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  1. Article ; Online: Prevalence of HIV, syphilis, hepatitis B, and hepatitis C in patients attending STI/RTI clinic of a tertiary care teaching hospital.

    Torane, Vijaya P / Patil, Pooja / Wanjare, Shashir / Nataraj, Gita

    Journal of the National Medical Association

    2024  

    Abstract: Background: Patients attending Sexually transmitted infection/ Reproductive tract infection (STI/RTI) clinics are investigated for HIV and syphilis under the National AIDS Control Program (NACP). Although sexual contact is one of the modes of ... ...

    Abstract Background: Patients attending Sexually transmitted infection/ Reproductive tract infection (STI/RTI) clinics are investigated for HIV and syphilis under the National AIDS Control Program (NACP). Although sexual contact is one of the modes of transmission of hepatitis B and C, they are not investigated under NACP. This study was planned to find the prevalence of HIV, syphilis, hepatitis B, and C in patients attending STI/RTI clinics and to identify the predictive risk factors.
    Methods: A prospective cross-sectional study was carried out over 5 years on 500 consenting adults. 10 ml blood was collected and tests were performed as per standard protocol for HIV, syphilis, hepatitis B, and C. Risk factors for the sexually transmitted diseases were queried.
    Results: 500 samples were tested, 117(23.4%) men and 383 (76.6%) women. 26(22.2%), 20(17.1%), 11(9.4%) and 01(0.9%) men and 8(2.1%), 36(9.4%), 01(0.3%) and 0(0%) women were positive for HIV, RPR, hepatitis B and C respectively. Dual infection for HIV and syphilis was detected in four (0.8%) men and HIV and hepatitis B in three (0.6%) men.
    Conclusion: To investigate all patients attending STI/RTI clinics for Hepatitis B and to integrate Hepatitis B testing into the National AIDS Control Program.
    Language English
    Publishing date 2024-01-19
    Publishing country United States
    Document type Journal Article
    ZDB-ID 419737-9
    ISSN 1943-4693 ; 0027-9684
    ISSN (online) 1943-4693
    ISSN 0027-9684
    DOI 10.1016/j.jnma.2024.01.001
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  2. Article ; Online: Comparison of xpert MTB/RIF assay, line probe assay, and culture in diagnosis of pulmonary tuberculosis on bronchoscopic specimen.

    Kanade, Swapna / Mohammed, Zakiuddin / Kulkarni, Anisha / Nataraj, Gita

    International journal of mycobacteriology

    2023  Volume 12, Issue 2, Page(s) 151–156

    Abstract: Background: In patients unable to expectorate good quality sputum or with minimal to none sputum production, bronchoscopic specimens may be collected. The objective of the study is to determine the use of Xpert MTB/RIF assay and line probe assay (LPA) ... ...

    Abstract Background: In patients unable to expectorate good quality sputum or with minimal to none sputum production, bronchoscopic specimens may be collected. The objective of the study is to determine the use of Xpert MTB/RIF assay and line probe assay (LPA) in the diagnosis of pulmonary TB (PTB) using specimens collected by bronchoscopy in a tertiary care center.
    Methods: Bronchoscopy specimens received in the TB laboratory were processed by microscopy, Xpert MTB/RIF assay, LPA, and mycobacteria growth indicator tube (MGIT) culture. Results of MGIT culture are considered gold standard.
    Results: Of the 173 specimens tested, MTB was detected in 48 (27.74%) samples by any of the above methods. Positivity in bronchoalveolar lavage was 31.4% (44/140) and in bronchial wash was 12.1% (4/33). Detection by microscopy, Xpert assay, and culture was 20 (11.56%), 45 (26.01%), and 38 (21.96%), respectively. Culture detected MTB in three additional specimens compared to Xpert assay. Xpert assay detected MTB in 45 (26%) specimens which include 10 specimens which were negative by culture. LPA detected MTB in 18 (90%) out of 20 smear-positive specimens. RIF resistance was detected in 20 (41.7%) specimens by Xpert and/or MGIT culture drug susceptibility testing (DST). Isoniazid (INH) resistance was detected in 19 specimens by LPA and MGIT culture DST.
    Conclusion: Bronchoscopy can provide alternative respiratory specimens for diagnosing PTB in patients with difficulty to expectorate sputum. The utility of Xpert MTB/RIF as a rapid, sensitive, and specific test should always be supplemented with culture in difficult-to-obtain and precious respiratory specimens. LPA plays an important role in rapid detection of INH monoresistance.
    MeSH term(s) Humans ; Mycobacterium tuberculosis/genetics ; Microbial Sensitivity Tests ; Sensitivity and Specificity ; Tuberculosis, Pulmonary/diagnosis ; Tuberculosis, Pulmonary/microbiology ; Bronchoalveolar Lavage ; Sputum/microbiology
    Language English
    Publishing date 2023-06-20
    Publishing country India
    Document type Journal Article
    ZDB-ID 2696590-2
    ISSN 2212-554X ; 2212-554X
    ISSN (online) 2212-554X
    ISSN 2212-554X
    DOI 10.4103/ijmy.ijmy_86_23
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  3. Article ; Online: Utility of laboratory diagnostic tests in women suspected of genital tuberculosis attending a tertiary care teaching hospital.

