MONDAY 6 DECEMBER 2021
D I AGN OSTI C TESTI NG
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CO N F E R E N C E N E W S PA P E R
Why is it important to understand diagnostic performance? THE SESSION “DIAGNOSTIC TESTING IN THE MANAGEMENT OF ACUTE RESPIRATORY INFECTIONS IN PRIMARY AND SECONDARY CARE”, WAS CHAIRED BY PROFESSOR MICHAEL ISON AND NICOLE TSANG. HERE, RESEARCHERS FROM VARIOUS COUNTRIES PRESENTED THEIR LATEST FINDINGS ON THE DIAGNOSTIC TESTING FOR SARS-COV-2. Since 2019, SARS-CoV-2 has spread globally with a number of confirmed cases growing to more than 263 million (as of December 3, 2021). Such increasing case number of COVID-19 further increases the heavy workload of healthcare workers directly incapacitating them from managing the pandemic in a timely and appropriate manner. Accurate and scalable testing capacity in different stages is very important to relieve clinical management, as the timely recognition of COVID-19 is critical for preventing nosocomial transmission. The risk of hospital-acquired COVID-19 (HA-COVID-19) infection is increased by cohorting infected and non-infected patients together in assessment areas whilst awaiting laboratory PCR results. Molecular point-of-care (mPOCT) testing for SARS-CoV-2 has been shown to reduce time to results and improve patient flow but the impact on HA-COVID-19 is unknown. Robert Livingstone from University Hospital Southampton, United Kingdom presented the impact of routine molecular point-of-care testing on hospital-acquired COVID-19 infection. During his intervention, he showed that routine mPOCT for SARSCoV-2 was associated with a reduced time
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to results, time spent in admission cohort areas, and proportion of HA-COVID-19. “Routine use of mPOCT should become the standard of care in hospital admission pathways”. Prognostic biomarkers could be used early in infection to identify the patient’s risk of severe disease. Kirsty Short from the University of Queensland, Australia examined the IFI27 transcription as a prognostic biomarker for COVID-19 and showed IFI27 expression is associated with the high viral load in the lung. While not as a prognostic marker in nasopharyngeal samples, the IFI27 expression in the blood is associated with COVID-19 severity. IFI27 expression in the blood likely predicts disease outcome in individual patients. This research suggested that diagnostic tools targeting IFI27 expression are likely to be of prognostic use in future viral pandemics. As data suggests, it can also be used for other respiratory virus infections. “IFI27 transcription in blood sample may potentially be developed into a prognostic biomarker”, to facilitate both patient triage and resource prioritisation. Monitoring virus shedding can inform isolation and discharge decisions of 1
confirmed cases, so to allocate the health resources to patients with higher needs and complications. Instead of the invasive nasopharyngeal swabs, gargling has been recently examined but the performance remains unclear. Nicole Ngai Yung Tsang from the University of Hong Kong, Hong Kong SAR presented the performance of using gargle for monitoring viral shedding in confirmed COVID-19 patients. Analysis revealed gargling is a good approach to monitor viral shedding. On occasions where swab materials, personal protective equipment and manpower are in short supply, “gargling offered scalable capacity for frequent and easily arrangeable SARS-CoV-2 testing” and to inform patients discharge from hospitals and isolation facilities in resource-limited and remote settings in a more efficient manner.
ESWI Viral Times is brought to you by a team of young scientists. More on page 3.
