Prevalence of SARS-CoV-2 in Patients with Severe Pneumonia in Khuzestan Province, Iran
-
Farhad Abolnezhadian
,
Manoochehr Makvandi
,
Seyed Mohammad Alavi
,
Azarakhsh Azaran
,
Shahram Jalilian
,
Mohammad Rashno
,
Gholam Abbas Kaydani
,
Maniya Arshadi
,
Seyed Mehdi Hosseinizadeh
,
Hatam Boostani
,
Seyed Saeed Seyedian
,
Sasan Moogahi
,
Shokrolah Salmanzadeh
,
Mehran Varnaseri
,
Niloofar Neisi
,
Hooman Keifarrokhi
,
Gholamreza Shariati
,
Homayoun Amiri
,
Mehdi Parsanahad
,
Roohangiz Nashibi
,
Farid Yousefi
,
Fatemeh Ahmadi
,
Kambiz AhmadiAngali
Abstract
The emergence of a highly pathogenic virus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) accounts for severe pneumonia throughout the world. More than 7 million world population have been infected with SARS-CoV-2, and the number of deaths is increasing every day. This study aimed to evaluate the frequency of SARS-CoV-2 in hospitalized patients with an acute respiratory infection (ARI).
During an outbreak of the SARS-CoV-2, the nasopharyngeal and oropharyngeal swabs were collected from 909 hospitalized patients with severe pneumonia, including 517 (56.9%) males and 392 (43.1%) females. All the collected samples were from different cities of Khuzestan province from 19 February to- 27 March 2020. The RNA was extracted from samples and subjected to real-time polymerase chain reaction (PCR) tests for the detection of the SARS-CoV-2. Simultaneously, the computerized tomography (CT) scan was tested for the presence of ground-glass opacity in the lung among the patients.
Of the total number of 909 specimens, 328 (36.08%) cases, including 185 (20.35%) females and 143 (15.73%) males, were positive for the SARS-CoV-2 while, 581 (63.9%) cases, including 374 (41.14%) males and 207 (22.77%) were negative for the SARS-CoV-2 by real-time PCR (p=0.001).Four hundred sixteen (45.76%) cases were positive for ground-glass opacity in the lung by CT scan, while 328/909 (36.08%) trials proved positive for SARS-CoV-2 by the real-time PCR (p=0.003).
In this study, 36.08% of patients were positive for SARS-CoV-2. Although the results of positive cases by CT scan showed higher than real-time PCR, screening the SARS-COV-2 with a real-time PCR method is the first line of choice.
1. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, Zhao X, Huang B, Shi W, Lu R, Niu P. China Novel Coronavirus Investigating and Research Team. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020 ;382(8):727-33.
2. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, Wang B, Xiang H, Cheng Z, Xiong Y, Zhao Y. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. JAMA. 2020 ;323(11):1061-1069.
3. Cowling BJ, Leung GM. Epidemiological research priorities for public health control of the ongoing global novel coronavirus (2019-nCoV) outbreak. Euro Surveill. 2020 ;25(6):2000110.
4. Xie M, Chen Q. Insight into 2019 novel coronavirus—an updated interim review and lessons from SARS-CoV and MERS-CoV. International Journal of Infectious Diseases 94 (2020) 119–124
5. Wu F, Zhao S, Yu B, Chen YM, Wang W, Song ZG, et al. A new coronavirus associated with human respiratory disease in China. Nature. 2020 ;579(7798):265-269.
6. Yin Y, Wunderink RG. MERS, SARS and other coronaviruses as causes of pneumonia. Respirology. 2018 ;23(2):130-137.
7. Drosten C, Günther S, Preiser W, Van Der Werf S, Brodt HR, Becker S, et al. Identification of a novel coronavirus in patients with severe acute respiratory syndrome. N Engl J Med. 2003;348(20):1967-76.
8. Zaki AM, Van Boheemen S, Bestebroer TM, Osterhaus AD, Fouchier RA. Isolation of a novel coronavirus from a man with pneumonia in Saudi Arabia. N Engl J Med. 2012;367(19):1814-20.
9. Elfiky AA, Mahdy SM, Elshemey WM. Quantitative structure‐activity relationship and molecular docking revealed a potency of anti‐hepatitis C virus drugs against human corona viruses. JMV. 2017;89(6):1040-7.
