Volume 45, Issue 1

Objectives Commercially available immunoassays have been developed for detection of antibodies against SARS-CoV-2. However, equivocal and discrepant results between different immunoassay can occur requiring further assessment by confirmatory tests. Methods We investigated the new commercial line assay recomLine SARS-CoV-2 IgG (Mikrogen, containing the antigens S1, receptor-binding domain of the spike protein, and nucleocapsid protein (NP) of SARS-CoV-2) within a collection of well characterized serum samples from COVID-19 outpatients (n=49) and SARS-CoV-2-PCR-positive asymptomatic contact persons (n=6) in comparison to two commercial immunoassays, the S1 antigen based Anti-SARS-CoV-2-ELISA IgG by Euroimmun and the NP based Elecsys ® Anti-SARS-CoV-2 by Roche. Results The recomLine assay was positive in all samples which had an equivocal or positive result for SARS-CoV-2 antibodies in at least one of the two immunoassays. It showed high agreement with the overall results of the immunoassays (94.5% [Cohen’s kappa = 0.85] and 92.7% [Cohen’s kappa 0.81] to the ELISA by Euroimmun and the assay by Roche, respectively). In addition, high agreement of the reactivity to the specific antigens S1 and NP in the recomLine assays compared to the results of the S1 based ELISA and NP based Elecsys ® assay, was found (90.9% [Cohen’s kappa 0.78] and 96.4% [Cohen’s kappa 0.91] for S1 and NP, respectively). Conclusions The new recomLine SARS-CoV-2 IgG assay may be used as an additional tool for investigation of equivocal or discrepant results of Anti-SARS-CoV-2 immunoassays and for antigen-specific detection of SARS-CoV-2 IgG antibodies.

Objectives Neonatal sepsis continues to be a leading and most important cause of mortality among low birth weight (LBW) preterm infants. Methods The study group included 226 LBW preterm infants with sepsis. A total of 100 normal birth weight infants with sepsis served as control. Blood and cerebrospinal fluid (CSF) samples collected for microbiological culture and processed according to standard protocol. Antibiotic resistance patterns were performed following standard guidelines. Results Out of 226 LBW preterm infants 106 (46.9%) showed positive blood culture, of which 52 (49%) Escherichia coli , 28 (26.4%) Klebsiella pneumoniae , 12 (11.32%) Enterobacter spp., 4 (3.7%) Pseudomonas aeruginosa , 2 (1.88%) Acinetobacter spp., 5 (4.7%) methicillin-resistant Staphylococcus aureus (MRSA), 3 (2.8%) Staphylococcus epidermidis were isolated. Out of 100 control group infants, 46 (46%) showed positive blood cultures, of which 18 (39.1%) E. coli , 12 (26.08%) Enterobacter spp., 8 (17.39%) K. pneumoniae , 1 (2.17%) P. aeruginosa , 2 (4.34%) MRSA, 3 (6.52%) S. epidermidis and 2 (4.34%) Candida spp. were isolated. Cephalosporin and Penicillin group showed highest resistance with 58 and 52%, respectively. Aminoglycosides showed 22% resistance. The control group showed highest resistance of 62% to the Penicillin group, 54% cephalosporin and 18% for aminoglycosides. Conclusions Our study highlights on the surveillance of resistant pathogens causing sepsis in LBW preterm infants emphasizing antimicrobial stewardship to control the mortality rate.