    Kanade, Swapna / Solanki, Mitali / Thombare, Swapnil / Nataraj, Gita

    International journal of mycobacteriology

    2023  Volume 12, Issue 2, Page(s) 135–138

    Abstract: Background: Genital Tuberculosis is a form of extrapulmonary tuberculosis, which if not diagnosed early can lead to complications. The objective of this study was to determine the sensitivity and specificity of Xpert Mycobacterium tuberculosis/rifampin ( ...

    Abstract Background: Genital Tuberculosis is a form of extrapulmonary tuberculosis, which if not diagnosed early can lead to complications. The objective of this study was to determine the sensitivity and specificity of Xpert Mycobacterium tuberculosis/rifampin (MTB/RIF) assay in genital tuberculosis (TB) in comparison with culture as a gold standard.
    Methods: The results of the Xpert MTB/RIF assay performed from January 2020 to August 2021 were compared with the results of culture by Mycobacterium Growth Indicator Tube (MGIT) 960.
    Results: Out of 75 specimens, fluorescent microscopy and liquid culture using MGIT and Xpert assay were positive in 3 (4%), 21 (28%), and 14 (18%), respectively. The sensitivity and specificity of the Xpert MTB/RIF assay were 66.67% and 100%. All smear-positive specimens were positive by culture and Xpert assay. Three specimens were positive by all the tests, i.e., microscopy, culture, and Xpert assay. Fifty-four specimens were negative by microscopy, culture, and Xpert assay. Discordance between the results of culture and Xpert assay was observed in seven specimens which were culture positive and Xpert assay negative. Three (21.42%) out of 21 culture-positive specimens showed monoresistance to rifampicin by Xpert MTB/RIF assay and culture drug susceptibility testing.
    Conclusion: Xpert MTB/RIF assay showed good sensitivity and specificity compared to liquid culture in genital TB. This test is easy to perform, provides results in 2 h, and can also detect rifampicin resistance, which is a surrogate marker for multidrug-resistant TB. Hence, the Xpert assay can be used under the National TB Elimination Program for early and rapid diagnosis of TB in endometrial specimens to prevent complications like infertility.
    MeSH term(s) Female ; Humans ; Rifampin/pharmacology ; Mycobacterium tuberculosis/genetics ; Microbial Sensitivity Tests ; Tertiary Healthcare ; Drug Resistance, Bacterial ; Tuberculosis, Multidrug-Resistant/diagnosis ; Tuberculosis, Multidrug-Resistant/microbiology ; Sensitivity and Specificity ; Tuberculosis, Urogenital ; Hospitals, Teaching ; Diagnostic Tests, Routine ; Genitalia ; Sputum/microbiology
    Chemical Substances Rifampin (VJT6J7R4TR)
    Language English
    Publishing date 2023-06-20
    Publishing country India
    Document type Journal Article
    ZDB-ID 2696590-2
    ISSN 2212-554X ; 2212-554X
    ISSN (online) 2212-554X
    ISSN 2212-554X
    DOI 10.4103/ijmy.ijmy_75_23
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  4. Article ; Online: Comparison of CBNAAT and conventional real time RT PCR for HIV 1 viral load testing.