10. Perlman S, Netland J. Coronaviruses post-SARS: update on replication and pathogenesis. Nat Rev Microbiol. 2009;7(6):439-50.
11. Báez-Santos YM, Mielech AM, Deng X, Baker S, Mesecar AD. Catalytic function and substrate specificity of the papain-like protease domain of nsp3 from the Middle East respiratory syndrome coronavirus. JVI. 2014;88(21):12511-12527.
12. Hemida MG, Alnaeem A. Some One Health based control strategies for the Middle East respiratory syndrome coronavirus. One Health. 2019; 8:100102.
13. German M, Olsha R, Kristjanson E, Marchand-Austin A, Peci A, Winter AL, Gubbay JB. Acute Respiratory Infections in Travelers Returning from MERS-CoV–Affected Areas. Emerg infect Dis. 2015 ;21(9):1654–1656
14. Masters PS. The molecular biology of coronaviruses. Adv Virus Rev. 2006 ;66:193-292.
15. Ziebuhr J, Snijder EJ, Gorbalenya AE. Virus-encoded proteinases and proteolytic processing in the Nidovirales. J Gen Virol. 2000 ;81(Pt4):853-79.
16. Hussain S, Chen Y, Yang Y, Xu J, Peng Y, Wu Y, Li Z, Zhu Y, Tien P, Guo D. Identification of novel subgenomic RNAs and noncanonical transcription initiation signals of severe acute respiratory syndrome coronavirus. JVirol. 2005;79(9):5288-95.
17. Kratzel A, Todt D, V'kovski P, Steiner S, Gultom M, Thao TT, et al. Inactivation of severe acute respiratory syndrome coronavirus 2 by WHO-recommended hand rub formulations and alcohols. Emerg Infect Dis. 2020; 26(7): 1592–1595.
18. Kampf G, Todt D, Pfaender S, Steinmann E. Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents. Journal of Hospital Infection. 2020;104(3):246-51.
19. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The Lancet. 2020;395(10223):507-513.
20. Singhal T. A review of coronavirus disease-2019 (COVID-19). Indian J Pediatr. 2020;87(4):281–286.
21. Li H, Wang Y, Ji M, Pei F, Zhao Q, Zhou Y, Hong Y, Han S, Wang J, Wang Q, Li Q. Transmission Routes Analysis of SARS-CoV-2: A Systematic Review and Case Report. Front Cell Dev Biol..2020 ;8:618.
22. Cha MH, Regueiro M, Sandhu DS. Gastrointestinal and hepatic manifestations of COVID-19: A comprehensive review. World J Gastroenterol. 2020;26(19):2323–2332.
23. Cheng ZJ, Shan J. 2019 novel coronavirus: where we are and what we know. Infection. 2020; 48:155–163
24. Vabret N, Britton GJ, Gruber C, Hegde S, Kim J, Kuksin M, et al. Immunology of COVID-19: current state of the science. Immunity. 2020 52(6): 910–941.
25. Coperchini F, Chiovato L, Croce L, Magri F, Rotondi M. The cytokine storm in COVID-19: an overview of the involvement of the chemokine/chemokine-receptor system. Cytokine Growth Factor Rev. 2020; 53: 25–32
26. Weiss P, Murdoch DR. Clinical course and mortality risk of severe COVID-19. Lancet. 2020 ;395(10229):1014-1015..
27. Jin YH, Cai L, Cheng ZS, Cheng H, Deng T, Fan YP, et al. A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version). Mil. Med. Res. 2020;7(1):4.
28. Huang P, Liu T, Huang L, Liu H, Lei M, Xu W, Hu X, Chen J, Liu B. Use of chest CT in combination with negative RT-PCR assay for the 2019 novel coronavirus but high clinical suspicion. Radiology. 2020;295(1):22-3.
29. Zheng J. SARS-CoV-2: an emerging coronavirus that causes a global threat. Int J Biol Sci. 2020; 16 (10):1678-1685
30. Sun Z, Thilakavathy K, Kumar SS, He G, Liu SV. Potential factors influencing repeated SARS outbreaks in China. In J Environ Res Public Health. 2020;17(5):1633.
