Nurse Infected with Covid-19 from a Provisional Dengue Patient. Emerging Microbes & Infections. Accepted .

Background: Clinical spectrum of Coronavirus Disease 2019 (COVID-19) remains unclear, especially with regard to the presence of pneumonia. We aimed to describe the clinical course and final outcomes of adult patients with laboratory-confirmed COVID-19 in the full spectrum of disease severity. We also aimed to identify potential predictive factors for COVID-19 pneumonia. Methods and findings: We conducted a retrospective study among adult patients with laboratory-confirmed COVID-19 who were hospitalized at Bamrasnaradura Infectious Diseases Institute, Thailand, between January 8 and April 16, 2020. One-hundred-and-ninety-three patients were included. The median (IQR) age was 37.0 (29.0-53.0) years, and 58.5% were male. More than half (56%) of the patients were mild disease severity, 22% were moderate, 14% were severe, and 3% were critical. Asymptomatic infection was found in 5%. The final clinical outcomes in 189 (97.9%) were recovered and 4 (2.1%) were deceased. The incidence of pneumonia was 39%. In multivariable logistic regression, increasing age (OR 2.55 per 10-year increase from 30 years old; 95% CI, 1.67-3.90; p<0.001), obesity (OR 8.74; 95%CI, 2.06-37.18; p=0.003), and higher temperature at presentation (OR 4.59 per 1°C increase from 37.2 °C; 95% CI, 2.30-9.17; p<0.001) were potential predictive factors for COVID-19 pneumonia. Conclusion: Across the spectrum of disease severities, most patients with COVID-19 in our cohort had good final clinical outcomes. COVID-19 pneumonia was found in one-third of them. Older age, obesity, and higher fever at presentation were independent predictors of COVID-19 pneumonia. Author summary: This report describes the clinical course and final clinical outcomes of the full spectrum of disease severity of Coronavirus Disease 2019 (COVID-19) and evaluates risk factors of pneumonia in 193 laboratory-confirmed cases of COVID-19 in the Bamrasnaradura Infectious Diseases Institute, Thailand. The majority of patients with COVID-19 had mild disease. COVID-19 pneumonia was found in approximately 40% of patients. Older age, obesity, and higher grade of fever at presentation were independent risk factors of pneumonia in adult patients with COVID-19. Most patients in our cohort recovered and were discharged from hospital (recovery rate, 98%). Our findings can help the public health systems to estimate the burden of the disease and identify vulnerable patients in a timely manner.

Background: Tuberculosis (TB) remains a leading cause of death among people living with HIV (PLWH), yet diagnostic methods vary in accuracy, accessibility, and implementation. Understanding how diagnostic modality influences TB detection is essential to optimizing co-infection management. Methods: We conducted a retrospective analysis of institutional data from Bamrasnaradura Infectious Diseases Institute (BIDI), Thailand, covering 2016–2023. TB detection rates were assessed across five diagnostic methods—chest radiography (CXR), smear microscopy, acid-fast bacilli (AFB) staining, culture, and GeneXpert MTB/RIF—relative to annual HIV-related visit volumes. Results: Among 56,599 HIV-related visits, TB detection rates varied substantially by diagnostic method. CXR was the most commonly used tool, detecting TB in up to 99 cases out of 6964 visits (1.42%) in 2016, though declining to 23 cases out of 6947 visits (0.33%) in 2023. GeneXpert was employed more consistently, yielding between 7 cases out of 7577 visits (0.09%) and 13 cases out of 6593 visits (0.20%) annually. Smear microscopy and AFB staining declined markedly, falling below 0.22% after 2020. These patterns reflect a gradual transition toward molecular diagnostics, which offer improved accuracy but remain underutilized in lower-tier settings. To address these gaps, we incorporated trend analyses confirming significant temporal shifts and propose a tiered TB screening framework tailored to resource availability across healthcare levels. Conclusions: TB detection among PLWH is strongly influenced by the diagnostic method used. Unlike HIV diagnosis—which is definitive and standardized—TB diagnosis remains fragmented and resource-dependent. Context-sensitive screening protocols are urgently needed to improve TB case detection and management, particularly in lower-level HIV care facilities.

Background: Latent tuberculosis infection (LTBI) is a major global health concern, particularly among individuals with chronic kidney disease (CKD), who are at increased risk of reactivation due to impaired immunity and frequent exposure to immunosuppressive therapies. Despite growing reliance on interferon-gamma release assays (IGRAs) such as QuantiFERON-TB Gold In-Tube (QFT-GIT) in BCG-vaccinated populations, data on IGRA performance across CKD stages remain limited in resource-limited settings. Objective: To determine the prevalence of LTBI and indeterminate IGRA results across CKD stages in a Thai population and assess the clinical utility of IGRA in this context. Materials and Methods: We conducted a cross-sectional study among 785 Thai adults receiving care at a national infectious disease institute, including diabetes clinic patients, hospital staff, and individuals on hemodialysis. Each participant underwent QFT-GIT testing, and the CKD stage was classified using the estimated glomerular filtration rate (eGFR) closest prior to testing. Results: Overall IGRA positivity was 22.2%, peaking in CKD stage G3 (31.6%) and declining in stage G5 (11.0%), where indeterminate results were also highest (6.8%). Limitations: Single-center design and lack of confirmatory testing may limit generalizability. Conclusions: IGRA performance is reliable in early-to-moderate CKD but less so in advanced stages. LTBI is prevalent in CKD stages G2–G4, supporting stage-specific approaches to LTBI screening and caution against overreliance on IGRA in advanced renal impairment.

Mulberry fruit extract (MFE) has been reported to show remarkable anti-obesity properties in vitro. While the trend for nutraceuticals is increasing, the study on the antiobesity potential of MFE in humans is limited. This study aimed to develop and evaluate the nutraceutical from MFE and examine the effects of the MFE capsule on anthropometric measures in overweight and obese adults. The nutraceutical was developed, and quality control was carried out. Cyanidin-3-O-glucoside, the major bioactive compound in MFE, was found at 21.50±0.54 mg in each MFE capsule when analyzed by using the validated HPLC method. The weight variation, disintegration, and dissolution profile of MFE capsules were acceptable within the USP 42 requirement for dietary supplements. A total of thirty-two overweight participants were assigned to consume a capsule containing MFE or a placebo capsule daily for 8 weeks in a randomized, double-blinded, and placebo-controlled trial (n = 16 per group). At the end of the study, MFE intake significantly caused a reduction in the visceral fat level when compared to the placebo group (p < 0.05). Moreover, in the MFE group, body weight, BMI, waist circumference, subcutaneous fat of the whole body, trunk, arms, and legs, total body fat, and visceral fat were significantly decreased (p < 0.001). In conclusion, MFE was successfully developed into capsules. MFE capsules showed a favourable effect in reducing anthropometric measurements in overweight and obese adults. This is the first report on the promising anti-obesity potential of MFE capsules in humans.