4951
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Sinclair A, Abdelhafiz A. Age, frailty and diabetes - triple jeopardy for vulnerability to COVID-19 infection. EClinicalMedicine 2020; 22:100343. [PMID: 32328575 PMCID: PMC7177130 DOI: 10.1016/j.eclinm.2020.100343] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 03/27/2020] [Indexed: 12/18/2022] Open
Affiliation(s)
- A.J. Sinclair
- Foundation for Diabetes Research in Older People, Diabetes Frail Ltd, Droitwich Spa, WR9 0QH, UK and Kings College, London, SE1 9NH, United Kingdom
| | - A.H. Abdelhafiz
- Department of Geriatric Medicine, Rotherham General Hospital, Moorgate Road, Rotherham S60 2UD, United Kingdom
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4952
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Dong E, Du H, Gardner L. An interactive web-based dashboard to track COVID-19 in real time. THE LANCET. INFECTIOUS DISEASES 2020; 20:533-534. [PMID: 32087114 PMCID: PMC7159018 DOI: 10.1016/s1473-3099(20)30120-1] [Citation(s) in RCA: 5924] [Impact Index Per Article: 1481.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 02/13/2020] [Indexed: 02/07/2023]
Affiliation(s)
- Ensheng Dong
- Department of Civil and Systems Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Hongru Du
- Department of Civil and Systems Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Lauren Gardner
- Department of Civil and Systems Engineering, Johns Hopkins University, Baltimore, MD 21218, USA.
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4953
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Affiliation(s)
- Colin Binns
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Wah Yun Low
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Asia-Europe Institute, University of Malaya, Kuala Lumpur, Malaysia
| | - Lee Mi Kyung
- College of Science, Health, Engineering and Education, Murdoch University, Perth, Western Australia, Australia
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4954
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Halpin DMG, Faner R, Sibila O, Badia JR, Agusti A. Do chronic respiratory diseases or their treatment affect the risk of SARS-CoV-2 infection? THE LANCET. RESPIRATORY MEDICINE 2020; 8:436-438. [PMID: 32251625 PMCID: PMC7270536 DOI: 10.1016/s2213-2600(20)30167-3] [Citation(s) in RCA: 484] [Impact Index Per Article: 121.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 03/31/2020] [Indexed: 12/31/2022]
Affiliation(s)
- David M G Halpin
- University of Exeter Medical School, College of Medicine and Health, University of Exeter, Exeter EX1 2LU, UK.
| | - Rosa Faner
- Respiratory Institute, Hospital Clinic, August Pi i Sunyer Biomedical Research Institute, University of Barcelona and National Spanish Network for Respiratory Research, Barcelona, Spain
| | - Oriol Sibila
- Respiratory Institute, Hospital Clinic, August Pi i Sunyer Biomedical Research Institute, University of Barcelona and National Spanish Network for Respiratory Research, Barcelona, Spain
| | - Joan Ramon Badia
- Respiratory Institute, Hospital Clinic, August Pi i Sunyer Biomedical Research Institute, University of Barcelona and National Spanish Network for Respiratory Research, Barcelona, Spain
| | - Alvar Agusti
- Respiratory Institute, Hospital Clinic, August Pi i Sunyer Biomedical Research Institute, University of Barcelona and National Spanish Network for Respiratory Research, Barcelona, Spain
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4955
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Yang J, Zheng Y, Gou X, Pu K, Chen Z, Guo Q, Ji R, Wang H, Wang Y, Zhou Y. Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis. Int J Infect Dis 2020; 94:91-95. [PMID: 32173574 PMCID: PMC7194638 DOI: 10.1016/j.ijid.2020.03.017] [Citation(s) in RCA: 2420] [Impact Index Per Article: 605.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 03/04/2020] [Accepted: 03/05/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND An outbreak of coronavirus disease 2019 (COVID-19) occurred in Wuhan, China; the epidemic is more widespread than initially estimated, with cases now confirmed in multiple countries. AIMS The aim of this meta-analysis was to assess the prevalence of comorbidities in the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infected patients and the risk of underlying diseases in severe patients compared to non-severe patients. METHODS A literature search was conducted using the databases PubMed, EMBASE, and Web of Science through February 25, 2020. Odds ratios (ORs) and 95% confidence intervals (CIs) were pooled using random-effects models. RESULTS Seven studies were included in the meta-analysis, including 1 576 infected patients. The results showed the most prevalent clinical symptom was fever (91.3%, 95% CI: 86-97%), followed by cough (67.7%, 95% CI: 59-76%), fatigue (51.0%, 95% CI: 34-68%) and dyspnea (30.4%, 95% CI: 21-40%). The most prevalent comorbidities were hypertension (21.1%, 95% CI: 13.0-27.2%) and diabetes (9.7%, 95% CI: 7.2-12.2%), followed by cardiovascular disease (8.4%, 95% CI: 3.8-13.8%) and respiratory system disease (1.5%, 95% CI: 0.9-2.1%). When compared between severe and non-severe patients, the pooled OR of hypertension, respiratory system disease, and cardiovascular disease were 2.36 (95% CI: 1.46-3.83), 2.46 (95% CI: 1.76-3.44) and 3.42 (95% CI: 1.88-6.22) respectively. CONCLUSION We assessed the prevalence of comorbidities in the COVID-19 patients and found that underlying disease, including hypertension, respiratory system disease and cardiovascular disease, may be risk factors for severe patients compared with non-severe patients.
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Affiliation(s)
- Jing Yang
- Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, China; The First Clinical Medical School of Lanzhou University, Lanzhou, China
| | - Ya Zheng
- Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, China; Key Laboratory for Gastrointestinal Diseases of Gansu Province, The First Hospital of Lanzhou University, Lanzhou, China
| | - Xi Gou
- Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, China; Gastrointestinal Endoscopy Center, Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, China
| | - Ke Pu
- Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, China; The First Clinical Medical School of Lanzhou University, Lanzhou, China
| | - Zhaofeng Chen
- Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, China; Gastrointestinal Endoscopy Center, Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, China
| | - Qinghong Guo
- Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, China; Key Laboratory for Gastrointestinal Diseases of Gansu Province, The First Hospital of Lanzhou University, Lanzhou, China; Gastrointestinal Endoscopy Center, Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, China
| | - Rui Ji
- Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, China; Key Laboratory for Gastrointestinal Diseases of Gansu Province, The First Hospital of Lanzhou University, Lanzhou, China; Gastrointestinal Endoscopy Center, Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, China
| | - Haojia Wang
- The First Clinical Medical School of Lanzhou University, Lanzhou, China
| | - Yuping Wang
- Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, China; Key Laboratory for Gastrointestinal Diseases of Gansu Province, The First Hospital of Lanzhou University, Lanzhou, China.
| | - Yongning Zhou
- Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, China; Key Laboratory for Gastrointestinal Diseases of Gansu Province, The First Hospital of Lanzhou University, Lanzhou, China; Gastrointestinal Endoscopy Center, Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, China.
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4956
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Alberici F, Delbarba E, Manenti C, Econimo L, Valerio F, Pola A, Maffei C, Possenti S, Piva S, Latronico N, Focà E, Castelli F, Gaggia P, Movilli E, Bove S, Malberti F, Farina M, Bracchi M, Costantino EM, Bossini N, Gaggiotti M, Scolari F. Management of Patients on Dialysis and With Kidney Transplantation During the SARS-CoV-2 (COVID-19) Pandemic in Brescia, Italy. Kidney Int Rep 2020; 5:580-585. [PMID: 32292866 PMCID: PMC7128395 DOI: 10.1016/j.ekir.2020.04.001] [Citation(s) in RCA: 173] [Impact Index Per Article: 43.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 04/02/2020] [Indexed: 12/30/2022] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as coronavirus disease (COVID-19), is a major pandemic challenging health care systems around the world. The optimal management of patients infected with COVID-19 is still unclear, although the consensus is moving toward the need of a biphasic approach. During the first phase of the disease (from onset of the symptoms up to 7-10 days) viral-induced effects are prominent, with the opportunity to institute antiviral therapy. In the second inflammatory phase of the disease, immunosuppressive strategies (for example with glucocorticoids or anticytokine drugs) may be considered. This latter stage is characterized by the development of progressive lung involvement with increasing oxygen requirements and occasionally signs of the hemophagocytic syndrome. The management of the disease in patients with kidney disease is even more challenging, especially in those who are immunosuppressed or with severe comorbidities. Here we present the therapeutic approach used in Brescia (Italy) for managing patients infected with COVID-19 who underwent kidney transplantation and are receiving hemodialysis. Furthermore, we provide some clinical and physiopathological background, as well as preliminary outcome data of our cohort, to better clarify the pathogenesis of the disease and clinical management.