#ESWI VIRAL TIMES
MONDAY 6 DECEMBER 2021
CO-IN FECTI O NS I N I NFLU E N ZA, R S V D I S E AS E AN D COV ID -19
Co-infections in all its aspects 1. SARS-CoV-2 replication inhibition by co-infecting respiratory viruses Previous research has shown that Rhinovirus infection causes an antiviral effect on the replication of influenza A virus and SARS-CoV-2 in infected respiratory epithelial cells. Kieran Dee from the University of Glasgow, United Kingdom, investigated the effect of Influenza A Virus (IAV) or Respiratory Syncytial Virus (RSV), on SARS-CoV-2 replication in air-liquid interface cultures of human bronchial cells. Both IAV and RSV inhibited SARS-CoV-2 replication, which was associated with innate antivirals. Interestingly, SARS-CoV-2 infection did not prevent RSV and IAV replication Kieran mentioned, “the closer the two individual infections occur in time, the higher the impact on SARS-CoV-2 replication is”
Katarzyna Schewe used ferrets as a model to study the effect on the pathogenesis of simultaneous replication of LAIV and SARSCoV-2. LAIV was delivered 3 days before or after SARS-CoV-2 infection. Irrespective of the order of LAIV administration, SARSCoV-2 infection did not exacerbate virus replication nor pathology. Instead, LAIV given before SARS-CoV-2 infection reduced viral replication and shedding from the upper respiratory tract of ferrets. 3. Legionella pneumophila and influenza infection in human cells In 2009, during the H1N1 pandemic, co-infections with Legionella pneumophila were reported. Maria Schwerdtner from Philipps-University Marburg, Germany investigated whether L. pneumophila affects hemagglutinin (HA)-cleavage of IAV, and identified two mechanisms. First, secreted L. pneumophila metalloprotease ProA mediates functional HA-activation of HINI and H3N2 viruses in Hela-cells and this activation is dependent on the host cell serine protease PRSS21.
! Figure shows infection in differentiated airway epithelial cultures with different respiratory viruses.
2. Sequential delivery of LAIV and SARS-CoV-2 reduces virus shedding and lung pathology in ferrets. Live Attenuated Influenza Vaccine (LAIV) is a valuable tool against influenza. However, as LAIV is replication-competent and delivered intranasal, it might result in replication of SARS-CoV-2 and LAIV simultaneously.
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4. Viral co-infections in hospitalised COVID-19 patients Recent studies have shown that viral co-infection might increase the severity of COVID-19 and thus increase hospital admissions, morbidity and mortality. Dr Elen Vink from the University of Glasgow, United Kingdom, discussed that viral co-infection does not occur often in a well-characterised cohort of hospitalised COVID-19 patients in Scotland during the first 8 months of the pandemic. Elen screened around 300 upper respiratory tract samples (URT) of COVID-19 patients admitted to 8 different Scottish hospitals. The average patient age was 60 and about 60% of patients were male. Out of this sample, 17.6% of patients required mechanical ventilation and 13.1% died in hospital. About 3% of patients reported a co-infection with other respiratory viruses involving Rhinovirus (1%), Parainfluenza virus (0.7%), Influenza B virus (0.3%), human coronavirus NL63 (0.3%), and parainfluenza viruses 2 and 3 (0.3%). Elen suggested a larger cohort to study the impact on disease severity.
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MONDAY 6 DECEMBER 2021
YO UN G SCI ENTI S EDI TOR I AL TE AM
Respiratory Voices PROFILE PAGE
ESWI is proud to present to you its brand new team of Young Scientist reporters actively covering the 8th ESWI Influenza Conference for the 2021 edition of the ESWI Viral Times. Spearheaded by this year's Young Scientist Ambassador Dr Debby van Riel, Erasmus MC, they will provide you with interesting content on the sessions they followed and shed more light on the next generation of influenza, COVID-19 and RSV scientists. Warm welcome to them and exciting reading to you!