Objectives To determine correlations of serum beta 2-microglobulin (β2-MG) level with disease activity and renal involvement in patients with systemic lupus erythematosus (SLE). Methods Two hundred eligible SLE patients were assigned into remission and active stage groups according to SLE disease activity index (SLEDAI) scores. They were also assigned into kidney damage and no kidney damage groups. Serum β2-MG, Scr, ALB, BUN, anti-dsDNA, complements C3, C4 and 24-h urinary total protein (UTP) were detected. Estimated glomerular filtration rate (eGFR) was calculated. Correlations of β2-MG level with SLEDAI score and eGFR were subjected to Spearman analysis. Affecting factors were explored by logistic multivariate regression analysis, and predictive values of β2-MG level for SLE, disease activity and renal damage were assessed by ROC curves. Results β2-MG, Scr, ALB, C3, C4, anti-dsDNA and UTP levels, eGFR and SLEDAI score were different between patients with different disease activities, and, except for eGFR, also between patients with different renal damage degrees (p<0.05). Serum β2-MG, Scr, ALB, C3, C4, anti-dsDNA, UTP, eGFR and SLEDAI score were independent factors for disease activity (p<0.05), and β2-MG, ALB, C3, UTP, eGFR and SLEDAI score were factors affecting renal damage (p<0.05). β2-MG level was correlated positively with SLEDAI score (r=0.877, p=0.000) and negatively with eGFR (r=−0.873, p=0.000). This level was highly valuable for predicting SLE, disease activity and renal damage. Conclusions Serum β2-MG levels in SLE patients are correlated positively with disease activity and negatively with renal involvement, being highly sensitive and specific for predicting SLE, disease activity and eGFR.

Objectives Hormonal disturbances during menopause are an established influencing factor on bone health, but the role of controlled ovarian hyperstimulation for fertility treatment remains unclear. To evaluate the influence of ovarian stimulation on bone metabolism with particular regard to serum follicle-stimulating hormone (FSH) levels this prospective observational study was conducted. Methods A total of 71 women underwent controlled ovarian hyperstimulation with recombinant FSH (rFSH) or human menopausal gonadotropin (HMG) (FSH + LH) administered in individual doses, with gonadotropin-releasing hormone (GnRH) agonist down-regulation initiated in the luteal phase of the previous cycle. At four time points (start of down-regulation [T1], start of ovarian stimulation [T2], oocyte retrieval [T3] and luteal phase of the stimulation cycle [T4]), luteinizing hormone (LH), FSH, estradiol (E2), osteocalcin (OC), bone-specific alkaline phosphatase (BAP), as well as the bone resorption markers β-isomerized C-terminal telopeptide of type I collagen (β-CTX) and tartrate-resistant acid phosphatase (TRACP) were measured. Results The cyclic variations in FSH levels had a positive effect on the concentration profile of the bone resorption marker β-CTX (p=0.0001). Supraphysiologic estradiol levels showed a negative association with osteocalcin concentrations (p=0.017), and significantly lower OC and TRACP levels were observed at T4 compared to T1. By group comparison, women treated with rFSH presented with a higher bone turnover than the HMG group at the end of a stimulation cycle (T4). Conclusions Our results show that FSH is a significant influencing factor of bone metabolism. Overall, there was no evidence of enhanced bone resorption under short-term ovarian stimulation therapy. Further studies with bigger sample sizes are warranted to validate these results. Highlights – FSH is an influencing factor on parameters of bone metabolism. – Short term rFSH/HMG-treatment does not significantly enhance parameters of bone resorption. – No significant difference between rFSH- und HMG-stimulation has been found.

Objectives Coronavirus disease 2019 (COVID-19) is currently a worldwide major health threat. Recognizing hypoxia in patients early on can have a considerable effect on therapy success and survival rate. Methods We collected data using a standard blood gas analyzer from 50 patients and analyzed measurements of partial pressure of carbon dioxide-pCO 2 , partial pressure of oxygen-pO 2 and oxygen saturation-sO 2 , bicarbonate concentrations-HCO 3− as well as ionized calcium concentrations. We further examined PCR test results for SARS-CoV-2 of the patients and analyzed differences between patients tested positive and those tested negative for the virus. Results Venous pCO 2 was significantly higher whereas pO 2 and sO 2 were significantly lower in patients who tested positive for SARS-CoV-2. The pH, and ionized calcium concentrations of patients tested positive for the virus were significantly lower than in those tested negative. Conclusions Symptomatic SARS-CoV-2-positive patients upon admission to the emergency room exhibit lower venous blood levels of oxygen, pH, and calcium and higher levels of carbon dioxide compared to symptomatic SARS-CoV-2-negative patients. This blood gas analysis constellation could help in identifying SARS-CoV-2-positive patients more rapidly and identifying early signs of hypoxia.