    Ingole, Nayana A / Nataraj, Gita

    Indian journal of medical microbiology

    2021  Volume 39, Issue 4, Page(s) 504–508

    Abstract: Purpose: HIV viral load testing is now recommended for monitoring of anti-retroviral treatment failure in PLHIV. Xpert® HIV-1 Viral Load is a fully automated CB-NAAT. A reduced turnaround time leads to prompt clinical management. Hence the current study ...

    Abstract Purpose: HIV viral load testing is now recommended for monitoring of anti-retroviral treatment failure in PLHIV. Xpert® HIV-1 Viral Load is a fully automated CB-NAAT. A reduced turnaround time leads to prompt clinical management. Hence the current study was undertaken to compare Xpert® HIV-1 Viral Load with the routinely used conventional real time RT PCR.
    Methods: The study was conducted in the Department of Microbiology of a tertiary care medical college after ethics committee approval. 100 HIV positive samples were tested by both CB-NAAT and conventional real time RT PCR for HIV 1 viral load. Results were analyzed using Spearman's correlation co-efficient and Bland Altman plot for agreement. The number of samples with inter assay differences in viral loads exceeding 0.5 log copies/ml was also recorded. The sensitivity, specificity, PPV and NPV as well as the possible misclassification were calculated at the clinically significant value of 1000 copies/ml.
    Results: 25 samples in each of the four groups with log 10 value of <3, 3 to <4, 4 to <5 and ≥5 respectively were included. The log difference between the groups varied from 0 to 1.54. CB-NAAT has shown a statistically significant correlation with conventional real time RT PCR by Spearman's rank correlation (R = 0.972) (P < 0.01) and acceptable level of agreement with Bland Altman plot. The sensitivity, specificity, PPV, NPV and diagnostic accuracy was 80%, 100%, 100%, 93.75% and 95% respectively. The overall concordance was 95% with an upward misclassification of 6.25% and downward misclassification of 0%.
    Conclusions: Point of care technology with sample in/answer out approach makes it an excellent choice especially in resource constrained and remote settings.
    MeSH term(s) HIV Infections/diagnosis ; HIV Infections/virology ; HIV-1/genetics ; Humans ; RNA, Viral/genetics ; Real-Time Polymerase Chain Reaction ; Sensitivity and Specificity ; Viral Load
    Chemical Substances RNA, Viral
    Language English
    Publishing date 2021-05-26
    Publishing country United States
    Document type Comparative Study ; Journal Article
    ZDB-ID 1038798-5
    ISSN 1998-3646 ; 0255-0857
    ISSN (online) 1998-3646
    ISSN 0255-0857
    DOI 10.1016/j.ijmmb.2021.05.007
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    Zs.A 2639: Show issues Location:
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  5. Article: Laboratory Diagnosis of COVID 19 - Perspectives.

    Nataraj, Gita / Ingole, Nayana

    The Journal of the Association of Physicians of India

    2020  Volume 68, Issue 7, Page(s) 11–12

    MeSH term(s) Betacoronavirus ; COVID-19 ; COVID-19 Testing ; Clinical Laboratory Techniques ; Coronavirus Infections/diagnosis ; Humans ; Pandemics ; Pneumonia, Viral/diagnosis ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-06-29
    Publishing country India
    Document type Journal Article
    ZDB-ID 800766-4
    ISSN 0004-5772
    ISSN 0004-5772
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    Zs.B 313: Show issues Location:
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  6. Article: Comparison of gastric lavage/sputum and stool specimens in the diagnosis of pediatric pulmonary tuberculosis- A pilot study.

