelmän kehityskulku. Vartiointisovelluksen pääominaisuudet ovat useista kameroista kaapatun videon samanaikainen esittäminen, kaapattujen videoiden tallentaminen palvelimelle, tallennettujen videoiden esittely, sisään- ja uloskirjautumistoiminnot sekä käyttäjänhallinta. Sovellus käyttää Reactia frontendinä, Laravelia ja useita Node.js palvelimia backendinä, MySQL sekä Redisiä tietokantana. Kaikki palvelimet pyörivät Docker-konteissa. Streamaaminen ja videoiden tallentaminen toteutettiin ffmpegillä ja kahdella node.js palvelimella. Muu backend toiminnallisuus, kuten kirjautuminen toteutettiin Laravelillä.This thesis addresses how to develop a surveillance camera web application with a small team using IP-cameras and modern web standards. The developed system can show multiple streams from the cameras simultaneously, record streams from the cameras to files, view the recorded files, login and logout functionality and account management among other features. The application utilizes React frontend and Laravel backend along multiple Node.js servers, a MySQL and Redis database in Docker containers. Streaming from the cameras and saving of the stream to files was handled by ffmpeg on two node.js servers. Other backend functionality, like logging in and out and routing was created with Laravel

Pollen exposure weakens innate defense against respiratory viruses

BACKGROUND: Hundreds of plant species release their pollen into the air every year during early spring. During that period, pollen allergic as well as non-allergic patients frequently present to doctors with severe respiratory tract infections. Our objective was therefore to assess whether pollen may interfere with antiviral immunity. METHODS: We combined data from real-life human exposure cohorts, a mouse model and human cell culture to test our hypothesis. RESULTS: Pollen significantly diminished interferon-λ and pro-inflammatory chemokine responses of airway epithelia to rhinovirus and viral mimics and decreased nuclear translocation of interferon regulatory factors. In mice infected with respiratory syncytial virus, co-exposure to pollen caused attenuated antiviral gene expression and increased pulmonary viral titers. In non-allergic human volunteers, nasal symptoms were positively correlated with airborne birch pollen abundance, and nasal birch pollen challenge led to downregulation of type I and -III interferons in nasal mucosa. In a large patient cohort, numbers of rhinoviruspositive cases were correlated with airborne birch pollen concentrations. CONCLUSION: The ability of pollen to suppress innate antiviral immunity, independent of allergy, suggests that high-risk population groups should avoid extensive outdoor activities when pollen and respiratory virus seasons coincide

Pollen exposure weakens innate defense against respiratory viruses.

BackgroundHundreds of plant species release their pollen into the air every year during early spring. During that period, pollen allergic as well as non-allergic patients frequently present to doctors with severe respiratory tract infections. Our objective was therefore to assess whether pollen may interfere with antiviral immunity.MethodsWe combined data from real-life human exposure cohorts, a mouse model and human cell culture to test our hypothesis.ResultsPollen significantly diminished interferon-lambda and pro-inflammatory chemokine responses of airway epithelia to rhinovirus and viral mimics and decreased nuclear translocation of interferon regulatory factors. In mice infected with respiratory syncytial virus, co-exposure to pollen caused attenuated antiviral gene expression and increased pulmonary viral titers. In non-allergic human volunteers, nasal symptoms were positively correlated with airborne birch pollen abundance, and nasal birch pollen challenge led to downregulation of type I and -III interferons in nasal mucosa. In a large patient cohort, numbers of rhinoviruspositive cases were correlated with airborne birch pollen concentrations.ConclusionThe ability of pollen to suppress innate antiviral immunity, independent of allergy, suggests that high-risk population groups should avoid extensive outdoor activities when pollen and respiratory virus seasons coincide