PROFILE PAGE
NAME: Shiyamalee Arunasalam
NAME: Margaret Lugin
BASED IN: Sri Lanka
BASED IN: Michigan, US
BACKGROUND: Bachelor’s degree in Medical
BACKGROUND: Chemical Engineering at the
CURRENT OCCUPATION: MPhil student
Master’s and PhD in Chemical and Biochemical Engineering at the University of California, Irvine
Laboratory Sciences from the University of Peradeniya in Sri Lanka
attached to the Diagnostic and Research Virology Laboratory in the Medicine Faculty of the University of Peradeniya, Sri Lanka PREVIOUS EXPERIENCE: Researcher on
circulating respiratory viruses in collaboration with Virology Laboratory at National Hospital Kandy, Sri Lanka
PROFILE PAGE
University of Michigan, Ann Arbor
CURRENT OCCUPATION: Scientist at BlueWillow
Biologics, vaccine company
FOCUS: Gene therapy, virology, and oncology
PROFILE PAGE
PROFILE PAGE
NAME: Nicole Ngai Yung Tsang
NAME: Ritika Khatri
NAME: Miriam Ruth Heindl
BASED IN: Hong Kong
BASED IN: India
BASED IN: Germany
BACKGROUND: Postgraduate in infectious
BACKGROUND: Genetic Manipulations and
BACKGROUND: Bachelor’s degree in Biology
CURRENT OCCUPATION: PhD candidate in the
CURRENT OCCUPATION: Senior Project
Master’s in Molecular and Cellular Biology from the Philipps University, Marburg
diseases and epidemiology, and MPH from the University of Hong Kong, Hong Kong SAR School of Public Health, Li Ka Shing Faculty of Medicine at the University of Hong Kong, Hong Kong SAR FOCUS: Epidemiology and the effectiveness
of major control and preventive strategies of respiratory infectious diseases of epidemic potential
Molecular Cell Biology from the University of Sussex, UK Associate in a Virology lab at Translational Health Science and Technology Institute, India PREVIOUS EXPERIENCE: Developing vaccine
candidates against Mycobacterium Tuberculosis as Junior Project Associate at the Indian Institute of Science (IISc) FOCUS: Influenza Virus and SARS-CoV-2 in
the BSL-III lab (testing drugs and antibodies, evaluating the role of host factors responsible for the virus infections) 3
with a specialisation in Cell Biology from the Philipps University, Marburg
CURRENT OCCUPATION: Finalising PhD thesis
on the activation of RSV, Influenza and SARS-CoV-2 and working at the BöttcherFriebertshäuser lab on Influenza viruses
FOCUS: Activation of fusion proteins in several
viruses
#ESWI VIRAL TIMES
MONDAY 6 DECEMBER 2021
I NN AT E AND ADAPTI VE I MMU N I TY TOWAR D S I N F LU ENZ A , R S V D IS EA S E A ND COV ID -19
Characterization of antibody response in asymptomatic and symptomatic SARS-CoV-2 infection THE COVID-19 PANDEMIC, CAUSED BY THE SARS-COV-2 VIRUS, CONTINUES TO DEVASTATE THE WORLD AS IT ENTERS ITS THIRD YEAR OF GLOBAL SPREAD. ONE DISTINCT FACET OF COVID-19 IS THE PROMINENCE OF ASYMPTOMATIC CARRIERS, WHICH CONTRACT AND CAN PASS ON SARS-COV-2 WITHOUT EXHIBITING SYMPTOMS. SERENA MARCHI EXPLORED THE ANTIBODY RESPONSE BY ASYMPTOMATIC AND SYMPTOMATIC SARS-COV-2 INFECTED PATIENTS TO DETERMINE THE DIFFERENCE IN THE IMMUNE RESPONSE TO INFECTIONS AND THE EFFECT OF NEW MUTANTS ON ANTIBODY RESPONSE. Serum samples were collected throughout the hospital stays of symptomatic COVID-19 patients ranging from day two to day 30 or in the case of discharge or death from disease. In asymptomatic COVID-19 infections, serum samples were collected at the time of positive test, two months after infection, and six months after infection. This allowed researchers to look at long term protective immunity from asymptomatic SARS-CoV-2 infection, the difference in antibody response to each kind of infection, and different variants. The hospitalised patients with COVID-19 had a strong antibody response against all variants. There was no significant difference in antibody titers between those that recovered from the disease and those that succumbed to the disease. Therefore antibody titers were not a reasonable determination of disease prognosis. After the original Wuhan strain, every variant elicited fewer antibodies, with beta eliciting the fewest.