    Torane, Vijaya P / Nataraj, Gita / Kanade, Swapna / Deshmukh, Chandrahas T

    The Indian journal of tuberculosis

    2023  Volume 70, Issue 4, Page(s) 445–450

    Abstract: Background and objective: Global TB report 2021 mentions 11 % prevalence of pediatric TB, whereas 5.65% of the cases were reported from India in 2020. India features in the list of TB high burden countries, HIV-TB high burden and MDR-TB high burden ... ...

    Abstract Background and objective: Global TB report 2021 mentions 11 % prevalence of pediatric TB, whereas 5.65% of the cases were reported from India in 2020. India features in the list of TB high burden countries, HIV-TB high burden and MDR-TB high burden countries. The diagnosis of pulmonary tuberculosis in children is difficult as they tend to swallow the sputum, invasive techniques of gastric aspirates needs to be followed and the disease itself is paucibacillary. The disease progresses rapidly in young children and hence rapid diagnosis is needed. Obtaining appropriate respiratory samples for diagnosis is difficult especially in primary care settings. Stool sample is easy to obtain and since children swallow sputum, it can be used to diagnose pulmonary tuberculosis. With this background, a pilot study was planned to evaluate the accuracy of the Xpert MTB/RIF assay for the detection of MTB in stool specimens obtained from pediatric pulmonary TB patients confirmed either by gastric lavage(GL) or sputum(SP) Xpert MTB/RIF assay. In addition, the results of microscopy of stool specimen were compared with that of gastric lavage/ sputum (GL/SP) specimen by Ziehl-Neelsen (ZN) and fluorescent light-emitting diode (LED) staining.
    Material and methods: A prospective study was carried out on 50 GL/SP Xpert MTB/RIF assay positive children (0-14 years). Stool specimens from these children were processed for Xpert MTB/RIF assay. The GL/SP and stool specimens were processed for ZN and Auramine O fluorescent microscopy as well.
    Results: Fluorescent staining detected acid fast bacilli (AFB) in 24 GL/SP and 16 stool specimens as compared to 20 GL/SP and 10 stool specimens by ZN staining. Stool Xpert MTB/ RIF assay was positive in 29 out of 50 children. Rifampicin resistance was detected in 13 of the 50 (26%) GL/SP specimens. Of these 13 children, rifampicin resistance was detected in 7 stool specimens, rifampicin indeterminate resistance was detected in one specimen and in the remaining 5 children, M.tuberculosis was not detected in stool.
    Conclusion: Stool is a good non-invasive specimen for the detection of pulmonary TB in children, especially in remote areas, where invasive techniques cannot be performed for sample collection.
    MeSH term(s) Humans ; Child ; Child, Preschool ; Rifampin ; Pilot Projects ; Gastric Lavage ; Sputum ; Prospective Studies ; Sensitivity and Specificity ; Tuberculosis, Pulmonary/diagnosis ; Mycobacterium tuberculosis
    Chemical Substances Rifampin (VJT6J7R4TR)
    Language English
    Publishing date 2023-04-05
    Publishing country India
    Document type Journal Article
    ZDB-ID 603129-8
    ISSN 0019-5707 ; 0019-5705
    ISSN 0019-5707 ; 0019-5705
    DOI 10.1016/j.ijtb.2023.03.017
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  7. Article ; Online: Rifampicin Resistance by Xpert MTB/RIF Assay in Pulmonary Tuberculosis- Is there a Need for Confirmation by Retesting?

    Swapna Rajesh Kanade / Swati Vijay / Gita Nataraj

    Journal of Clinical and Diagnostic Research, Vol 16, Iss 5, Pp DC46-DC

    2022  Volume 49

    Abstract: Introduction: Xpert Mycobacterium tuberculosis/Resistance to Rifampicin (MTB/RIF) assay detects MTB Complex (MTBC) and rifampicin resistance simultaneously. In high prevalence countries like India, detection of rifampicin resistance in sputum specimen of ...