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Affiliation(s)
- Federico Alberici
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
- Nephrology Unit, Spedali Civili Hospital, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Elisa Delbarba
- Nephrology Unit, Spedali Civili Hospital, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Chiara Manenti
- Nephrology Unit, Spedali Civili Hospital, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Laura Econimo
- Nephrology Unit, Spedali Civili Hospital, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Francesca Valerio
- Nephrology Unit, Spedali Civili Hospital, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Alessandra Pola
- Nephrology Unit, Spedali Civili Hospital, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Camilla Maffei
- Nephrology Unit, Spedali Civili Hospital, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Stefano Possenti
- Nephrology Unit, Spedali Civili Hospital, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Simone Piva
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
- Intensive Care Unit, Spedali Civili Hospital, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Nicola Latronico
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
- Intensive Care Unit, Spedali Civili Hospital, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Emanuele Focà
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Infectious and Tropical Diseases, Spedali Civili Hospital, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Francesco Castelli
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Infectious and Tropical Diseases, Spedali Civili Hospital, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Paola Gaggia
- Nephrology Unit, Spedali Civili Hospital, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Ezio Movilli
- Nephrology Unit, Spedali Civili Hospital, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Sergio Bove
- Nephrology Unit, Montichiari Hospital, ASST Spedali Civili di Brescia, Montichiari, Italy
| | | | | | | | | | - Nicola Bossini
- Nephrology Unit, Spedali Civili Hospital, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Mario Gaggiotti
- Nephrology Unit, Spedali Civili Hospital, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Francesco Scolari
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
- Nephrology Unit, Spedali Civili Hospital, ASST Spedali Civili di Brescia, Brescia, Italy
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4957
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Wilcox MH, McGovern BH, Hecht GA. The Efficacy and Safety of Fecal Microbiota Transplant for Recurrent Clostridium difficile Infection: Current Understanding and Gap Analysis. Open Forum Infect Dis 2020; 7:ofaa114. [PMID: 32405509 PMCID: PMC7184446 DOI: 10.1093/ofid/ofaa114] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Accepted: 03/31/2020] [Indexed: 02/06/2023] Open
Abstract
The leading risk factor for Clostridioides (Clostridium) difficile infection (CDI) is broad-spectrum antibiotics, which lead to low microbial diversity, or dysbiosis. Current therapeutic strategies for CDI are insufficient, as they do not address the key role of the microbiome in preventing C. difficile spore germination into toxin-producing vegetative bacteria, which leads to symptomatic disease. Fecal microbiota transplant (FMT) appears to reduce the risk of recurrent CDI through microbiome restoration. However, a wide range of efficacy rates have been reported, and few placebo-controlled trials have been conducted, limiting our understanding of FMT efficacy and safety. We discuss the current knowledge gaps driven by questions around the quality and consistency of clinical trial results, patient selection, diagnostic methodologies, use of suppressive antibiotic therapy, and methods for adverse event reporting. We provide specific recommendations for future trial designs of FMT to provide improved quality of the clinical evidence to better inform treatment guidelines.
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Affiliation(s)
- Mark H Wilcox
- Department of Microbiology, Old Medical School, Leeds Teaching Hospitals NHS Trust, Leeds, UK
- University of Leeds, Leeds, UK
| | | | - Gail A Hecht
- Department of Medicine, Division of Gastroenterology, Loyola University Chicago, Chicago, Illinois, USA
- Department of Microbiology and Immunology, Loyola University Chicago, Chicago, Illinois, USA
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4958
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Zhang X, Cai H, Hu J, Lian J, Gu J, Zhang S, Ye C, Lu Y, Jin C, Yu G, Jia H, Zhang Y, Sheng J, Li L, Yang Y. Epidemiological, clinical characteristics of cases of SARS-CoV-2 infection with abnormal imaging findings. Int J Infect Dis 2020; 94:81-87. [PMID: 32205284 PMCID: PMC7270493 DOI: 10.1016/j.ijid.2020.03.040] [Citation(s) in RCA: 172] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 03/11/2020] [Accepted: 03/15/2020] [Indexed: 12/28/2022] Open
Abstract
PURPOSE To investigate the epidemiological and clinical characteristics of COVID-19 patients with abnormal imaging findings. METHODS Patients confirmed with SARS-CoV-2 infection in Zhejiang province from January 17 to February 8 who had undergone CT or X-ray were enrolled. Epidemiological and clinical data were analyzed among those with abnormal or normal imaging findings. RESULTS Excluding 72 patients with normal images, 230 of 573 patients showed abnormalities affecting more than two lung lobes. The median radiographic score was 2.0, and there was a negative correlation between that score and the oxygenation index (ρ = -0.657, P < 0.001). Patients with abnormal images were older (46.65 ± 13.82), with a higher rate of coexisting condition (28.8%), a lower rate of exposure history, and longer time between onset and confirmation (5 days) than non-pneumonia patients (all P < 0.05). A higher rate of fever, cough, expectoration and headache, a lower level of lymphocytes, albumin, and serum sodium levels and a higher total bilirubin, creatine kinase, lactate dehydrogenase, and C-reactive protein levels and a lower oxygenation index were observed in pneumonia patients (all P < 0.05). Muscle ache, shortness of breath, nausea and vomiting, lower lymphocytes levels, and higher serum creatinine and radiographic score at admission were predictive factors for the severe/critical subtype. CONCLUSION Patients with abnormal images have more obvious clinical manifestations and laboratory changes. Combing clinical features and radiographic scores can effectively predict severe/critical types.
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Affiliation(s)
- Xiaoli Zhang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 79 QingChun Road, Hangzhou, Zhejiang 310003, China
| | - Huan Cai
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 79 QingChun Road, Hangzhou, Zhejiang 310003, China
| | - Jianhua Hu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 79 QingChun Road, Hangzhou, Zhejiang 310003, China
| | - Jiangshan Lian
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 79 QingChun Road, Hangzhou, Zhejiang 310003, China
| | - Jueqing Gu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 79 QingChun Road, Hangzhou, Zhejiang 310003, China
| | - Shanyan Zhang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 79 QingChun Road, Hangzhou, Zhejiang 310003, China
| | - Chanyuan Ye
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 79 QingChun Road, Hangzhou, Zhejiang 310003, China
| | - Yingfeng Lu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 79 QingChun Road, Hangzhou, Zhejiang 310003, China
| | - Ciliang Jin
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 79 QingChun Road, Hangzhou, Zhejiang 310003, China
| | - Guodong Yu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 79 QingChun Road, Hangzhou, Zhejiang 310003, China
| | - Hongyu Jia
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 79 QingChun Road, Hangzhou, Zhejiang 310003, China
| | - Yimin Zhang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 79 QingChun Road, Hangzhou, Zhejiang 310003, China
| | - Jifang Sheng
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 79 QingChun Road, Hangzhou, Zhejiang 310003, China.
| | - Lanjuan Li
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 79 QingChun Road, Hangzhou, Zhejiang 310003, China.
| | - Yida Yang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 79 QingChun Road, Hangzhou, Zhejiang 310003, China.
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4959
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Bombardini T, Picano E. Angiotensin-Converting Enzyme 2 as the Molecular Bridge Between Epidemiologic and Clinical Features of COVID-19. Can J Cardiol 2020; 36:784.e1-784.e2. [PMID: 32299780 PMCID: PMC7118531 DOI: 10.1016/j.cjca.2020.03.026] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 03/18/2020] [Indexed: 10/25/2022] Open
Affiliation(s)
- Tonino Bombardini
- Consiglio Nazionale Ricerche - National Research Council, Institute of Clinical Physiology, Biomedicine Department, Pisa, Italy.
| | - Eugenio Picano
- Consiglio Nazionale Ricerche - National Research Council, Institute of Clinical Physiology, Biomedicine Department, Pisa, Italy
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4960
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Affiliation(s)
- Bill Gates
- From the Bill and Melinda Gates Foundation, Seattle
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4961
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Rahman A, Sathi NJ. Knowledge, Attitude, and Preventive Practices toward COVID-19 among Bangladeshi Internet Users. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2020. [DOI: 10.29333/ejgm/8223] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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4962
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Ogimi C, Kim YJ, Martin ET, Huh HJ, Chiu CH, Englund JA. What's New With the Old Coronaviruses? J Pediatric Infect Dis Soc 2020; 9:210-217. [PMID: 32314790 PMCID: PMC7188130 DOI: 10.1093/jpids/piaa037] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 04/07/2020] [Indexed: 02/06/2023]
Abstract
Coronaviruses contribute to the burden of respiratory diseases in children, frequently manifesting in upper respiratory symptoms considered to be part of the "common cold." Recent epidemics of novel coronaviruses recognized in the 21st century have highlighted issues of zoonotic origins of transmissible respiratory viruses and potential transmission, disease, and mortality related to these viruses. In this review, we discuss what is known about the virology, epidemiology, and disease associated with pediatric infection with the common community-acquired human coronaviruses, including species 229E, OC43, NL63, and HKU1, and the coronaviruses responsible for past world-wide epidemics due to severe acute respiratory syndrome and Middle East respiratory syndrome coronavirus.
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Affiliation(s)
- Chikara Ogimi
- Department of Pediatrics, Seattle Children’s Hospital Research Institute, University of Washington, Seattle, Washington, USA
| | - Yae Jean Kim
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea
| | - Emily T Martin
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Hee Jae Huh
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea
| | - Cheng-Hsun Chiu
- Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung Universit,y College of Medicine, Taoyuan, Taiwan
| | - Janet A Englund
- Department of Pediatrics, Seattle Children’s Hospital Research Institute, University of Washington, Seattle, Washington, USA
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4963
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Cheke RS, Shinde S, Ambhore J, Adhao V, Cheke D. Coronavirus: Hotspot on coronavirus disease 2019 in India. ACTA ACUST UNITED AC 2020. [PMCID: PMC7217275 DOI: 10.25259/ijms_33_2020] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The novel coronavirus disease (COVID-19) or also known as the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has been recognized as the cause of respiratory infection in Wuhan, Hubei Province, China, in late December 2019. As of April 5, 2020, this epidemic had spread to worldwide with 12,03,485 confirmed cases, including 62,000 deaths. The World Health Organization has declared it a Global Public Health Crisis. Coronavirus causes respiratory illness coughing, sneezing, breathlessness, and fever including pneumonia. The disease is transmitted person to person through infected droplets. At present, the research on novel coronavirus is still in the primary stage. Based on the published study, we thoroughly summarize the history and origin, microbiology and taxonomy, mode of transmissions, target receptor, clinical features, diagnosis, prevention, and treatment about COVID-19. This short report writes in hope for providing platform to community and researcher dealings against with the novel coronavirus and providing a reference for further studies.