31. Wang W, Xu Y, Gao R, Lu R, Han K, Wu G, Tan W. Detection of SARS-CoV-2 in different types of clinical specimens. JAMA.2020 ;323(18):1843-1844.
32. He JL, Luo L, Luo ZD, Lyu JX, Ng MY, Shen XP, Wen Z. Diagnostic performance between CT and initial real-time RT-PCR for clinically suspected 2019 coronavirus disease (COVID-19) patients outside Wuhan, China..Respir Med.2020;168:105980
33. Lee JE, Choe KW, Lee SW. Clinical and radiological characteristics of2009 H1N1 influenza associated pneumonia in young male adults. Yonsei Med J. 2013;54(4):927–34.
34. Kim MC, Kim MY, Lee HJ, Lee SO, Choi SH, Kim YS, et al. CT findings in viral lower respiratory tract infections caused by parainfluenza virus, influenza virus and respiratory syncytial virus. Medicine (Baltimore).2016;95(26):(e4003).
35. Lee J, Lim JK, Seo H, Lee SY, Choi KJ, Yoo SS, et al. Clinical relevance of ground glass opacity in 105 patients with miliary tuberculosis. RespirMed. 2014;108(6):924-30.
36. Haroon A, Higa F, Fujita J, Watanabe A, Aoki N, Niki Y, et al. Pulmonary computed tomography findings in 39 cases of Streptococcus pneumoniae pneumonia. Intern Med. 2012;51(24):3343-9
37. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with SARS-COV-2in Wuhan, China: a retrospective cohort study. The Lancet. 2020;395:1054–1062
38. Lu X, Zhang L, Du H, et al. SARS-CoV-2 Infection in Children. N Engl J Med. 2020;382(17):1663-1665.
39. Lai CC, Shih TP, Ko WC, Tang HJ, Hsueh PR. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and corona virus disease-2019 (COVID-19): the epidemic and the challenges.. Int J Antimicrob Agents. 2020;55(3):105924.
40. Chen ZM, Fu JF, Shu Q, Chen YH, Hua CZ, Li FB, Lin R, Tang LF, Wang TL, Wang W, Wang YS. Diagnosis and treatment recommendations for pediatric respiratory infection caused by the 2019 novel coronavirus. World J Pediatr. 2020:16(3):240-246
41. Russell CD, Millar JE, Baillie JK. Clinical evidence does not support corticosteroid treatment for 2019-nCoV lung injury. The Lancet. 2020;395(10223):473-475.
42. Zha L, Li S, Pan L, Tefsen B, Li Y, French N, et al. Corticosteroid treatment of patients with coronavirus disease 2019 (COVID‐19). Med J Aust. 2020;212(9):416-420.
43. Wang M, Cao R, Zhang L, Yang X, Liu J, Xu M, et al. Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro. Cell Res. 2020;30(3):269-271.
44. Chen L, Xiong J, Bao L, Shi Y. Convalescent plasma as a potential therapy for COVID-19. Lancet Infect Dis. 2020;20(4):398-400.
2. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, Wang B, Xiang H, Cheng Z, Xiong Y, Zhao Y. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. JAMA. 2020 ;323(11):1061-1069.
3. Cowling BJ, Leung GM. Epidemiological research priorities for public health control of the ongoing global novel coronavirus (2019-nCoV) outbreak. Euro Surveill. 2020 ;25(6):2000110.
4. Xie M, Chen Q. Insight into 2019 novel coronavirus—an updated interim review and lessons from SARS-CoV and MERS-CoV. International Journal of Infectious Diseases 94 (2020) 119–124
5. Wu F, Zhao S, Yu B, Chen YM, Wang W, Song ZG, et al. A new coronavirus associated with human respiratory disease in China. Nature. 2020 ;579(7798):265-269.
6. Yin Y, Wunderink RG. MERS, SARS and other coronaviruses as causes of pneumonia. Respirology. 2018 ;23(2):130-137.
7. Drosten C, Günther S, Preiser W, Van Der Werf S, Brodt HR, Becker S, et al. Identification of a novel coronavirus in patients with severe acute respiratory syndrome. N Engl J Med. 2003;348(20):1967-76.