    Abstract Introduction: Xpert Mycobacterium tuberculosis/Resistance to Rifampicin (MTB/RIF) assay detects MTB Complex (MTBC) and rifampicin resistance simultaneously. In high prevalence countries like India, detection of rifampicin resistance in sputum specimen of a newly diagnosed case of pulmonary TB with a low pretest probability needs to be confirmed by retesting. Aim: To evaluate the results of retesting of rifampicin resistant specimens in newly diagnosed pulmonary TB cases. Materials and Methods: A retrospective analysis of the data of Xpert assay was performed on specimens received in Department of Microbiology, Seth G.S. Medical College and KEM Hospital, Mumbai, Maharashtra, India from 1st June 2018 to 31st May 2020. If rifampicin resistance was detected in a newly diagnosed case of Tuberculosis (TB), a second specimen was retested by Xpert assay for confirmation. Concordance of retesting was seen with results of Line Probe Assay (LPA). Results: Total 27,429 specimens were processed by Xpert assay of which 803 specimens showed rifampicin resistance, 157 sputum specimens fulfilling criteria of Programmatic Management of Drug resistant Tuberculosis (PMDT) guidelines were retested. High, medium, low and very low bacterial load was observed in 30, 51, 34 and 42 specimens’ respectively. All specimens having high or medium bacillary load showed rifampicin resistant result on retesting. On retesting 34 sputum specimens with low bacterial load, rifampicin resistance was confirmed in 30 specimens. LPA done after growing them by liquid culture confirmed rifampicin resistance in remaining four specimens. Conclusion: Xpert assay is recommended when the bacterial load identified by Xpert assay is very low and when there is discordance between Xpert results of rifampicin resistance and the reflex LPA testing.
    Keywords drug resistance ; molecular assay ; mycobacterium tuberculosis/resistance to rifampicin ; repeat testing ; Medicine ; R
    Language English
    Publishing date 2022-05-01T00:00:00Z
    Publisher JCDR Research and Publications Private Limited
    Document type Article ; Online
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  9. Article ; Online: Performance of loop-mediated isothermal amplification assay for diagnosis of extrapulmonary tuberculosis and antituberculosis treatment initiation.

    Singh, Priyanka / Kanade, Swapna / Nataraj, Gita

    International journal of mycobacteriology

    2021  Volume 10, Issue 4, Page(s) 373–378

    Abstract: Background: Extra-pulmonary TB(EPTB) accounts for 15-20% of total TB cases in India. Many cases remain undiagnosed due to poor sensitivity/long turn-around-time of conventional diagnostic tests. Molecular tests offer rapidity, improved sensitivity and ... ...

    Abstract Background: Extra-pulmonary TB(EPTB) accounts for 15-20% of total TB cases in India. Many cases remain undiagnosed due to poor sensitivity/long turn-around-time of conventional diagnostic tests. Molecular tests offer rapidity, improved sensitivity and exquisite specificity, but are expensive, require skilled manpower and enhanced laboratory infrastructure. Loop-mediated isothermal amplification (LAMP) assay is a unique, temperature-independent DNA amplification test facilitated by visual optic-readout. WHO has recommended use of LAMP for pulmonary TB diagnosis in 2016. For END-TB strategy to succeed, its necessary to capture all forms of TB. The aim of the study was to determine the sensitivity and specificity of LAMP assay against culture, Xpert MTB/RIF assay and Composite Reference Standard(CRS) for diagnosis of EPTB.
    Methods: In a cross-sectional study hundred consecutive EPTB specimens were processed for microscopy, culture, Xpert and LAMP assay. Standard formulae of sensitivity and specificity and McNemar chi square test of significance was applied.
    Results: Hundred specimens included in the study were fluids(65), pus(19) and tissue(16). TB was detected in 38 specimens by any of the four methods. Positivity of microscopy-5%, culture-28%, Xpert-25% and LAMP-32%. Sensitivity and specificity of LAMP against culture was 85.71% and 88.89%; against Xpert was 88% and 86.67%; against CRS was 80% and 88.6% respectively. LAMP detected TB in 32 patients of which 28 were put on anti-TB treatment (ATT). Of the 62 patients with negative results in all the tests, 22 were put on ATT.
    Conclusions: LAMP has good sensitivity for EPTB diagnosis. Further studies are required to establish utility of LAMP as EPTB diagnostic tool.
    MeSH term(s) Antitubercular Agents ; Cross-Sectional Studies ; Humans ; Molecular Diagnostic Techniques ; Mycobacterium tuberculosis/genetics ; Nucleic Acid Amplification Techniques ; Sensitivity and Specificity ; Sputum ; Tuberculosis/diagnosis
    Chemical Substances Antitubercular Agents
    Language English
    Publishing date 2021-12-16
    Publishing country Netherlands
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2696590-2
    ISSN 2212-554X ; 2212-554X
    ISSN (online) 2212-554X
    ISSN 2212-554X
    DOI 10.4103/ijmy.ijmy_218_21
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  10. Article ; Online: A single-center observational study on clinical features and outcomes of 21 SARS-CoV-2-infected neonates from India.