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Affiliation(s)
- Rameshwar S. Cheke
- Department of Pharmacy, Dr. Rajendra Gode College of Pharmacy, Malkapur, Maharashtra, India,
| | - Sachin Shinde
- Department of Pharmacy, Shri. R. D. Bhakt College of Pharmacy, Jalna, Maharashtra, India,
| | - Jaya Ambhore
- Department of Pharmacy, Dr. Rajendra Gode College of Pharmacy, Malkapur, Maharashtra, India,
| | - Vaibhav Adhao
- Department of Pharmacy, Dr. Rajendra Gode College of Pharmacy, Malkapur, Maharashtra, India,
| | - Dnyaneshwar Cheke
- Department of General Medicine, Kashibai Navale Medical College and Hospital, Pune, Maharashtra, India,
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4964
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Matrajt L, Leung T. Evaluating the Effectiveness of Social Distancing Interventions to Delay or Flatten the Epidemic Curve of Coronavirus Disease. Emerg Infect Dis 2020; 26:1740-1748. [PMID: 32343222 PMCID: PMC7392458 DOI: 10.3201/eid2608.201093] [Citation(s) in RCA: 205] [Impact Index Per Article: 51.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
By April 2, 2020, >1 million persons worldwide were infected with severe acute respiratory syndrome coronavirus 2. We used a mathematical model to investigate the effectiveness of social distancing interventions in a mid-sized city. Interventions reduced contacts of adults >60 years of age, adults 20–59 years of age, and children <19 years of age for 6 weeks. Our results suggest interventions started earlier in the epidemic delay the epidemic curve and interventions started later flatten the epidemic curve. We noted that, while social distancing interventions were in place, most new cases, hospitalizations, and deaths were averted, even with modest reductions in contact among adults. However, when interventions ended, the epidemic rebounded. Our models suggest that social distancing can provide crucial time to increase healthcare capacity but must occur in conjunction with testing and contact tracing of all suspected cases to mitigate virus transmission.
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4965
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Tang LY, Wang J. Anesthesia and COVID-19: What We Should Know and What We Should Do. Semin Cardiothorac Vasc Anesth 2020; 24:127-137. [PMID: 32336243 DOI: 10.1177/1089253220921590] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Coronavirus disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2), was first reported in Wuhan, Hubei, China, and has spread to more than 200 other countries around the world. COVID-19 is a highly contagious disease with continuous human-to-human transmission. The origin of the virus is unknown. Airway manipulations and intubations, which are common during anesthesia procedures may increasingly expose anesthesia providers and intensive care unit team members to SARS-CoV-2. Through a comprehensive review of existing studies on COVID-19, this article presents the epidemiological and clinical characteristics of COVID-19, reviews current medical management, and suggests ways to improve the safety of anesthetic procedures. Owing to the highly contagious nature of the virus and the lack of therapeutic drugs or vaccines, precautions should be taken to prevent medical staff from COVID-19.
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Affiliation(s)
- Linda Y Tang
- Duke University Trinity College, Durham, NC, USA
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4966
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Baloch S, Baloch MA, Zheng T, Pei X. The Coronavirus Disease 2019 (COVID-19) Pandemic. TOHOKU J EXP MED 2020; 250:271-278. [PMID: 32321874 DOI: 10.1620/tjem.250.271] [Citation(s) in RCA: 182] [Impact Index Per Article: 45.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The present study provides an overview of the coronavirus disease 2019 (COVID-19) outbreak which has rapidly extended globally within a short period. COVID-19 is a highly infectious respiratory disease caused by a new coronavirus known as SARS-CoV-2 (severe acute respiratory syndrome-coronavirus-2). SARS-CoV-2 is different from usual coronaviruses responsible for mild sickness such as common cold among human beings. It is crucial to understand the impact and outcome of this pandemic. We therefore overview the changes in the curves of COVID-19 confirmed cases and fatality rate in China and outside of China from 31st of December 2019 to 25th of March 2020. We also aimed to assess the temporal developments and death rate of COVID-19 in China and worldwide. More than 414,179 confirmed cases of COVID-19 have been reported in 197 countries, including 81,848 cases in China and 332,331 outside of China. Furthermore, 18,440 infected patients died from COVID-19 infection; 3,287 cases were from China and 15,153 fatalities were reported worldwide. Among the worldwide infected cases, 113,802 patients have been recovered and discharged from different hospitals. Effective prevention and control measures should be taken to control the disease. The presented Chinese model (protocol) of disease prevention and control could be utilized in order to curb the pandemic situation.
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Affiliation(s)
- Saira Baloch
- Department of Public Health Laboratory Sciences, West China School of Public Health (No.4 West China Teaching Hospital), Sichuan University
| | - Mohsin Ali Baloch
- School of Chemical Engineering Pharmaceutical Engineering, Sichuan University of Science and Engineering
| | - Tianli Zheng
- Department of Public Health Laboratory Sciences, West China School of Public Health (No.4 West China Teaching Hospital), Sichuan University
| | - Xiaofang Pei
- Department of Public Health Laboratory Sciences, West China School of Public Health (No.4 West China Teaching Hospital), Sichuan University
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4967
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Sommer DD, Engels PT, Weitzel EK, Khalili S, Corsten M, Tewfik MA, Fung K, Cote D, Gupta M, Sne N, Brown TFE, Paul J, Kost KM, Witterick IJ. Recommendations from the CSO-HNS taskforce on performance of tracheotomy during the COVID-19 pandemic. J Otolaryngol Head Neck Surg 2020; 49:23. [PMID: 32340627 PMCID: PMC7184547 DOI: 10.1186/s40463-020-00414-9] [Citation(s) in RCA: 106] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 04/13/2020] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION The performance of tracheotomy is a common procedural request by critical care departments to the surgical services of general surgery, thoracic surgery and otolaryngology - head & neck surgery. A Canadian Society of Otolaryngology - Head & Neck Surgery (CSO-HNS) task force was convened with multi-specialty involvement from otolaryngology-head & neck surgery, general surgery, critical care and anesthesiology to develop a set of recommendations for the performance of tracheotomies during the COVID-19 pandemic. MAIN BODY The tracheotomy procedure is highly aerosol generating and directly exposes the entire surgical team to the viral aerosol plume and secretions, thereby increasing the risk of transmission to healthcare providers. As such, we believe extended endotracheal intubation should be the standard of care for the entire duration of ventilation in the vast majority of patients. Pre-operative COVID-19 testing is highly recommended for any non-emergent procedure. CONCLUSION The set of recommendations in this document highlight the importance of avoiding tracheotomy procedures in patients who are COVID-19 positive if at all possible. Recommendations for appropriate PPE and environment are made for COVID-19 positive, negative and unknown patients requiring consideration of tracheotomy. The safety of healthcare professionals who care for ill patients and who keep critical infrastructure operating is paramount.
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Affiliation(s)
- D D Sommer
- Division of Otolaryngology - Head & Neck Surgery - Department of Surgery, McMaster University Medical Centre, McMaster University, 3V1 Clinic, 1200 Main St West, Hamilton, ON, L8N 3Z5, Canada.
| | - P T Engels
- Department of Surgery and Critical Care, McMaster University, Hamilton, ON, Canada
| | - E K Weitzel
- United States Army Institute of Surgical Research, Fort Sam Houston, TX, USA
| | - S Khalili
- Aurora Neuroscience Innovation Institute, Milwaukee, WI, USA
| | - M Corsten
- Division of Otolaryngology - Head & Neck Surgery, Dalhousie University, Halifax, NS, Canada
| | - M A Tewfik
- Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, QC, Canada
| | - K Fung
- Department of Otolaryngology - Head and Neck Surgery, Western University, London, ON, Canada
| | - D Cote
- Division of Otolaryngology - Head and Neck Surgery, University of Alberta, Edmonton, AB, Canada
| | - M Gupta
- Division of Otolaryngology - Head & Neck Surgery - Department of Surgery, McMaster University Medical Centre, McMaster University, 3V1 Clinic, 1200 Main St West, Hamilton, ON, L8N 3Z5, Canada
| | - N Sne
- Department of Surgery and Critical Care, McMaster University, Hamilton, ON, Canada
| | - T F E Brown
- Division of Otolaryngology - Head & Neck Surgery, Dalhousie University, Halifax, NS, Canada
| | - J Paul
- Department of Anesthesia, McMaster University, Hamilton, ON, Canada
| | - K M Kost
- Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, QC, Canada
| | - I J Witterick
- Department of Otolaryngology - Head & Neck Surgery, University of Toronto, Toronto, ON, Canada
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4968
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Mo C, Tan D, Mai T, Bei C, Qin J, Pang W, Zhang Z. An analysis of spatiotemporal pattern for COIVD-19 in China based on space-time cube. J Med Virol 2020; 92:1587-1595. [PMID: 32249952 DOI: 10.1002/jmv.25834] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 04/02/2020] [Indexed: 12/23/2022]
Abstract
This study seeks to examine and analyze the spatial and temporal patterns of 2019 novel coronavirus disease (COVID-19) outbreaks and identify the spatiotemporal distribution characteristics and changing trends of cases. Hence, local outlier analysis and emerging spatiotemporal hot spot analysis were performed to analyze the spatiotemporal clustering pattern and cold/hot spot trends of COVID-19 cases based on space-time cube during the period from 23 January 2020 to 24 February 2020. The main findings are as follows: (1) The outbreak had spread rapidly throughout the country within a short time and the current totality incidence rate has decreased. (2) The spatiotemporal distribution of cases was uneven. In terms of the spatiotemporal clustering pattern, Wuhan and Shiyan city were the center as both cities had high-high clustering pattern with a surrounding unstable multiple-type pattern in partial areas of Henan, Anhui, Jiangxi, and Hunan provinces, and Chongqing city. Those regions are continuously in the hot spot on the spatiotemporal tendency. (3) The spatiotemporal analysis technology based on the space-time cube can analyze comprehensively the spatiotemporal pattern of epidemiological data and produce a visual output of the consequences, which can reflect intuitively the distribution and trend of data in space-time. Therefore, the Chinese government should strengthen the prevention and control efforts in a targeted manner to cope with a highly changeable situation.
