Recent case-series of small size implied a pathophysiological association between coronavirus disease 2019 (COVID-19) and severe large-vessel acute ischemic stroke. Given that severe strokes are typically associated with poor prognosis and can be very efficiently treated with recanalization techniques, confirmation of this putative association is urgently warranted in a large representative patient cohort to alert stroke clinicians, and inform pre- and in-hospital acute stroke patient pathways. We pooled all consecutive patients hospitalized with laboratory-confirmed COVID-19 and acute ischemic stroke in 28 sites from 16 countries. To assess whether stroke severity and outcomes (assessed at discharge or at the latest assessment for those patients still hospitalized) in patients with acute ischemic stroke are different between patients with COVID-19 and non-COVID-19, we performed 1:1 propensity score matching analyses of our COVID-19 patients with non-COVID-19 patients registered in the Acute Stroke Registry and Analysis of Lausanne Registry between 2003 and 2019. Between January 27, 2020, and May 19, 2020, 174 patients (median age 71.2 years; 37.9% females) with COVID-19 and acute ischemic stroke were hospitalized (median of 12 patients per site). The median National Institutes of Health Stroke Scale was 10 (interquartile range [IQR], 4–18). In the 1:1 matched sample of 336 patients with COVID-19 and non-COVID-19, the median National Institutes of Health Stroke Scale was higher in patients with COVID-19 (10 [IQR, 4–18] versus 6 [IQR, 3–14]), P =0.03; (odds ratio, 1.69 [95% CI, 1.08–2.65] for higher National Institutes of Health Stroke Scale score). There were 48 (27.6%) deaths, of which 22 were attributed to COVID-19 and 26 to stroke. Among 96 survivors with available information about disability status, 49 (51%) had severe disability at discharge. In the propensity score-matched population (n=330), patients with COVID-19 had higher risk for severe disability (median mRS 4 [IQR, 2–6] versus 2 [IQR, 1–4], P <0.001) and death (odds ratio, 4.3 [95% CI, 2.22–8.30]) compared with patients without COVID-19. Our findings suggest that COVID-19 associated ischemic strokes are more severe with worse functional outcome and higher mortality than non-COVID-19 ischemic strokes.

7 P De Togn e t a / , i b~d , p 703, T. A Banks et a1 , J /n?n?uno/ 155, 1685 (1 995) 8 Mce were ~mmun~zed intrapertoneally w~th 100 &I of phosphate-buffered sane contanng 10% SRBCs (22) Ten days later, spleens were harvested, embedded In 0 C.T compound (M~les), and frozen In q u d ntrogen Frozen t~ssue sections (6 to 10 &m th~ck) were f~xed n cold acetone Endogenous per-ox~dase was q~~enched w~th 0 2% H, O, n methanol Sectons were sta~ned by f~rst ncubatng w~t h PNA-b~o t~n (Vector) and w~th rat antserum produced to IgD (Southern B~otechnology) After wash~ng, the sections were further incubated w~th strepta\/id~n conj~lgated w~th alkalne phosphatase (AP) (Zymed) and rabb~t ant~body to rat IgG conjugated w~th horse-rad~sh perox~dase (HRP) (Southern B~otechnology) Color development for bound AP and HRP was w~th an AP reacton k~t (Vector) and w~t h d~arn~nobenz-d~ne Sect~ons were then countersta~ned w~th 1 % methyl green 9 M. L Rose, M S C B~rbeck, V J Wall~s, J A Forrester. A J Daves. Nature 284, 364 (1980) 10 T

In these very advanced HIV-infected ARV-naive subjects, EFV-based highly active antiretroviral therapy had superior virologic efficacy than LPV/r-based highly active antiretroviral therapy, with a more favorable lipid profile.

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Three isolates of Histoplasma capsulatum were identified from mice lung, liver, and spleen inoculated with soil samples of the X hotel's ornamental potted plants that had been fertilized with organic material known as compost. The presence of H. capsulatum in the original compost was detected using the dot-enzyme-linked immunosorbent assay. Nested-PCR, using a specific protein Hcp100 coding gene sequence, confirmed the fungal identification associated with an unusual histoplasmosis outbreak in Acapulco. Although, diversity between the H. capsulatum isolate from the hotel and some clinical isolates from Guerrero (positive controls) was observed using random amplification of polymorphic DNA based-PCR, sequence analyses of H-anti and ole fragment genes revealed a high homology (92-99%) between them.