8. Zaki AM, Van Boheemen S, Bestebroer TM, Osterhaus AD, Fouchier RA. Isolation of a novel coronavirus from a man with pneumonia in Saudi Arabia. N Engl J Med. 2012;367(19):1814-20.
9. Elfiky AA, Mahdy SM, Elshemey WM. Quantitative structure‐activity relationship and molecular docking revealed a potency of anti‐hepatitis C virus drugs against human corona viruses. JMV. 2017;89(6):1040-7.
10. Perlman S, Netland J. Coronaviruses post-SARS: update on replication and pathogenesis. Nat Rev Microbiol. 2009;7(6):439-50.
11. Báez-Santos YM, Mielech AM, Deng X, Baker S, Mesecar AD. Catalytic function and substrate specificity of the papain-like protease domain of nsp3 from the Middle East respiratory syndrome coronavirus. JVI. 2014;88(21):12511-12527.
12. Hemida MG, Alnaeem A. Some One Health based control strategies for the Middle East respiratory syndrome coronavirus. One Health. 2019; 8:100102.
13. German M, Olsha R, Kristjanson E, Marchand-Austin A, Peci A, Winter AL, Gubbay JB. Acute Respiratory Infections in Travelers Returning from MERS-CoV–Affected Areas. Emerg infect Dis. 2015 ;21(9):1654–1656
14. Masters PS. The molecular biology of coronaviruses. Adv Virus Rev. 2006 ;66:193-292.
15. Ziebuhr J, Snijder EJ, Gorbalenya AE. Virus-encoded proteinases and proteolytic processing in the Nidovirales. J Gen Virol. 2000 ;81(Pt4):853-79.
16. Hussain S, Chen Y, Yang Y, Xu J, Peng Y, Wu Y, Li Z, Zhu Y, Tien P, Guo D. Identification of novel subgenomic RNAs and noncanonical transcription initiation signals of severe acute respiratory syndrome coronavirus. JVirol. 2005;79(9):5288-95.
17. Kratzel A, Todt D, V'kovski P, Steiner S, Gultom M, Thao TT, et al. Inactivation of severe acute respiratory syndrome coronavirus 2 by WHO-recommended hand rub formulations and alcohols. Emerg Infect Dis. 2020; 26(7): 1592–1595.
18. Kampf G, Todt D, Pfaender S, Steinmann E. Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents. Journal of Hospital Infection. 2020;104(3):246-51.
19. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The Lancet. 2020;395(10223):507-513.
20. Singhal T. A review of coronavirus disease-2019 (COVID-19). Indian J Pediatr. 2020;87(4):281–286.
21. Li H, Wang Y, Ji M, Pei F, Zhao Q, Zhou Y, Hong Y, Han S, Wang J, Wang Q, Li Q. Transmission Routes Analysis of SARS-CoV-2: A Systematic Review and Case Report. Front Cell Dev Biol..2020 ;8:618.
22. Cha MH, Regueiro M, Sandhu DS. Gastrointestinal and hepatic manifestations of COVID-19: A comprehensive review. World J Gastroenterol. 2020;26(19):2323–2332.
23. Cheng ZJ, Shan J. 2019 novel coronavirus: where we are and what we know. Infection. 2020; 48:155–163
24. Vabret N, Britton GJ, Gruber C, Hegde S, Kim J, Kuksin M, et al. Immunology of COVID-19: current state of the science. Immunity. 2020 52(6): 910–941.
25. Coperchini F, Chiovato L, Croce L, Magri F, Rotondi M. The cytokine storm in COVID-19: an overview of the involvement of the chemokine/chemokine-receptor system. Cytokine Growth Factor Rev. 2020; 53: 25–32
26. Weiss P, Murdoch DR. Clinical course and mortality risk of severe COVID-19. Lancet. 2020 ;395(10229):1014-1015..
27. Jin YH, Cai L, Cheng ZS, Cheng H, Deng T, Fan YP, et al. A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version). Mil. Med. Res. 2020;7(1):4.
28. Huang P, Liu T, Huang L, Liu H, Lei M, Xu W, Hu X, Chen J, Liu B. Use of chest CT in combination with negative RT-PCR assay for the 2019 novel coronavirus but high clinical suspicion. Radiology. 2020;295(1):22-3.