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Affiliation(s)
- Chunbao Mo
- Department of Pathophysiology, Faculty of Basic Medical Sciences, Guilin Medical University, Guilin, Guangxi, China
| | - Dechan Tan
- Department of Environmental Health and Occupational Medicine, School of Public Health, Guilin Medical University, Guilin, Guangxi, China
| | - Tingyu Mai
- Department of Environmental Health and Occupational Medicine, School of Public Health, Guilin Medical University, Guilin, Guangxi, China
| | - Chunhua Bei
- Department of Epidemiology and Health Statistics, School of Public Health, Guilin Medical University, Guilin, Guangxi, China
| | - Jian Qin
- Department of Environmental and Occupational Health, School of Public Health, Guangxi Medical University, Nanning, China
| | - Weiyi Pang
- Department of Environmental Health and Occupational Medicine, School of Public Health, Guilin Medical University, Guilin, Guangxi, China
| | - Zhiyong Zhang
- Department of Environmental Health and Occupational Medicine, School of Public Health, Guilin Medical University, Guilin, Guangxi, China
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4969
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Leung K, Wu JT, Liu D, Leung GM. First-wave COVID-19 transmissibility and severity in China outside Hubei after control measures, and second-wave scenario planning: a modelling impact assessment. Lancet 2020; 395:1382-1393. [PMID: 32277878 PMCID: PMC7195331 DOI: 10.1016/s0140-6736(20)30746-7] [Citation(s) in RCA: 502] [Impact Index Per Article: 125.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 03/23/2020] [Accepted: 03/24/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND As of March 18, 2020, 13 415 confirmed cases and 120 deaths related to coronavirus disease 2019 (COVID-19) in mainland China, outside Hubei province-the epicentre of the outbreak-had been reported. Since late January, massive public health interventions have been implemented nationwide to contain the outbreak. We provide an impact assessment of the transmissibility and severity of COVID-19 during the first wave in mainland Chinese locations outside Hubei. METHODS We estimated the instantaneous reproduction number (Rt) of COVID-19 in Beijing, Shanghai, Shenzhen, Wenzhou, and the ten Chinese provinces that had the highest number of confirmed COVID-19 cases; and the confirmed case-fatality risk (cCFR) in Beijing, Shanghai, Shenzhen, and Wenzhou, and all 31 Chinese provinces. We used a susceptible-infectious-recovered model to show the potential effects of relaxing containment measures after the first wave of infection, in anticipation of a possible second wave. FINDINGS In all selected cities and provinces, the Rt decreased substantially since Jan 23, when control measures were implemented, and have since remained below 1. The cCFR outside Hubei was 0·98% (95% CI 0·82-1·16), which was almost five times lower than that in Hubei (5·91%, 5·73-6·09). Relaxing the interventions (resulting in Rt >1) when the epidemic size was still small would increase the cumulative case count exponentially as a function of relaxation duration, even if aggressive interventions could subsequently push disease prevalence back to the baseline level. INTERPRETATION The first wave of COVID-19 outside of Hubei has abated because of aggressive non-pharmaceutical interventions. However, given the substantial risk of viral reintroduction, particularly from overseas importation, close monitoring of Rt and cCFR is needed to inform strategies against a potential second wave to achieve an optimal balance between health and economic protection. FUNDING Health and Medical Research Fund, Hong Kong, China.
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Affiliation(s)
- Kathy Leung
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Joseph T Wu
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.
| | - Di Liu
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Gabriel M Leung
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
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4970
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Epidemiological Features of New Coronavirus Infection (COVID-19). Communication 1: Modes of Implementation of Preventive and Anti-Epidemic Measures. PROBLEMS OF PARTICULARLY DANGEROUS INFECTIONS 2020. [DOI: 10.21055/0370-1069-2020-1-6-13] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The review analyses the information on the epidemiological situation on COVID-19 around the world. Presented is the assessment of the major epidemiological parameters (basic reproductive rate, lethality, incubation period, and serial interval). Demonstrated is the share of severe cases among different age groups and the general structure of incidence by the severity of clinical course. The paper provides the classification of response models internationally depending upon the complex of measures undertaken at different stages of epidemic process. Reviewed are the key response actions to control the COVID-19 transmission in different countries of the world and the Russian Federation and given is the assessment of their effectiveness.
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4971
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Mei X, Lee HC, Diao K, Huang M, Lin B, Liu C, Xie Z, Ma Y, Robson PM, Chung M, Bernheim A, Mani V, Calcagno C, Li K, Li S, Shan H, Lv J, Zhao T, Xia J, Long Q, Steinberger S, Jacobi A, Deyer T, Luksza M, Liu F, Little BP, Fayad ZA, Yang Y. Artificial intelligence-enabled rapid diagnosis of COVID-19 patients. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020:2020.04.12.20062661. [PMID: 32511559 PMCID: PMC7274240 DOI: 10.1101/2020.04.12.20062661] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
For diagnosis of COVID-19, a SARS-CoV-2 virus-specific reverse transcriptase polymerase chain reaction (RT-PCR) test is routinely used. However, this test can take up to two days to complete, serial testing may be required to rule out the possibility of false negative results, and there is currently a shortage of RT-PCR test kits, underscoring the urgent need for alternative methods for rapid and accurate diagnosis of COVID-19 patients. Chest computed tomography (CT) is a valuable component in the evaluation of patients with suspected SARS-CoV-2 infection. Nevertheless, CT alone may have limited negative predictive value for ruling out SARS-CoV-2 infection, as some patients may have normal radiologic findings at early stages of the disease. In this study, we used artificial intelligence (AI) algorithms to integrate chest CT findings with clinical symptoms, exposure history, and laboratory testing to rapidly diagnose COVID-19 positive patients. Among a total of 905 patients tested by real-time RT-PCR assay and next-generation sequencing RT-PCR, 419 (46.3%) tested positive for SARS-CoV-2. In a test set of 279 patients, the AI system achieved an AUC of 0.92 and had equal sensitivity as compared to a senior thoracic radiologist. The AI system also improved the detection of RT-PCR positive COVID-19 patients who presented with normal CT scans, correctly identifying 17 of 25 (68%) patients, whereas radiologists classified all of these patients as COVID-19 negative. When CT scans and associated clinical history are available, the proposed AI system can help to rapidly diagnose COVID-19 patients.
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4972
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Chen Y, Li Z, Zhang YY, Zhao WH, Yu ZY. Maternal health care management during the outbreak of coronavirus disease 2019. J Med Virol 2020; 92:731-739. [PMID: 32219871 DOI: 10.1002/jmv.25787] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 03/22/2020] [Indexed: 01/01/2023]
Abstract
Coronavirus disease 2019 (COVID-19) is a novel type of highly contagious pneumonia caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Despite the strong efforts taken to control the epidemic, hundreds of thousands of people were infected worldwide by 11 March, and the situation was characterized as a pandemic by the World Health Organization. Pregnant women are more susceptible to viral infection due to immune and anatomic alteration, though hospital visits may increase the chance of infection, the lack of medical care during pregnancy may do more harm. Hence, a well-managed system that allows pregnant women to access maternal health care with minimum exposure risk is desired during the outbreak. Here, we present the managing processes of three pregnant women who had fever during hospitalization in the gynecology or obstetrics department, and then, we further summarize and demonstrate our maternal health care management strategies including antenatal care planning, patient triage based on the risk level, admission control, and measures counteracting emergencies and newly discovered high-risk cases at in-patient department. In the meantime, we will explain the alterations we have done throughout different stages of the epidemic and also review relative articles in both Chinese and English to compare our strategies with those of other areas. Although tens of COVID-19 cases were confirmed in our hospital, no nosocomial infection has occurred and none of the pregnant women registered in our hospital was reported to be infected.
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Affiliation(s)
- Yu Chen
- Department of Gynecology, Shenzhen Second People's Hospital/the First Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, China
| | - Zhe Li
- The First Clinical Medical College of Southern Medical University, Guangzhou, China
| | - Yuan-Yuan Zhang
- Department of Gynecology, Shenzhen Second People's Hospital/the First Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, China
| | - Wei-Hua Zhao
- Department of Obstetrics, Shenzhen Second People's Hospital/the First Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, China
| | - Zhi-Ying Yu
- Department of Gynecology, Shenzhen Second People's Hospital/the First Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, China
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4973
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Kivela P. Paradigm Shift for COVID-19 Response: Identifying High-risk Individuals and Treating Inflammation. West J Emerg Med 2020; 21:473-476. [PMID: 32302283 PMCID: PMC7234699 DOI: 10.5811/westjem.2020.3.47520] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 03/28/2020] [Accepted: 03/28/2020] [Indexed: 12/26/2022] Open
Affiliation(s)
- Paul Kivela
- The University of Alabama at Birmingham, Department of Emergency Medicine, Birmingham, Alabama
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4974
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Chen S, Liao E, Cao D, Gao Y, Sun G, Shao Y. Clinical analysis of pregnant women with 2019 novel coronavirus pneumonia. J Med Virol 2020; 92:1556-1561. [PMID: 32222119 PMCID: PMC7228212 DOI: 10.1002/jmv.25789] [Citation(s) in RCA: 131] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 03/15/2020] [Accepted: 03/16/2020] [Indexed: 01/08/2023]
Abstract
The aim is to evaluate pregnant women infected with coronavirus disease 2019 (COVID‐19) and provide help for clinical prevention and treatment. All five cases of pregnant women confirmed COVID‐19 were collected among patients who admitted to the Maternal and Child Hospital of Hubei Province between January 20 and February 10, 2020. All patients, aging from 25 to 31 years old, had the gestational week from 38th weeks to 41st weeks. All pregnant women did not have an antepartum fever but developed a low‐grade fever (37.5℃‐38.5℃) within 24 hours after delivery. All patients had normal liver and renal function, two patients had elevated plasma levels of the myocardial enzyme. Unusual chest imaging manifestations, featured with ground‐grass opacity, were frequently observed in bilateral (three cases) or unilateral lobe (two cases) by computed tomography (CT) scan. All labors smoothly processed, the Apgar scores were 10 points 1 and 5 minutes after delivery, no complications were observed in the newborn. Pregnancy and perinatal outcomes of patients with COVID‐19 should receive more attention. It is probable that pregnant women diagnosed with COVID‐19 have no fever before delivery. Their primary initial manifestations were merely low‐grade postpartum fever or mild respiratory symptoms. Therefore, the protective measures are necessary on admission; the instant CT scan and real‐time reverse‐transcriptase polymerase‐chain‐reaction assay should be helpful in early diagnosis and avoid cross‐infection on the occasion that patients have fever and other respiratory signs. Pregnant woman with COVID‐19.
