-associated infective endocarditis: Case series, literature review, and genetic study.

Key Clinical Message: -associated endocarditis is a rare occurrence, raising diagnostic challenges, and is often associated with considerable morbidity. However, vigilance can prevent devastating consequences.

Abstract: -associated endocarditis is rarely reported but often associated with considerable morbidity.

Innovative dual-function protective scope mask and filtration system for aerosol generating ENT scope procedures.

Background: Aerosol-generating procedures (AGPs), such as nasoendoscopy, are considered high-risk during the COVID-19 pandemic due to risk of virus aerosol transmission. We aim to evaluate the efficacy of an innovative system in reduction of aerosol contamination.

Methods: Pilot study involving 15 healthy volunteers performing aerosol-generating activities with the prototype, compared with and without a standard surgical mask.

The first imported case of monkeypox in Singapore during the 2022 outbreak - Reflections and lessons.

On June 21, 2022, Singapore reported its second ever case of imported monkeypox and first linked to the ongoing multi-country outbreak that has since been declared a public health emergency of international concern. There was quick initiation of public health measures including identification and quarantine of contacts, with post-exposure smallpox vaccination.

Heterologous booster vaccination with CoronaVac following prime vaccination with mRNA vaccine.

Objective: Despite the high vaccine efficacy of mRNA COVID-19 vaccines, there are individuals who developed excessive reactogenic and/or allergic responses after the first mRNA dose and were considered ineligible for further mRNA doses. CoronaVac, an inactivated SARS-CoV-2 vaccine, is recommended in Singapore as an alternative.

Methods: Individuals, ineligible for further mRNA vaccines (BNT162b2 or mRNA-1273) because of excessive reactive responses to prime mRNA vaccination, were recruited and offered two doses of CoronaVac as booster vaccination 38-224 days post their mRNA vaccine dose.

Organ-specific immune response in lethal SARS-CoV-2 infection by deep spatial phenotyping.

Objectives: Immunopathology of ongoing COVID-19 global pandemic is not limited solely to pulmonary tissue, but is often associated with multi-organ complications, mechanisms of which are intensely being investigated. In this regard, the interplay between immune, stromal cells and cytokines in pulmonary and extrapulmonary infected tissues, especially in young adults (median age 46 years, range 30-53 years) without comorbidities, remains poorly characterised.

Methods: We profiled lung, heart and intestinal autopsy samples from five SARS-CoV-2-infected cases for 18-20 targets to detect immune, cytokine and stromal cell status at subcellular resolution by a novel IHC-based deep-phenotyping technique, iSPOT (immunoSpatial histoPhenOmics using TSA-IHC), to assess spatial and functional patterns of immune response , in lethal COVID-19 infection.

Human neutralising antibodies elicited by SARS-CoV-2 non-D614G variants offer cross-protection against the SARS-CoV-2 D614G variant.

Objectives: The emergence of a SARS-CoV-2 variant with a point mutation in the spike (S) protein, D614G, has taken precedence over the original Wuhan isolate by May 2020. With an increased infection and transmission rate, it is imperative to determine whether antibodies induced against the D614 isolate may cross-neutralise against the G614 variant.

Methods: Antibody profiling against the SARS-CoV-2 S protein of the D614 variant by flow cytometry and assessment of neutralising antibody titres using pseudotyped lentiviruses expressing the SARS-CoV-2 S protein of either the D614 or G614 variant tagged with a luciferase reporter were performed on plasma samples from COVID-19 patients with known D614G status ( = 44 infected with D614,  = 6 infected with G614,  = 7 containing all other clades: O, S, L, V, G, GH or GR).

Bracing for impact: operational upshots from the National Centre for Infectious Diseases Screening Centre (Singapore) during the COVID-19 outbreak.

To combat the ongoing COVID-19 pandemic, Singapore has adopted a rigorous screening approach that involves aggressive contact tracing, rapid isolation of confirmed or suspect cases, and immediate ring-fencing of emerging local clusters and hotspots. Our screening centre team has been involved in running Singapore's designated screening centre since the end of January this year. With a well-defined blueprint and substantial pre-outbreak preparatory work, initial operations at our screening centre commenced within a day on activation and full operational status was attained in 3 days.

Associations of viral ribonucleic acid (RNA) shedding patterns with clinical illness and immune responses in Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection.

Objectives: A wide range of duration of viral RNA shedding in patients infected with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has been observed. We aimed to investigate factors associated with prolonged and intermittent viral RNA shedding in a retrospective cohort of symptomatic COVID-19 patients.

Methods: Demographic, clinical and laboratory data from hospitalised COVID-19 patients from a single centre with two consecutive negative respiratory reverse transcription-polymerase chain reaction (RT-PCR) results were extracted from electronic medical records.

Safety and potential efficacy of cyclooxygenase-2 inhibitors in coronavirus disease 2019.

Objectives: While the safety of non-steroidal anti-inflammatory drugs in COVID-19 has been questioned, they may be beneficial given the hyper-inflammatory immune response associated with severe disease. We aimed to assess the safety and potential efficacy of cyclooxygenase-2 (COX-2) selective inhibitors in high-risk patients.

Methods: Retrospective study of patients with COVID-19 pneumonia and aged ≥ 50 years who were admitted to hospital.

Patients with acute and chronic coronary syndromes have elevated long-term thrombin generation.

Coronary artery disease is a leading cause of morbidity and mortality worldwide. Despite significant advances in revascularization strategies and antiplatelet therapy with aspirin and/or P2Y receptor antagonist, patients with acute coronary syndrome (ACS) continue to be at long-term risk of further cardiovascular events. Besides platelet activation, the role of thrombin generation (TG) in atherothrombotic complications is widely recognized.

Immunological observations and transcriptomic analysis of trimester-specific full-term placentas from three Zika virus-infected women.

Objectives: Effects of Zika virus (ZIKV) infection on placental development during pregnancy are unclear.

Methods: Full-term placentas from three women, each infected with ZIKV during specific pregnancy trimesters, were harvested for anatomic, immunologic and transcriptomic analysis.

Results: In this study, each woman exhibited a unique immune response with raised IL-1RA, IP-10, EGF and RANTES expression and neutrophil numbers during the acute infection phase.