Coronavirus (COVID-19) Collection
Drug-drug interaction with oral antivirals for early treatment of COVID-19 – Authors’ replyI thank Vuorio et al.  for their very relevant concerns and comments on the Danish population-based study estimating the risk of significant drug-drug-interactions (DDIs) with the oral antiviral nirmatrelvir/ritonavir in the elderly Danish population [1,2].
Drug-drug interaction with oral antivirals for the early treatment of COVID-19We read with interest the Danish population-based study estimating the risk of significant drug-drug interactions (DDIs) with the antiviral component, nirmatrelvir, of the drug combination nirmatrelvir/ritonavir (NMV/r) in the age groups ≥65 years and ≥80 years . The study highlights the potentially detrimental effects of DDIs if this antiviral treatment is used as part of polypharmacy in this elderly population at a high risk for the progression of SARS-CoV-2 infection to severe COVID-19.
Could nucleocapsid be a next-generation COVID-19 vaccine candidate – author's replyThis is in response to a letter to the editor by Saldivar-Espinoza et al. (2022) commenting on a short perspective that we wrote in the September 2022 issue of the International Journal of Infectious Disease entitled, “Nucleocapsid as a next-generation COVID-19 vaccine candidate” (Oronsky et al., 2022). The main point of this perspective was that nucleocapsid (N), being highly conserved among coronaviruses (CoVs), less mutable than spike (S), and strongly immunogenic, especially for T cells (Lineburg et al.
Could nucleocapsid be a next-generation COVID-19 vaccine candidate?We have read with interest the article by Oronsky et al. (2022) about including the SARS-CoV-2 nucleocapsid (N) protein in future COVID-19 vaccines. One of the main reasons for this suggestion is that the N gene is much less vulnerable to mutation and may provide stronger immunity to novel viral variants. Although when the proteins of SARS-CoV-2 and SARS-CoV are compared, the N protein is more conserved than the spike (S) protein (Dutta et al., 2020); the current data we have analyzed about SARS-CoV-2 mutations show that the N gene is one of the most mutated genes (Figure 1).
Workup of cerebral involvement in patients with COVID-19 – authors’ replyWe thank  for their comments on our article  discussing the new spike protein mutation of SARS-CoV-2 and its potential effects on immune regulation associated with the apparent increase in the incidence of severe neurological symptoms in Taiwanese pediatric patients.
Workup for cerebral involvement in COVID-19 requires cerebral imaging, electroencephalography, and cerebrospinal fluid studiesWe read with interest the article by Chen et al. (2022) concerning five pediatric patients with severe neurological complications of acute SARS-CoV-2 infection. It was concluded that a new mutation in the spike protein of the Omicron BA.2.3.7 variant may be responsible for the sudden increase in neurological complications of COVID-19 (Chen et al., 2022). The study is appealing but raises concerns.
Comment to the article by Pedro Brotons: Validation and implementation of a direct RT-qPCR method for rapid screening of SARS-CoV-2 infection by using non-invasive saliva samples, IJID 110 (2021) 363–370We read with interest the article entitled “Validation and implementation of a direct RT-qPCR method for rapid screening of SARS-CoV-2 infection by using non-invasive saliva samples” (Brotons et al., 2021). This study validates and implements an optimized screening method for the detection of SARS-CoV-2 ribonucleic acid, integrating the use of self-collected raw saliva samples, single-step heat-treated virus inactivation and ribonucleic acid extraction, and direct reverse transcription-quantitative polymerase chain reaction (RT-qPCR).
Comment on “High population burden of Omicron variant (B.1.1.529) is associated with the emergence of severe hepatitis of unknown etiology in children”The worldwide outbreak of severe acute hepatitis of unknown etiology in children has raised an alert around the world for its speed and severity (World Health Organization [WHO], 2022). One study by Nishiura et al. (Nishiura et al.,2022) drew a conclusion that prior exposure to the Omicron variant may be associated with an increased risk for severe hepatitis among children only by comparing the absolute number of Omicron cumulative cases between the “hepatitis-detected” countries and “hepatitis-undetected” countries.
Failure to account for population size introduces spurious correlation for almost all diseases at a country levelCountries differ by size (Sheldrick, 2022).
Rule out appropriately all differentials before attributing severe rhabdomyolysis to SARS-CoV-2 vaccinationWe read with interest the article by Kamura et al. about a 57-year-old, previously healthy male patient, who presented with leg pain 2 weeks after the first dose of the Moderna vaccine (Kamura et al., 2022). Four weeks after the vaccination, he was diagnosed with rhabdomyolysis upon the clinical presentation (muscle pain), elevated creatine-kinase (maximal value 74,804 U/l [n, 60-287 U/l]), and the muscle magnetic resonance imaging (MRI) (Kamura et al., 2022). During the following course, the patient additionally developed multiorgan infarctions and, finally, died despite intensive diagnostic and therapeutic approaches (Kamura et al., 2022).
Severe rhabdomyolysis and SARS-CoV-2 vaccination: a reply to the letter by Dr. Josef Finsterer.: Reply to Letter to the Editor regarding our report to Dr. Finsterer.Thank you very much for your insightful comments on our article. We will respond to each and every one of your points.
Commentary on the paper: Association of smoking and severity of COVID-19 infection among 5,889 patients in Malaysia: a multi-center observational study, by Ismail N, Hassan N, Hamid MHNA, Yusoff UN, Khamal NR, Omar MA, et al. Published in Int J Infect Dis 2022;116:189–96We read with interest the paper by Ismail et al. (2022) reporting data on the severity of COVID-19 in smokers concerning never smokers in a large group of hospitalized patients with COVID-19.