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Affiliation(s)
- Siyu Chen
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - E Liao
- Department of Obstetrics and Gynecology, Maternal and Child Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Dongmei Cao
- Department of Obstetrics and Gynecology, Maternal and Child Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Ying Gao
- Department of Obstetrics and Gynecology, Maternal and Child Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Guoqiang Sun
- Department of Obstetrics and Gynecology, Maternal and Child Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yong Shao
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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4975
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Qian Y, Zeng T, Wang H, Xu M, Chen J, Hu N, Chen D, Liu Y. Safety management of nasopharyngeal specimen collection from suspected cases of coronavirus disease 2019. Int J Nurs Sci 2020; 7:153-156. [PMID: 32292635 PMCID: PMC7129371 DOI: 10.1016/j.ijnss.2020.03.012] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 03/29/2020] [Indexed: 12/02/2022] Open
Abstract
This article introduces safety management strategies of nasopharyngeal specimen collection from suspected cases of coronavirus disease 2019 in a tertiary designated hospital. The key points include establishing a special sampling room, strict sterilization of the entire environment, training of professional nurses, enhancement of personal protection, standardization of methods and processes for swab collection, and a timely and safety sample submission. More than 11,000 nasopharyngeal specimens were collected by eight nurses, with an average of 1,375 specimen swab collections each nurse, and no one was infected.
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Affiliation(s)
- Yan Qian
- Tongji Hospital, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Tieying Zeng
- Tongji Hospital, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Hui Wang
- Tongji Hospital, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Min Xu
- Tongji Hospital, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Junhua Chen
- Tongji Hospital, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Na Hu
- Tongji Hospital, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Daiqi Chen
- Tongji Hospital, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Yu Liu
- Tongji Hospital, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, Hubei, China
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4976
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Coronavirus Disease 2019 in Children - United States, February 12-April 2, 2020. MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT 2020; 69:422-426. [PMID: 32271728 PMCID: PMC7147903 DOI: 10.15585/mmwr.mm6914e4] [Citation(s) in RCA: 1038] [Impact Index Per Article: 259.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
As of April 2, 2020, the coronavirus disease 2019 (COVID-19) pandemic has resulted in >890,000 cases and >45,000 deaths worldwide, including 239,279 cases and 5,443 deaths in the United States (1,2). In the United States, 22% of the population is made up of infants, children, and adolescents aged <18 years (children) (3). Data from China suggest that pediatric COVID-19 cases might be less severe than cases in adults and that children might experience different symptoms than do adults (4,5); however, disease characteristics among pediatric patients in the United States have not been described. Data from 149,760 laboratory-confirmed COVID-19 cases in the United States occurring during February 12-April 2, 2020 were analyzed. Among 149,082 (99.6%) reported cases for which age was known, 2,572 (1.7%) were among children aged <18 years. Data were available for a small proportion of patients on many important variables, including symptoms (9.4%), underlying conditions (13%), and hospitalization status (33%). Among those with available information, 73% of pediatric patients had symptoms of fever, cough, or shortness of breath compared with 93% of adults aged 18-64 years during the same period; 5.7% of all pediatric patients, or 20% of those for whom hospitalization status was known, were hospitalized, lower than the percentages hospitalized among all adults aged 18-64 years (10%) or those with known hospitalization status (33%). Three deaths were reported among the pediatric cases included in this analysis. These data support previous findings that children with COVID-19 might not have reported fever or cough as often as do adults (4). Whereas most COVID-19 cases in children are not severe, serious COVID-19 illness resulting in hospitalization still occurs in this age group. Social distancing and everyday preventive behaviors remain important for all age groups as patients with less serious illness and those without symptoms likely play an important role in disease transmission (6,7).
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4977
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Shidham VB, Frisch NK, Layfield LJ. Severe acute respiratory syndrome coronavirus 2 (the cause of COVID 19) in different types of clinical specimens and implications for cytopathology specimen: An editorial review with recommendations. Cytojournal 2020; 17:7. [PMID: 32395151 PMCID: PMC7210469 DOI: 10.25259/cytojournal_24_2020] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 04/08/2020] [Indexed: 01/25/2023] Open
Affiliation(s)
- Vinod B. Shidham
- Department of Pathology, Karmanos Cancer Center and Detroit Medical Center, Wayne State University School of Medicine, Detroit, Michigan
| | - Nora K. Frisch
- Department of Pathology, The University of Vermont Medical Center, Burlington, Vermont, United States
| | - Lester J. Layfield
- Department of Pathology, University of Missouri, Columbia, Missouri, United States
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4978
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Li Y, Liu X, Guo L, Li J, Zhong D, Zhang Y, Clarke M, Jin R. Traditional Chinese herbal medicine for treating novel coronavirus (COVID-19) pneumonia: protocol for a systematic review and meta-analysis. Syst Rev 2020; 9:75. [PMID: 32268923 PMCID: PMC7138957 DOI: 10.1186/s13643-020-01343-4] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 03/30/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND A new type of coronavirus, novel coronavirus (COVID-19), is causing an increasing number of cases of pneumonia and was declared a Public Health Emergency of International Concern by the World Health Organization on 30 January 2020. The virus first appeared in Wuhan, China, in late December 2019, and traditional Chinese herbal medicine is being used for its treatment. This systematic review and meta-analysis will assess studies of the effects of traditional Chinese herbal medicine in COVID-19 pneumonia. METHODS We will search electronic databases including PubMed, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Periodical Database (VIP), and Wanfang database using keywords related to COVID-19 and traditional Chinese herbal medicine. Reference lists of relevant trials and reviews will be searched. We will manually search gray literature, such as conference proceedings and academic degree dissertations, and trial registries. Two independent reviewers will screen studies (XL and DZ), extract data (YL and LG), and evaluate risk of bias (YL and DZ). Data analysis will be conducted using the Review Manager software (version 5.3.5) and R software (version 3.6.1). Statistical heterogeneity will be assessed using a standard chi-square test with a significance level of P < 0.10. Biases associated with study size (e.g., publication bias) will be investigated using funnel plots, Egger's test and Begg's test, and Trim and Fill analysis. DISCUSSION This study will provide a high-quality synthesis of the effects of traditional Chinese herbal medicine for COVID-19. The use of traditional Chinese herbal medicine for treatment or prevention of these novel viral infections affecting the pneumonia will be investigated. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration number: CRD42020168004.
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Affiliation(s)
- Yuxi Li
- School of Acupuncture-Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiaobo Liu
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Liuxue Guo
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Juan Li
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Dongling Zhong
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | | | - Mike Clarke
- Northern Ireland Clinical Trials Unit and Methodology Hub, Centre for Public Health, Queen's University Belfast, Belfast, UK.
| | - Rongjiang Jin
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
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4979
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Qian X, Ren R, Wang Y, Guo Y, Fang J, Wu ZD, Liu PL, Han TR. Fighting against the common enemy of COVID-19: a practice of building a community with a shared future for mankind. Infect Dis Poverty 2020; 9:34. [PMID: 32264957 PMCID: PMC7137400 DOI: 10.1186/s40249-020-00650-1] [Citation(s) in RCA: 81] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 03/20/2020] [Indexed: 01/18/2023] Open
Abstract
The outbreak of coronavirus disease 2019 (COVID-19) has caused more than 80 813 confirmed cases in all provinces of China, and 21 110 cases reported in 93 countries of six continents as of 7 March 2020 since middle December 2019. Due to biological nature of the novel coronavirus, named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with faster spreading and unknown transmission pattern, it makes us in a difficulty position to contain the disease transmission globally. To date, we have found it is one of the greatest challenges to human beings in fighting against COVID-19 in the history, because SARS-CoV-2 is different from SARS-CoV and MERS-CoV in terms of biological features and transmissibility, and also found the containment strategies including the non-pharmaceutical public health measures implemented in China are effective and successful. In order to prevent a potential pandemic-level outbreak of COVID-19, we, as a community of shared future for mankind, recommend for all international leaders to support preparedness in low and middle income countries especially, take strong global interventions by using old approaches or new tools, mobilize global resources to equip hospital facilities and supplies to protect noisome infections and to provide personal protective tools such as facemask to general population, and quickly initiate research projects on drug and vaccine development. We also recommend for the international community to develop better coordination, cooperation, and strong solidarity in the joint efforts of fighting against COVID-19 spreading recommended by the joint mission report of the WHO-China experts, against violating the International Health Regulation (WHO, 2005), and against stigmatization, in order to eventually win the battle against our common enemy - COVID-19.
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Affiliation(s)
- Xu Qian
- School of Public Health/Global Health Institute, Fudan University, Shanghai, 200032, China.
| | - Ran Ren
- Global Health Center, Dalian Medical University, Dalian, 116021, China
| | - Youfa Wang
- Global Health Institute, School of Public Health, Xi'an Jiaotong University, Xi'an, 710061, China
| | - Yan Guo
- Global Health Center, School of Public Health, Beijing University, Beijing, 100871, China
| | - Jing Fang
- Kunming Medical University, Yunnan, 650500, China
| | - Zhong-Dao Wu
- Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Pei-Long Liu
- Global Health Center, School of Public Health, Beijing University, Beijing, 100871, China
| | - Tie-Ru Han
- Society of Global Health, Chinese Preventive Medicine Association, Beijing, 100013, China.