    Nanavati, Ruchi / Mascarenhas, Dwayne / Goyal, Medha / Haribalakrishna, Anitha / Nataraj, Gita

    European journal of pediatrics

    2021  Volume 180, Issue 6, Page(s) 1895–1906

    Abstract: Coronavirus disease-19 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is an ongoing pandemic with significant morbidity and mortality. Neonates represent a vulnerable population, in which we have limited knowledge of ... ...

    Abstract Coronavirus disease-19 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is an ongoing pandemic with significant morbidity and mortality. Neonates represent a vulnerable population, in which we have limited knowledge of its natural history, optimal management, and outcomes. In this retrospective observational study from a low-middle-income setting, clinical characteristics and outcomes of neonatal SARS-CoV-2 infection were evaluated. We report an incidence of 10.6% of SARS-CoV-2 infection (21 neonates), among a group of 198 neonates with suspected infection. Most of the SARS-CoV-2-infected neonates were term (80.9%) and none required any resuscitation. The infection was detected by a positive nasopharyngeal swab reverse transcriptase-polymerase chain reaction (RT-PCR) for SARS-CoV-2. Neonatal COVID-19 manifestations developed in one-third (33.3%) of the infected neonates. Most of them demonstrated the involvement of respiratory (33.3%) and gastrointestinal systems (4.8%). Laboratory parameters suggested multi-systemic involvement, with elevated creatine kinase (CK) (76.2%), creatine kinase-myocardial band (CK-MB) (76.2%), and lactate dehydrogenase (LDH) (71.4%) levels. Supportive treatment was given to infected neonates with intensive care required in six neonates (28.6%). This included four preterm and two term neonates, of which two received non-invasive and one received invasive ventilation with intra-tracheal surfactant instillation. IgM antibodies against COVID-19 were detected in one neonate. All neonates with COVID-19 improved and were successfully discharged.Conclusion: SARS-CoV-2 in neonates has a wide clinical spectrum. Further studies are needed which are adequately powered to completely understand the course of this infection in neonates, its implications not only in the neonatal period but also on long-term follow-up. What is Known: • SARS-CoV-2 infection has a predilection for all age groups but with limited literature on clinical profile, outcomes, and long-term follow-up in neonates. What is New: • SARS-CoV-2 infection in neonates has a wide clinical spectrum and displays a significant overlap with common neonatal conditions. • Most neonates with COVID-19 improved with supportive care, though a subset required intensive care, emphasizing the need for cautious monitoring and management.
    MeSH term(s) COVID-19 ; Female ; Humans ; India/epidemiology ; Infant, Newborn ; Infectious Disease Transmission, Vertical ; Pregnancy ; Pregnancy Complications, Infectious ; SARS-CoV-2
    Language English
    Publishing date 2021-02-05
    Publishing country Germany
    Document type Journal Article ; Observational Study
    ZDB-ID 194196-3
    ISSN 1432-1076 ; 0340-6199 ; 0943-9676
    ISSN (online) 1432-1076
    ISSN 0340-6199 ; 0943-9676
    DOI 10.1007/s00431-021-03967-7
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