29. Zheng J. SARS-CoV-2: an emerging coronavirus that causes a global threat. Int J Biol Sci. 2020; 16 (10):1678-1685
30. Sun Z, Thilakavathy K, Kumar SS, He G, Liu SV. Potential factors influencing repeated SARS outbreaks in China. In J Environ Res Public Health. 2020;17(5):1633.
31. Wang W, Xu Y, Gao R, Lu R, Han K, Wu G, Tan W. Detection of SARS-CoV-2 in different types of clinical specimens. JAMA.2020 ;323(18):1843-1844.
32. He JL, Luo L, Luo ZD, Lyu JX, Ng MY, Shen XP, Wen Z. Diagnostic performance between CT and initial real-time RT-PCR for clinically suspected 2019 coronavirus disease (COVID-19) patients outside Wuhan, China..Respir Med.2020;168:105980
33. Lee JE, Choe KW, Lee SW. Clinical and radiological characteristics of2009 H1N1 influenza associated pneumonia in young male adults. Yonsei Med J. 2013;54(4):927–34.
34. Kim MC, Kim MY, Lee HJ, Lee SO, Choi SH, Kim YS, et al. CT findings in viral lower respiratory tract infections caused by parainfluenza virus, influenza virus and respiratory syncytial virus. Medicine (Baltimore).2016;95(26):(e4003).
35. Lee J, Lim JK, Seo H, Lee SY, Choi KJ, Yoo SS, et al. Clinical relevance of ground glass opacity in 105 patients with miliary tuberculosis. RespirMed. 2014;108(6):924-30.
36. Haroon A, Higa F, Fujita J, Watanabe A, Aoki N, Niki Y, et al. Pulmonary computed tomography findings in 39 cases of Streptococcus pneumoniae pneumonia. Intern Med. 2012;51(24):3343-9
37. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with SARS-COV-2in Wuhan, China: a retrospective cohort study. The Lancet. 2020;395:1054–1062
38. Lu X, Zhang L, Du H, et al. SARS-CoV-2 Infection in Children. N Engl J Med. 2020;382(17):1663-1665.
39. Lai CC, Shih TP, Ko WC, Tang HJ, Hsueh PR. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and corona virus disease-2019 (COVID-19): the epidemic and the challenges.. Int J Antimicrob Agents. 2020;55(3):105924.
40. Chen ZM, Fu JF, Shu Q, Chen YH, Hua CZ, Li FB, Lin R, Tang LF, Wang TL, Wang W, Wang YS. Diagnosis and treatment recommendations for pediatric respiratory infection caused by the 2019 novel coronavirus. World J Pediatr. 2020:16(3):240-246
41. Russell CD, Millar JE, Baillie JK. Clinical evidence does not support corticosteroid treatment for 2019-nCoV lung injury. The Lancet. 2020;395(10223):473-475.
42. Zha L, Li S, Pan L, Tefsen B, Li Y, French N, et al. Corticosteroid treatment of patients with coronavirus disease 2019 (COVID‐19). Med J Aust. 2020;212(9):416-420.
43. Wang M, Cao R, Zhang L, Yang X, Liu J, Xu M, et al. Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro. Cell Res. 2020;30(3):269-271.
44. Chen L, Xiong J, Bao L, Shi Y. Convalescent plasma as a potential therapy for COVID-19. Lancet Infect Dis. 2020;20(4):398-400.
| Files | ||
| Issue | Vol 19 No 5 (2020) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijaai.v19i5.4462 | |
| PMID | 33463114 | |
| Keywords | ||
| Nucleocapsid protein Pneumonia Real-time polymerase chain reaction Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Abolnezhadian F, Makvandi M, Alavi SM, Azaran A, Jalilian S, Rashno M, Kaydani GA, Arshadi M, Hosseinizadeh SM, Boostani H, Seyedian SS, Moogahi S, Salmanzadeh S, Varnaseri M, Neisi N, Keifarrokhi H, Shariati G, Amiri H, Parsanahad M, Nashibi R, Yousefi F, Ahmadi F, AhmadiAngali K. Prevalence of SARS-CoV-2 in Patients with Severe Pneumonia in Khuzestan Province, Iran. Iran J Allergy Asthma Immunol. 2020;19(5):471-477.