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4980
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Sommerstein R, Kochen MM, Messerli FH, Gräni C. Coronavirus Disease 2019 (COVID-19): Do Angiotensin-Converting Enzyme Inhibitors/Angiotensin Receptor Blockers Have a Biphasic Effect? J Am Heart Assoc 2020; 9:e016509. [PMID: 32233753 PMCID: PMC7428596 DOI: 10.1161/jaha.120.016509] [Citation(s) in RCA: 177] [Impact Index Per Article: 44.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Rami Sommerstein
- Department of Infectious DiseasesBern University HospitalBernSwitzerland
| | | | - Franz H. Messerli
- Department of CardiologyBern University HospitalBernSwitzerland
- Jagiellonian UniversityKrakowPoland
- Division of CardiologyMount Sinai Health Medical CenterIcahn School of MedicineNew YorkNY
| | - Christoph Gräni
- Department of CardiologyBern University HospitalBernSwitzerland
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4981
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Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA 2020; 323:1239-1242. [PMID: 32091533 DOI: 10.1001/jama.2020.2648] [Citation(s) in RCA: 11142] [Impact Index Per Article: 2785.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Zunyou Wu
- Chinese Center for Disease Control and Prevention, Beijing, China
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4982
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Rosero RJ, Polanco JP, Sánchez P, Hernández E, Pinzón JB, Lizcano F. Obesidad: un problema en la atención de Covid-19. REPERTORIO DE MEDICINA Y CIRUGÍA 2020. [DOI: 10.31260/repertmedcir.01217372.1035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Actualmente el mundo atraviesa una de las peores crisis a nivel salud secundario a la infección por un nuevo coronavirus de alta transmisibilidad y mortalidad, que ha impactado múltiples aspectos. Se ha establecido de forma general que la severidad de la infección está asociada con edad avanzada y comorbilidades como hipertensión y diabetes. Por otro lado, la obesidad en este momento representa una de las mayores amenazas del sector salud, por su gran relación con morbimortalidad a nivel cardiometabólico, esto conlleva a un alto costo de la enfermedad. Este artículo busca alertar sobre lo que han llamado algunos expertos el “choque de dos pandemias”, esto dado al aumento de la prevalencia de obesidad a nivel mundial, donde nuestro país no está exento, que podría relacionarse con un número mayor de personas vulnerables a la infección por COVID-19 y sus complicaciones respiratorias y de esta manera evitar desenlaces catastróficos.
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4983
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Kim ES, Chin BS, Kang CK, Kim NJ, Kang YM, Choi JP, Oh DH, Kim JH, Koh B, Kim SE, Yun NR, Lee JH, Kim JY, Kim Y, Bang JH, Song KH, Kim HB, Chung KH, Oh MD. Clinical Course and Outcomes of Patients with Severe Acute Respiratory Syndrome Coronavirus 2 Infection: a Preliminary Report of the First 28 Patients from the Korean Cohort Study on COVID-19. J Korean Med Sci 2020; 35:e142. [PMID: 32242348 PMCID: PMC7131901 DOI: 10.3346/jkms.2020.35.e142] [Citation(s) in RCA: 265] [Impact Index Per Article: 66.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 03/27/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected pneumonia emerged in Wuhan, China in December 2019. In this retrospective multicenter study, we investigated the clinical course and outcomes of novel coronavirus disease 2019 (COVID-19) from early cases in Republic of Korea. METHODS All of the cases confirmed by real time polymerase chain reaction were enrolled from the 1st to the 28th patient nationwide. Clinical data were collected and analyzed for changes in clinical severity including laboratory, radiological, and virologic dynamics during the progression of illness. RESULTS The median age was 40 years (range, 20-73 years) and 15 (53.6%) patients were male. The most common symptoms were cough (28.6%) and sore throat (28.6%), followed by fever (25.0%). Diarrhea was not common (10.7%). Two patients had no symptoms. Initial chest X-ray (CXR) showed infiltration in 46.4% of the patients, but computed tomography scan confirmed pneumonia in 88.9% (16/18) of the patients. Six patients (21.4%) required supplemental oxygen therapy, but no one needed mechanical ventilation. Lymphopenia was more common in severe cases. Higher level of C-reactive protein and worsening of chest radiographic score was observed during the 5-7 day period after symptom onset. Viral shedding was high from day 1 of illness, especially from the upper respiratory tract (URT). CONCLUSION The prodromal symptoms of COVID-19 were mild and most patients did not have limitations of daily activity. Viral shedding from URT was high from the prodromal phase. Radiological pneumonia was common from the early days of illness, but it was frequently not evident in simple CXR. These findings could be plausible explanations for the easy and rapid spread of SARS-CoV-2 in the community.
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Affiliation(s)
- Eu Suk Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Bum Sik Chin
- Division of Infectious Diseases, Department of Internal Medicine, National Medical Center, Seoul, Korea
| | - Chang Kyung Kang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Nam Joong Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Yu Min Kang
- Department of Infectious Diseases, Myongji Hospital, Goyang, Korea
| | - Jae Phil Choi
- Department of Internal Medicine, Seoul Medical Center, Seoul, Korea
| | - Dong Hyun Oh
- Department of Internal Medicine, Seoul Medical Center, Seoul, Korea
| | - Jeong Han Kim
- Division of Infectious Diseases, Department of Internal Medicine, Armed Forces Capital Hospital, Seongnam, Korea
| | - Boram Koh
- Department of Internal Medicine, Gyeonggi Provincial Medical Center Ansung Hospital, Anseong, Korea
| | - Seong Eun Kim
- Department of Infectious Diseases, Chonnam National University Medical School, Gwangju, Korea
| | - Na Ra Yun
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Korea
| | - Jae Hoon Lee
- Department of Internal Medicine, Wonkwang University School of Medicine, Iksan, Korea
| | - Jin Yong Kim
- Division of Infectious Diseases, Department of Internal Medicine, Incheon Medical Center, Incheon, Korea
| | - Yeonjae Kim
- Division of Infectious Diseases, Department of Internal Medicine, National Medical Center, Seoul, Korea
| | - Ji Hwan Bang
- Division of Infectious Diseases, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
| | - Kyoung Ho Song
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Hong Bin Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Ki Hyun Chung
- Department of Pediatrics, National Medical Center, Seoul, Korea
| | - Myoung Don Oh
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
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4984
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Ryan JJ, Melendres-Groves L, Zamanian RT, Oudiz RJ, Chakinala M, Rosenzweig EB, Gomberg-Maitland M. Care of patients with pulmonary arterial hypertension during the coronavirus (COVID-19) pandemic. Pulm Circ 2020; 10:2045894020920153. [PMID: 32426111 PMCID: PMC7222260 DOI: 10.1177/2045894020920153] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 03/30/2020] [Indexed: 01/08/2023] Open
Abstract
The COVID-19 pandemic presents many unique challenges when caring for patients with pulmonary hypertension. The COVID-19 pandemic has altered routine standard of care practice and the acute management particularly for those patients with pulmonary arterial hypertension, where pulmonary arterial hypertension-specific treatments are used. It is important to balance the ongoing care and evaluation of pulmonary arterial hypertension patients with "exposure risk" to COVID-19 for patients coming to clinic or the hospital. If there is a morbidity and mortality benefit from starting pulmonary arterial hypertension therapies, for example in a patient with high-likelihood of pulmonary arterial hypertension, then it remains important to complete the thorough evaluation. However, the COVID-19 outbreak may also represent a unique time when pulmonary hypertension experts have to weigh the risks and benefits of the diagnostic work-up including potential exposure to COVID-19 versus initiating targeted pulmonary arterial hypertension therapy in a select high-risk, high likelihood World Symposium Pulmonary Hypertension Group 1 pulmonary arterial hypertension patients. This document will highlight some of the issues facing providers, patients, and the pulmonary arterial hypertension community in real-time as the COVID-19 pandemic is evolving and is intended to share expected common clinical scenarios and best clinical practices to help the community at-large.
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Affiliation(s)
- John J. Ryan
- Division of Cardiovascular Medicine, University of Utah, Salt Lake City, UT, USA
| | - Lana Melendres-Groves
- Division of Pulmonary and Critical Care Medicine, University of New Mexico, Albuquerque, NM, USA
| | - Roham T. Zamanian
- Division of Pulmonary and Critical Care Medicine, Stanford University, Stanford, CA, USA
| | - Ronald J. Oudiz
- Division of Cardiology, Lundquist Institute for Biomedical Innovation & Research at Harbor–UCLA Medical Center, Torrance, CA, USA
| | - Murali Chakinala
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Erika B. Rosenzweig
- Division of Pediatric Cardiology, Columbia University College of Physicians & Surgeons, New York, NY, USA
| | - Mardi Gomberg-Maitland
- Division of Cardiovascular Medicine, George Washington University Medicine and Health Sciences, Washington, DC, USA
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4985
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Shi H, Han X, Jiang N, Cao Y, Alwalid O, Gu J, Fan Y, Zheng C. Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. THE LANCET. INFECTIOUS DISEASES 2020; 20:425-434. [PMID: 32105637 PMCID: PMC7159053 DOI: 10.1016/s1473-3099(20)30086-4] [Citation(s) in RCA: 2244] [Impact Index Per Article: 561.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 02/10/2020] [Accepted: 02/11/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND A cluster of patients with coronavirus disease 2019 (COVID-19) pneumonia caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were successively reported in Wuhan, China. We aimed to describe the CT findings across different timepoints throughout the disease course. METHODS Patients with COVID-19 pneumonia (confirmed by next-generation sequencing or RT-PCR) who were admitted to one of two hospitals in Wuhan and who underwent serial chest CT scans were retrospectively enrolled. Patients were grouped on the basis of the interval between symptom onset and the first CT scan: group 1 (subclinical patients; scans done before symptom onset), group 2 (scans done ≤1 week after symptom onset), group 3 (>1 week to 2 weeks), and group 4 (>2 weeks to 3 weeks). Imaging features and their distribution were analysed and compared across the four groups. FINDINGS 81 patients admitted to hospital between Dec 20, 2019, and Jan 23, 2020, were retrospectively enrolled. The cohort included 42 (52%) men and 39 (48%) women, and the mean age was 49·5 years (SD 11·0). The mean number of involved lung segments was 10·5 (SD 6·4) overall, 2·8 (3·3) in group 1, 11·1 (5·4) in group 2, 13·0 (5·7) in group 3, and 12·1 (5·9) in group 4. The predominant pattern of abnormality observed was bilateral (64 [79%] patients), peripheral (44 [54%]), ill-defined (66 [81%]), and ground-glass opacification (53 [65%]), mainly involving the right lower lobes (225 [27%] of 849 affected segments). In group 1 (n=15), the predominant pattern was unilateral (nine [60%]) and multifocal (eight [53%]) ground-glass opacities (14 [93%]). Lesions quickly evolved to bilateral (19 [90%]), diffuse (11 [52%]) ground-glass opacity predominance (17 [81%]) in group 2 (n=21). Thereafter, the prevalence of ground-glass opacities continued to decrease (17 [57%] of 30 patients in group 3, and five [33%] of 15 in group 4), and consolidation and mixed patterns became more frequent (12 [40%] in group 3, eight [53%] in group 4). INTERPRETATION COVID-19 pneumonia manifests with chest CT imaging abnormalities, even in asymptomatic patients, with rapid evolution from focal unilateral to diffuse bilateral ground-glass opacities that progressed to or co-existed with consolidations within 1-3 weeks. Combining assessment of imaging features with clinical and laboratory findings could facilitate early diagnosis of COVID-19 pneumonia. FUNDING None.