Response to Abdelrahman M et al commentary on “Parasites Protect from Severe COVID-19. Myth or Reality?”In a recent correspondence, Abdelrahman et al. (2022) described the protective effect of parasites on COVID-19 as a myth rather than a reality (Bamorovat et al., 2021; Wolday et al., 2021a). In addition, they indicated that a study (Abdoli, 2020) has found that parasitic infections, like helminths, increase the risk of COVID-19 severity.
Parasites Protect from Severe COVID-19. Myth or Reality?During the overheating investigations of factors that can decrease COVID-19 severity, coinfection with some parasitic diseases was identified (Gluchowska et al., 2021). In this letter, we will elaborate why we think that the protective effect of intestinal parasitic coinfection with COVID-19 could be a myth.
Exclude differentials before diagnosing SARS-CoV-2-associated acute haemorrhagic necrotising encephalitisWe eagerly read the article by Mierzewska-Schmidt et al., about a 2-month-old boy who developed progressive neurological compromise (initially irritability, apathia, nystagmus) 2 days after the clinical onset of COVID-19 (Mierzewska-Schmidt et al., 2021). On cerebrospinal fluid (CSF) investigation pleocytosis, lactic acidosis, and low glucose was noted, and cerebral magnetic resonance imaging (MRI) helped diagnose acute, hemorrhaghic, necrotising encephalitis (AHNE) (Mierzewska-Schmidt et al., 2021).
The presence of anti–SARS-CoV-2 antibodies does not necessarily reflect efficient neutralizationWe read with interest the article by Gargouria et al. (Gargouria et al., 2022), which described the cases of 4 patients with recurrent SARS-CoV-2 infection despite “the presence of (anti–SARS-CoV-2 S1 IgG) antibodies.” Although the continuous emergence of new and highly mutated SARS-CoV-2 variants is posing paramount challenges to adaptative immunity (Lippi et al., 2021), the message delivered by the authors is not supported by data and is thus potentially misleading.
Correspondence on “The Low Yield of SARS-CoV-2 Rapid Antigen Testing in Screening Asymptomatic Hospital Visitors in Low-incidence Settings”We note the interest by Boddeti et al. (Boddeti et al., 2022) in our article that reported the use of rapid-antigen detection (RAD) in screening asymptomatic hospital visitors for SARS-CoV-2 at the point-of-entry during the COVID-19 pandemic (Wee et al., 2022).
The Low Yield of SARS-CoV-2 Rapid Antigen Testing in Screening Asymptomatic Hospital Visitors in Low-incidence SettingsWe read with great interest the recent article by Wee et. al. (Wee et al., 2021), which explores the use of rapid-antigen detection (RAD) testing in asymptomatic hospital visitor screening. It certainly adds depth to the current literature, and we would like to share some comments.
Comment on a case of pityriasis rosea shortly after Moderna COVID-19 vaccinationThe article by Shin et al. (Shin et al., 2021) prompted us to make some considerations. They described a patient developing pityriasis rosea (PR) 2 hours after the second dose of Moderna COVID-19 vaccination. They suggested that the short time elapsed between vaccination and PR onset resembled that of delayed localized cutaneous reactions occurring shortly after the second vaccine dose. Indeed, among the patients with a reaction to first dose of the vaccine, most developed a similar localized injection-site reaction also to the second dose; this second reaction frequently developed sooner than the first (Johnston et al.
Impaired hearing following SARS-CoV-2 vaccinationsWe appreciated reading the article by Jeong et al. regarding 3 patients developing sensorineural hearing loss (SNHL) 3−16 days after the second Astra Zeneca vaccine (case-1), and after the first (case-2) and second Pfizer vaccine (case-3) (Table 1) [Jeong et al. 2021]. Only 2 patients benefited from steroids. In case-3, SNHL deteriorated under treatment [Jeong et al. 2021]. The study is appealing but raises concerns.
Response to Comments on “Preliminary estimation of the basic reproduction number of novel coronavirus (2019-nCoV) in China, from 2019 to 2020: a data-driven analysis in the early phase of the outbreak”This letter refers to the recently published comments (Dhungana, 2020) on the article “Preliminary estimation of the basic reproduction number of novel coronavirus (2019-nCoV) in China, from 2019 to 2020: a data-driven analysis in the early phase of the outbreak” by Zhao et al. (Zhao et al., 2020). The 2019-nCoV (now known as severe acute respiratory syndrome coronavirus 2, SARS-CoV-2) is similar to the virus causing middle east respiratory syndrome (MERS) and severe acute respiratory syndrome (SARS); therefore, in the published paper (Zhao et al., 2020), the serial interval (SI) used by the authors in the study was the average of the reported SIs of MERS (Assiri et al., 2013) and SARS (Lipsitch et al., 2003).
Regional differences in NPI efficacy and recommendations for AfricaNon-pharmaceutical interventions (NPIs) remain a key component of COVID response, particularly in low- and middle-income countries (LMICs) where vaccination is limited (Padma 2021). Much of what we know about NPI efficacy, however, comes from HIC contexts, and this knowledge is not necessarily transferrable to LMICs (Chowdhury et al. 2020). It is well-established that lockdowns have had detrimental effects in LMICs, including increased food insecurity and diminished healthcare access (Amare et al. 2021; Harling et al. 2021).
SARS-CoV-2 in cardiomyocytesWe read with interest the article by Nakamura et al. about a 72-year-old male with follicular lymphoma being treated with steroids and chemotherapy who acquired a severe SARS-CoV-2 infection of the lungs (COVID-19) (Nakamura et al. 2021). Despite treatment with steroids and remdesivir, the patient died 24 days after clinical onset of the infection (Nakamura et al. 2021). Autopsy revealed the virus within cardiomyocytes, liver cells, muscle cells, and tubular and glomerular cells (Nakamura et al. 2021).