In asymptomatic COVID-19 subjects, 64% were found to have no detectable antibody titers at any time point, regardless of variants. In the subjects with an antibody response, it was significantly reduced compared to symptomatic infection. Therefore, there is little to no immunity conferred by asymptomatic infection. These results show that antibody response does not determine prognosis in severe COVID-19 infection, as both patients who recovered and succumbed to disease had similar antibody levels. Antibody titers were reduced in patients infected with COVID-19 variants compared to the original strain, indicating poorer induced immunity and a higher likelihood of reinfection after contracting a COVID-19 variant. Finally, asymptomatic COVID-19 carriers mount minimal or no antibody response to COVID-19, meaning little to no protection from future reinfection.
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POSTER SESSIONS
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B Y MAR GA RE T LU G IN
#ESWI VIRAL TIMES
MONDAY 6 DECEMBER 2021
YO UN G SCI ENTI STS I NT E R V I E W S
Generation ESWI
B Y M IRIAM RUT H HEIND L
TEMITOPE FALEYE
GALINA LANDGRAF
PROFILE PAGE
FELINE BENAVIDES
PROFILE PAGE
PROFILE PAGE
WHAT DO YOU WANT TO ACCOMPLISH AS A
Temitope Faleye WHO ARE YOU?
I am a Nigerian male, husband and father currently resident in Tempe, Arizona with my family. I’m a postdoctoral fellow at the Center for Environmental Health Engineering, Biodesign Institute, Arizona State University. I have a Bachelor’s degree in microbiology and a Master’s and PhD in Virology, both from the University of Ibadan, Nigeria. My research focuses on molecular epidemiology of viruses of medical importance, documenting presence and diversity in populations using clinical samples, wastewater, and sewage-contaminated surface water. HOW DID YOU EXPERIENCE THE COVID PANDEMIC AS AN UPCOMING SCIENTIST IN THE FIELD OF INFLUENZA, RSV AND SARS-COV-2?
The pandemic has impacted us all in ways we couldn’t have fathomed. One thing that has particularly stuck with me is that our success with SARS-CoV-2 to this date is based on important work done by obscure but brilliant minds globally. It re-emphasises the need for scientists to keep investigating basic scientific topics that intrigue them irrespective of how the community perceives the relative importance of such topics.
SCIENTIST IN THE NEAR FUTURE?
I have been lucky to have great mentors who provided me with a safe environment to express myself and develop as a scientist. I desire to do the same for brilliant young minds, enabling them to tackle viruses of medical importance with a particular focus on emerging but neglected viruses circulating in tropical regions of the world.
Galina Landgraf WHO ARE YOU?
I am Galina Landgraf and I am a Junior Researcher at the St. Petersburg State University. HOW DID YOU EXPERIENCE THE COVID PANDEMIC AS AN UPCOMING SCIENTIST IN THE FIELD OF INFLUENZA, RSV AND SARS-COV-2?
The COVID pandemic allowed me to spend more time working on my PhD dissertation. WHAT DO YOU WANT TO ACCOMPLISH AS A SCIENTIST IN THE NEAR FUTURE?
Next year, I will submit my PhD dissertation “Molecular cell markers in the preclinical characterisation of multivalent vaccines against influenza and bacterial complications” for which I have a patent. Afterwards, I plan to research immunology and virology according to my thesis topic. 5
Feline Benavides WHO ARE YOU?
I am Feline Benavides, a PhD candidate at the Erasmus MC’s Viroscience department led by Dr Debby van Riel in the Netherlands. HOW DID YOU EXPERIENCE THE COVID PANDEMIC AS AN UPCOMING SCIENTIST IN THE FIELD OF INFLUENZA, RSV AND SARS-COV-2?