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Affiliation(s)
- Heshui Shi
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan, Hubei, China
| | - Xiaoyu Han
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan, Hubei, China
| | - Nanchuan Jiang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan, Hubei, China
| | - Yukun Cao
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan, Hubei, China
| | - Osamah Alwalid
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan, Hubei, China
| | - Jin Gu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan, Hubei, China
| | - Yanqing Fan
- Department of Radiology, Wuhan Jinyintan Hospital, Wuhan, Hubei, China.
| | - Chuansheng Zheng
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan, Hubei, China.
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4986
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Cao Y, Li Q, Chen J, Guo X, Miao C, Yang H, Chen Z, Li C, Li L. Hospital Emergency Management Plan During the COVID-19 Epidemic. Acad Emerg Med 2020; 27:309-311. [PMID: 32124506 PMCID: PMC7159322 DOI: 10.1111/acem.13951] [Citation(s) in RCA: 99] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 02/26/2020] [Indexed: 02/05/2023]
Affiliation(s)
- Yubin Cao
- Department of Head and Neck OncologyWest China College of StomatologySichuan UniversityChengduChina
- State Key Laboratory of Oral DiseasesWest China College of StomatologySichuan UniversityChengduChina
| | - Qin Li
- Emergency DepartmentWest China HospitalSichuan UniversityChengduChina
- Institute of Disaster MedicineSichuan UniversityChengduChina
- West China School of NursingSichuan UniversityChengduChina
| | - Jing Chen
- State Key Laboratory of Oral DiseasesWest China College of StomatologySichuan UniversityChengduChina
- West China School of NursingSichuan UniversityChengduChina
- Operation RoomSichuan UniversityChengduChina
| | - Xia Guo
- College of Foreign Languages and CulturesSichuan UniversityChengduChina
| | - Cheng Miao
- Department of Head and Neck OncologyWest China College of StomatologySichuan UniversityChengduChina
- State Key Laboratory of Oral DiseasesWest China College of StomatologySichuan UniversityChengduChina
| | - Hui Yang
- State Key Laboratory of Oral DiseasesWest China College of StomatologySichuan UniversityChengduChina
- West China School of NursingSichuan UniversityChengduChina
- Operation RoomSichuan UniversityChengduChina
| | - Zihang Chen
- Department of PathologyWest China HospitalSichuan UniversityChengduChina
| | - Chunjie Li
- Department of Head and Neck OncologyWest China College of StomatologySichuan UniversityChengduChina
- State Key Laboratory of Oral DiseasesWest China College of StomatologySichuan UniversityChengduChina
- Medical Administration DepartmentWest China Hospital of StomatologySichuan UniversityChengduChina
| | - Longjiang Li
- Department of Head and Neck OncologyWest China College of StomatologySichuan UniversityChengduChina
- State Key Laboratory of Oral DiseasesWest China College of StomatologySichuan UniversityChengduChina
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4987
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Chang R, Wang H, Zhang S, Wang Z, Dong Y, Tsamlag L, Yu X, Xu C, Yu Y, Long R, Liu NN, Chu Q, Wang Y, Xu G, Shen T, Wang S, Deng X, Huang J, Zhang X, Wang H, Cai Y. Phase- and epidemic region-adjusted estimation of the number of coronavirus disease 2019 cases in China. Front Med 2020; 14:199-209. [PMID: 32279219 PMCID: PMC7148426 DOI: 10.1007/s11684-020-0768-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 03/14/2020] [Indexed: 10/28/2022]
Abstract
The outbreak of the coronavirus disease 2019 was first reported in Wuhan in December 2019 and gradually spread to other areas in China. After implementation of prevention and control measures, the estimation of the epidemic trend is needed. A phase- and region-adjusted SEIR model was applied for modeling and predicting the number of cases in Wuhan, Hubei Province and regions outside Hubei Province in China. The estimated number of infections could reach its peak in late February 2020 in Wuhan and Hubei Province, which is 55 303-84 520 and 83 944-129 312, respectively, while the epidemic peaks in regions outside Hubei Province in China could appear on February 13, 2020 with the estimated 13 035-19 108 cases. According to the estimation, the outbreak would abate in March and April all over China. Current estimation provided evidence for planned work resumption under stringent prevention and control in China to further support the fight against the epidemic. Nevertheless, there is still possibility of the second outbreak brought by the work resumption and population migration, especially from Hubei Province and high intensity cities outside Hubei Province. Strict prevention and control measures still need to be considered in the regions with high intensity of epidemic and densely-populated cities.
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Affiliation(s)
- Ruijie Chang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Huwen Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Shuxian Zhang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Zezhou Wang
- Department of Cancer Prevention, Shanghai Cancer Center, Fudan University, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200025, China
| | - Yinqiao Dong
- Department of Environmental and Occupational Health, School of Public Health, China Medical University, Shenyang, 110122, China
| | - Lhakpa Tsamlag
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Xiaoyue Yu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Chen Xu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Yuelin Yu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Rusi Long
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Ning-Ning Liu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Qiao Chu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Ying Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Gang Xu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Tian Shen
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Suping Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Xiaobei Deng
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Jinyan Huang
- State Key Laboratory of Medical Genomics, Shanghai Institute of Hematology, National Research Center for Translational Medicine (Shanghai), Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Xinxin Zhang
- Research Laboratory of Clinical Virology, National Research Center for Translational Medicine (Shanghai), Ruijin Hospital and Ruijin Hospital North Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
| | - Hui Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
| | - Yong Cai
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
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4988
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Abstract
OBJECTIVE:
To identify the epidemiological characteristics and transmission patterns of pediatric patients with the 2019 novel coronavirus disease (COVID-19) in China.
METHODS:
Nationwide case series of 2135 pediatric patients with COVID-19 reported to the Chinese Center for Disease Control and Prevention from January 16, 2020, to February 8, 2020, were included. The epidemic curves were constructed by key dates of disease onset and case diagnosis. Onset-to-diagnosis curves were constructed by fitting a log-normal distribution to data on both onset and diagnosis dates.
RESULTS:
There were 728 (34.1%) laboratory-confirmed cases and 1407 (65.9%) suspected cases. The median age of all patients was 7 years (interquartile range: 2–13 years), and 1208 case patients (56.6%) were boys. More than 90% of all patients had asymptomatic, mild, or moderate cases. The median time from illness onset to diagnoses was 2 days (range: 0–42 days). There was a rapid increase of disease at the early stage of the epidemic, and then there was a gradual and steady decrease. The disease rapidly spread from Hubei province to surrounding provinces over time. More children were infected in Hubei province than any other province.
CONCLUSIONS:
Children of all ages appeared susceptible to COVID-19, and there was no significant sex difference. Although clinical manifestations of children’s COVID-19 cases were generally less severe than those of adult patients, young children, particularly infants, were vulnerable to infection. The distribution of children’s COVID-19 cases varied with time and space, and most of the cases were concentrated in Hubei province and surrounding areas. Furthermore, this study provides strong evidence of human-to-human transmission.
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4989
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Wu JT, Leung K, Bushman M, Kishore N, Niehus R, de Salazar PM, Cowling BJ, Lipsitch M, Leung GM. Estimating clinical severity of COVID-19 from the transmission dynamics in Wuhan, China. Nat Med 2020; 26:506-510. [PMID: 32284616 PMCID: PMC7094929 DOI: 10.1038/s41591-020-0822-7] [Citation(s) in RCA: 717] [Impact Index Per Article: 179.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 03/09/2020] [Indexed: 11/08/2022]
Abstract
As of 29 February 2020 there were 79,394 confirmed cases and 2,838 deaths from COVID-19 in mainland China. Of these, 48,557 cases and 2,169 deaths occurred in the epicenter, Wuhan. A key public health priority during the emergence of a novel pathogen is estimating clinical severity, which requires properly adjusting for the case ascertainment rate and the delay between symptoms onset and death. Using public and published information, we estimate that the overall symptomatic case fatality risk (the probability of dying after developing symptoms) of COVID-19 in Wuhan was 1.4% (0.9-2.1%), which is substantially lower than both the corresponding crude or naïve confirmed case fatality risk (2,169/48,557 = 4.5%) and the approximator1 of deaths/deaths + recoveries (2,169/2,169 + 17,572 = 11%) as of 29 February 2020. Compared to those aged 30-59 years, those aged below 30 and above 59 years were 0.6 (0.3-1.1) and 5.1 (4.2-6.1) times more likely to die after developing symptoms. The risk of symptomatic infection increased with age (for example, at ~4% per year among adults aged 30-60 years).
