Background Since the pandemic of SARS-CoV-2 began, our understanding of the pathogenesis and immune responses to this virus has continued to evolve. It has been shown that this infection produces natural detectable immune responses in many cases. However, the duration and durability of immunity and its effect on the severity of the illness are still under investigation. Moreover, the protective effects of antibodies against new SARS-CoV-2 variants still remain unclear. Objectives To assess the incidence and associated demographic features of SARS-CoV-2 infection in anti-nucleocapsid IgG-positive and anti-nucleocapsid IgG-negative healthcare workers. Material and methods This prospective longitudinal cohort study was conducted in Peshawar Medical College group of hospitals of Prime Foundation. Anti-nucleocapsid IgG sero-positive and anti-nucleocapsid IgG sero-negative healthcare workers were followed for a period of 6 months (from 1 Aug 2020 to 31 Jan 2021), and the incidence of SARS-CoV-2 was confirmed by RT-PCR. Results A total number of 555 cohorts were followed for a period of 6 months; of them 365 (65.7%) were anti-nucleocapsid-negative (group A) and 190 (34.3%) were anti-nucleocapsid-positive (group B) healthcare workers. The mean age of the study cohort was 33.85 ± 9.80 (anti-N (–), 34.2 ± 10.58; anti-N ( +), 33.5 ± 9.50). The median antibody level in anti-nucleocapsid-positive HCWs was 15.95 (IQR: 5.24–53.4). Male gender was the majority in both groups (group A, 246 (67%), group B, 143 (48%)) with statistically significant difference ( P < 0.05). Majority of the HCWs were blood group B in both groups (34% each). None of the 190 anti-nucleocapsid-positive HCWs developed subsequent SARS-CoV-2 re-infection, while 17% ( n = 65) HCWs developed infection in anti-nucleocapsid-negative group during the 6-month follow-up period. Conclusion In conclusion, none of the anti-nucleocapsid-positive HCWs developed SARS-CoV-2 re-infection in this study, and the presence of IgG anti-nucleocapsid antibodies substantially reduce the risk of re-infection for a period of 6 months. Supplementary information The online version contains supplementary material available at 10.1007/s11845-022-02997-w.

Objective: To determine the clinical features, laboratory variants, and outcome of patients with Corona virus Dis- ease-2019 (COVID-19) infection. Methods: A descriptive, single-center case series was conducted between October to December 2020. It included patients diagnosed with COVID-19 infection via Polymerase Chain Reaction (PCR). Patients were recruited through non-probability convenience-based sampling. After history and detailed examination of the patients, their demographic and clinical characteristics, including complete blood count (CBC), renal & electrolytes profile, inflammatory markers like C-reactive protein (CRP), lactate dehydrogenase (LDH), ferritin, and D-dimers were recorded using a structured questionnaire. Patients were managed according to the severity of the disease and disease progression was monitored regularly. Treatment offered to these patients was based on their presentation and severity of the disease. Results:  Out of 1092 patients, 77% were males. Most of them were diabetic (71.0%) and aged between 51-70 years (58.97%). Furthermore, 1051 of the total enrolled cases were symptomatic and had shortness of breath (94.32%), dry cough (91.20%), anorexia (91.20%), fatigue (90.65%), and etc. Among the laboratory parameters, raised C-reactive protein (CRP) was found in 96.24% of patients while leukocyte count, Alkaline phosphatase (ALP), D-dimers, ferritin and lactate dehydrogenase (LDH) levels were elevated in 89.37%, 71.61%, 68.77%, 56.86%, and 44.04% respectively. Hyponatremia was also observed in 53.75% patients. Most patients (32.60%) had oxygen saturation between 80 to 89%, while it was   80% among 20.42% patients. Moreover, 31.05% patients were categorized as having mild disease, 23.68% had moderate severity, and 24.84% had severe disease on the basis of clinical criteria. About 20.42% were critical and had respiratory failure. The recovery rate was high (96.0%), and the mortality rate was only 4.0%. Conclusion: We observed dynamic changes in the clinical and laboratory features of the COVID-19 patient’s ad- mitted at District Health Quarter in Charsada, highlighting the significance of each of these parameters for individual patient’s recovery and survival.

No abstract

Objective: To assess the clinical outcome in treatment naïve and non-cirrhotic patients with HCV genotype 3 infection after treatment with Sofosbuvir with declastasvir and valpatasvir (in case of non-responsiveness). Methods: Study included 263 participants. The inclusion criteria were HCV genotype 3 infection confirmed through PCR, age above 18 years, treatment naïve and non-cirrhotic. HCV PCR below the threshold of quantification at 12th week of treatment was defined as SVR12 (sustained virological response). The patients were started on a fixed dose generic combination of declastasvir 60 mg and Sofosbuvir 400 mg and PCR was performed at 12, 24 and 48 weeks. PCR positive patients at 24 weeks were given valpatasvir with Sofosbuvir. Results: There were 162 males and 101 females. PCR performed at 12 weeks showed that 251 patients (95.4%) became PCR negative and 12 (4.56%) remained positive. Repeat PCR of these 12 patients started on valpatasvir and Sofosbuvir at 48 weekswas negative. The treatment was well tolerated by all.Probability of positive HCV PCR at 12 weeks decreases by 0.73 with one unit increase in the hemoglobin, whereas one unit increase in TLC reduces the probability of HCV PCR at 12 weeks, positive by 0.001. Conclusion: The combination of Sofosbuvir and declastasvir is a cheap and effective treatment strategy for treatment naïve and non-cirrhotic HCV genotype 3 infections. Those not responding will achieve PCR negativity with a 6 month therapy of Sofosbuvir and valpatasvir combination. A high hemoglobin level and high total leucocyte count are predictors of good treatment response.