The COVID pandemic has been hard on all of us, of course. On the one hand, the lockdowns were sometimes lonely, and online meetings were definitely not the same as physical ones. But on the other hand, it did give me a lot of chances. The confinement somehow gave me the time I needed to change the path of my Master’s to get more involved in the field of virology by starting an internship in that field. Thanks to this I met amazing people and learned a ton about different viruses, from influenza to SARS-CoV-2. WHAT DO YOU WANT TO ACCOMPLISH AS A SCIENTIST IN THE NEAR FUTURE?
Since I just started my PhD, I would like to have a nice four years of cool and innovative research into different influenza viruses.
#ESWI VIRAL TIMES
MONDAY 6 DECEMBER 2021
BEH IN D THE SCENES
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#ESWI VIRAL TIMES
MONDAY 6 DECEMBER 2021
S OCIE TAL I MPACT O F I N F LU E N ZA AN D COV I D - 1 9
The impact of Influenza and COVID on us.
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S HIYAMALE E A RUNA S A LA M
The session “Societal impact of influenza and COVID-19” chaired by Terho Heikkinen University of Turku, Finland, presented the latest findings on the impact of influenza and COVID-19 on the global society. Terho Heikkinen discussed the importance of vaccinating children against influenza. Influenza places a great burden especially on young children because they are the main transmitters of influenza in the community. Rather than the non-pharmaceutical measures, vaccination is considered as one of the effective preventive actions against many viral infections. Influenza vaccines are effective in preventing disease, complications and hospitalisations in young children. He concluded that vaccination of children is beneficial primarily for children themselves, but also other members of society. Caroline de Courville, Sanofi Pasteur, Lyon, France discussed the economic burden of Influenza among adults aged 1864. Her systematic review reported on the direct cost and hospitalisation cost caused by influenza. Hospitalisation and influenzarelated costs increased with age with more variability observed in more than 65 years of age. Direct costs represent ~20% in 18 to 64 years of age and are driven by hospitalisations. Up to 59% of people usually take sick leave due to influenza for 2 to 7 days and these indirect costs represent ~80% in 18 to 64 years of age which directly leads to the economic burden of influenza in adults.
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symptoms and capture changes in disease severity. The symptoms of infection with coronavirus (SIC) composite scores were reliable and valid, supporting their use as appropriate and useful measures of COVID-19 symptom severity in clinical trials of COVID-19 vaccines and treatment in adults. Additional longitudinal analyses are ongoing to strengthen the psychometric properties of the SIC. A cross-sectional study to support the content validity of a patient-reported outcome measure of COVID-19 was carried out to collect additional evidence to support the content validity of the SIC by Carla DeMuro Romano RTI Health Solutions, United States. He reported a range of disease severity and comorbidities among the study participants. comorbidities include asthma, COPD,
Valerie Williams, NC, USA, evaluated the Psychometric Properties of a PatientReported Outcome Measure for the Assessment of COVID-19 signs and symptoms. The psychometric evaluation supported the use of COVID-19 symptoms in studies of vaccines and therapies for COVID-19 in adults. COVID-19 specific patient-reported outcome (PRO) instruments were needed to accurately measure COVID-19 signs and 7
hypertension, heart disease, obesity and type 1 diabetes. Patients described a broad range of signs and symptoms of COVID-19. The top symptoms experienced by patients with COVID-19 were fatigue (80%), cough and shortness of breath (65%), decreased sense of taste and smell (60%), headache (55%), and nasal congestion (50%). Symptoms such as shortness of breath, headache and fatigue required complete resolution before resuming normal activities and cough and congestion needed improvement but not necessarily resolution before resuming activities. Moreover, Carla DeMuro Romano emphasised that the additional evidence obtained regarding the complex and symptomatic experience of COVID-19 support the use of the SIC in treatment and vaccine clinical trials and may also contribute to a potential role in the diagnosis and evaluation of long COVID-19.
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MONDAY 6 DECEMBER 2021
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