Disease Spectrum in COVID-19 Cohort with Travel History from Iran

Background: Coronavirus disease 2019 (Covid-19), declared as a pandemic in March 2020, is an acute respiratory tract illness caused by coronavirus 2 (SARS-CoV2) with clinical manifestations ranging from mild upper respiratory tract symptoms to severe pneumonia. Objectives: To determine the disease spectrum of Covid-19 in a cohort with a travel history from Iran. Materials & Methods: This cross-sectional study with a retrospective collection of data was conducted at Agha Khan University, Karachi from 15th March to 19th April 2020. One hundred and fifty-five laboratory-confirmed cases of Covid-19 were recruited from a government quarantine facility. Data were obtained from the Punjab Emergency Services (Rescue 1122) database where a record of SARS-CoV-2 positive cases and quarantined persons is maintained. Study subjects with a travel history to Iran were contacted by telephone to obtain information about demographics, symptoms, and co-morbid conditions.  SPSS version 24 was used to analyze the data. Frequencies and percentages were calculated. Results: Among the returning travelers, 213 had laboratory-confirmed Covid-19, out of which 155 were included in this study. 56.1% were males with a mean age of 40 years. Among the study participants, 91.6% remained asymptomatic throughout the stay, while 8.4 % became symptomatic. 77.5% of the participants had received BCG vaccination in childhood. Among symptomatic cases 15.4% had asthma and 7.7% had hypertension. The most common clinical manifestation was cough which was present in 38.5% of the study participants. None died among the study participants. Conclusion: A mild presentation of COVID-19 was seen in our study participants with 91.6% among them being asymptomatic, while 8.4% were symptomatic. There was a high positivity rate in males as compared to females.  

Biochemical and Immunochemical Characteristics of Wheat Gluten

The current research work was undertaken to characterize different Pakistani wheat varieties for physicochemical, rheological, technological and immunochemical characteristics. The modification of wheat gluten through methionine binding to develop bread for celiac disease patients was also the main aim of this study. The results revealed that wheat varieties differ significantly for the characteristics studied. Significant effect of crop year was observed on grain width, moisture content, falling number value and dough rheological parameters. The antibody response against glutenin and HMW-GS was positively correlated to the total score of breads, chapattis and naans. The electrophoretic patterns of molecular weight of glutenin subunits of different wheat varieties showed the presence of glutenin subunits in the range of 28.23 to 110.89 kDa and 28.29 to 113.51 kDa, while total gliadin electrophoregrams ranged from 31.03 to 89.61 kDa and 32.91 to 92.22 kDa among different wheat varieties during the crop years 2010-11 and 2011-12, respectively. The wheat variety AARI-11 outperformed other varieties in most of the physico-chemical, rheological and technological characteristics. Therefore, it was selected for gluten modification. The immunoreactivity to the modified gluten proteins was decreased as the reaction proceeds and minimum immunoreactivity (26±0.37%) was observed near to 60 minutes of reaction time with 5% methionine added to the system. The results showed that the serum of each patient had positive IgA index to gliadins from unmodified gluten, but just sera of two patients had positive IgA index to gliadins from modified gluten and when these proteins were digested the sera of no patient’s serum had positive IgA reactivity. The gluten content in breads prepared with modified gluten was observed to be 79 ppm, which is within the limits set by Codex Alimentarius Commission. The study concludes that the methionine binding to gluten induced a remarkable reduction of celiac IgA immunoreactivity to gliadin. ELISA is a reliable method and can be used as single tool for the wheat quality assessment therefore it should be developed for all wheat varieties. Prospectus of modified gluten for different wheat based foodstuffs like the assayed bread in this study needs to be investigated. A research project should also be conducted to investigate the antibody response of modified gluten.