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Affiliation(s)
- Joseph T Wu
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
| | - Kathy Leung
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Mary Bushman
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Nishant Kishore
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Rene Niehus
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Pablo M de Salazar
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Benjamin J Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Marc Lipsitch
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Gabriel M Leung
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
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4990
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Anand K, Karade S, Sen S, Gupta R. SARS-CoV-2: Camazotz's Curse. Med J Armed Forces India 2020; 76:136-141. [PMID: 32341622 PMCID: PMC7183968 DOI: 10.1016/j.mjafi.2020.04.008] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 04/22/2020] [Indexed: 02/08/2023] Open
Abstract
The world is currently face to face with a pandemic which is spreading rapidly across the globe caused by SARS-CoV-2, a strain of Coronaviruses (CoVs) belonging to subgenus Sarbecovirus of genus Betacoronavirus. World Health Organisation (WHO) on 11 Feb 20 named this disease caused by SARS-CoV-2 as Covid-19. This pandemic is spreading rapidly and more than 20,00,000 cases have occurred globally. The human Coronaviruses discovered in 1960s were considered potentially harmless endemic viruses with seasonal distribution before late 2002. The CoVs are found in a large number of domestic and wild animals and birds. The first pandemic caused by Coronavirus caused by SARS-CoV was recognized in the late 2002 in Guangdong Province and resulted in widespread morbidity and mortality. This was followed by MERS-CoV which began in 2012 in the Arabian peninsula with multiple outbreaks related to it in various parts of the globe. Various studies have suggested how these viruses made their entry from their natural reservoir bats via intermediate host like civets and camels in case of SARS-CoV and MERS-CoV respectively. The intermediate host of the SARS-CoV-2 still needs to be established. The SARS-CoV-2 has 96.2% similarity to the bat Severe Acute Respiratory Syndrome related-Coronavirus (SARSr-CoV RaTG13). SARS-CoV-2 has been found to be more distant in relation to SARS-CoV (79%) and MERS-CoV (50%). At the whole genome sequence level pangolin CoV and SARSr-CoV RaTG13 show 91.02% and 96.2% similarity with SARS-CoV-2 but the S1 subunit of spike protein of pangolin CoV is more closely related to SARS-CoV-2 than SARSr-CoV RaTG13. The genetic analysis of the currently circulating strains of the pandemic have shown 99.98-100% similarity in their genomes implying a recent shift to humans. The animal source of SARS-CoV-2 needs to be identified to implement control measures in the present pandemic. Also, how the virus moves interspecies will help predict and prevent future pandemics.
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Affiliation(s)
- K.B. Anand
- Associate Professor, Department of Microbiology, Armed Forces Medical College, Pune 411040, India
| | - S. Karade
- Assistant Professor, Department of Microbiology, Armed Forces Medical College, Pune 411040, India
| | - S. Sen
- Professor & Head, Department of Microbiology, Armed Forces Medical College, Pune 411040, India
| | - R.M. Gupta
- Professor (Microbiology) & Dean and Deputy Commandant, Armed Forces Medical College, Pune 411040, India
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4991
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Wang A, Zhao W, Xu Z, Gu J. Timely blood glucose management for the outbreak of 2019 novel coronavirus disease (COVID-19) is urgently needed. Diabetes Res Clin Pract 2020; 162:108118. [PMID: 32179126 PMCID: PMC7102524 DOI: 10.1016/j.diabres.2020.108118] [Citation(s) in RCA: 124] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 03/06/2020] [Indexed: 02/06/2023]
Affiliation(s)
- Aihong Wang
- Department of Endocrinology, PLA Strategic Support Force Characteristic Medical Center (The 306th Hospital of PLA), Beijing, China.
| | - Weibo Zhao
- Department of Endocrinology, PLA Strategic Support Force Characteristic Medical Center (The 306th Hospital of PLA), Beijing, China
| | - Zhangrong Xu
- Department of Endocrinology, PLA Strategic Support Force Characteristic Medical Center (The 306th Hospital of PLA), Beijing, China
| | - Jianwen Gu
- Prevention and Control Group of COVID-19, PLA Strategic Support Force Characteristic Medical Center, Beijing, China.
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4992
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Summary of the coronavirus disease 2019 (COVID-19) update from the 2020 Conference on Retroviruses and Opportunistic Infections, 8–11 March 2020, Boston, USA. J Virus Erad 2020. [PMID: 32405428 PMCID: PMC7331563 DOI: 10.1016/s2055-6640(20)30023-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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4993
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Tsai J, Wilson M. COVID-19: a potential public health problem for homeless populations. Lancet Public Health 2020; 5:e186-e187. [PMID: 32171054 PMCID: PMC7104053 DOI: 10.1016/s2468-2667(20)30053-0] [Citation(s) in RCA: 355] [Impact Index Per Article: 88.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 03/09/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Jack Tsai
- School of Public Health, University of Texas Health Science Center at Houston, Houston, TX 78229, USA; National Center on Homelessness Among Veterans, US Department of Veterans Affairs, Tampa, FL, USA; Department of Psychiatry, Yale University School of Medicine, Yale University, New Haven, CT, USA.
| | - Michal Wilson
- School of Public Health, University of Texas Health Science Center at Houston, Houston, TX 78229, USA
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4994
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Arshad Ali S, Baloch M, Ahmed N, Arshad Ali A, Iqbal A. The outbreak of Coronavirus Disease 2019 (COVID-19)-An emerging global health threat. J Infect Public Health 2020; 13:644-646. [PMID: 32199792 PMCID: PMC7102664 DOI: 10.1016/j.jiph.2020.02.033] [Citation(s) in RCA: 208] [Impact Index Per Article: 52.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 02/18/2020] [Accepted: 02/23/2020] [Indexed: 12/31/2022] Open
Abstract
The outbreak of Coronavirus Disease 2019 (COVID-19) causing novel coronavirus-infected pneumonia (NCIP), has affected the lives of 71,429 people globally. Originating in China, the disease has a rapid progression to other countries. Research suggests remarkable genomic resemblance of 2019-nCoV with Severe Acute Respiratory Syndrome (SARS) which has a history of a pandemic in 2002. With evidence of nosocomial spread, a number of diligent measures are being employed to constrain its propagation. Hence, the Public Health Emergency of International Concern (PHEIC) has been established by the World Health Organization (WHO) with strategic objectives for public health to curtail its impact on global health and economy.
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Affiliation(s)
- Shajeea Arshad Ali
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.
| | - Mariam Baloch
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.
| | - Naseem Ahmed
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.
| | | | - Ayman Iqbal
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.
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4995
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Zhavoronkov A. Geroprotective and senoremediative strategies to reduce the comorbidity, infection rates, severity, and lethality in gerophilic and gerolavic infections. Aging (Albany NY) 2020; 12:6492-6510. [PMID: 32229705 PMCID: PMC7202545 DOI: 10.18632/aging.102988] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 03/24/2020] [Indexed: 01/08/2023]
Abstract
The recently identified SARS-CoV-2 betacoronavirus responsible for the COVID-19 pandemic has uncovered the age-associated vulnerability in the burden of disease and put aging research in the spotlight. The limited data available indicates that COVID-19 should be referred to as a gerolavic (from Greek, géros "old man" and epilavís, "harmful") infection because the infection rates, severity, and lethality are substantially higher in the population aged 60 and older. This is primarily due to comorbidity but may be partially due to immunosenescence, decreased immune function in the elderly, and general loss of function, fitness, and increased frailty associated with aging. Immunosenescence is a major factor affecting vaccination response, as well as the severity and lethality of infectious diseases. While vaccination reduces infection rates, and therapeutic interventions reduce the severity and lethality of infections, these interventions have limitations. Previous studies showed that postulated geroprotectors, such as sirolimus (rapamycin) and its close derivative rapalog everolimus (RAD001), decreased infection rates in a small sample of elderly patients. This article presents a review of the limited literature available on geroprotective and senoremediative interventions that may be investigated to decrease the disease burden of gerolavic infections. This article also highlights a need for rigorous clinical validation of deep aging clocks as surrogate markers of biological age. These could be used to assess the need for, and efficacy of, geroprotective and senoremediative interventions and provide better protection for elderly populations from gerolavic infections. This article does not represent medical advice and the medications described are not yet licensed or recommended as immune system boosters, as they have not undergone clinical evaluation for this purpose.
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Affiliation(s)
- Alex Zhavoronkov
- Insilico Medicine, Hong Kong Science and Technology Park (HKSTP), Tai Po, Hong Kong
- The Biogerontology Research Foundation, London, UK
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4996
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Koh D, Cunningham AC. Counting Coronavirus Disease-2019 (COVID-19) Cases: Case Definitions, Screened
Populations and Testing Techniques Matter. ANNALS ACADEMY OF MEDICINE SINGAPORE 2020. [DOI: 10.47102/annals-acadmedsg.202038] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
While counting cases of disease appears straightforward, there are issues to consider
when enumerating disease counts during an epidemic. For example, for Coronavirus
Disease-2019 (COVID-19), how is a case defined? Hubei province in China changed
its case definition twice in a fortnight—from laboratory-confirmed cases to clinically confirmed cases without laboratory tests, and back to laboratory-confirmed cases. This
caused confusion in the reported number of cases. If a confirmed case requires laboratory testing, what is the population who are laboratory-tested? Due to limited laboratory testing capacity in the early phase of an emerging epidemic, only “suspected cases” are laboratory-tested in most countries. This will result in underdiagnosis of confirmed cases and also raises the question: how is a “suspect case” defined? With the passage of time and increased capability to perform laboratory tests, more people can be screened and the number of confirmed cases will increase. What are the technical considerations of laboratory testing? This includes specimen collection (variable collection methods), samples collected (upper or lower respiratory tract biospecimens), time of collection in relation to course of
disease, different laboratory test methods and kits (not all of which may be standardised or approved by authorities such as the Food and Drug Administration). Are approved laboratory facilities and trained manpower available, and how are test results interpreted and false-negatives excluded? These issues will affect the accuracy of disease counts, which in turn will have implications on how we mount an appropriate response to the outbreak.
Key words: Diagnosis, Laboratory testing, Outbreak, Pandemic, Screening
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Affiliation(s)
- David Koh
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Brunei Darussalam. Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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4997
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Wang LP, Wang J, Zhao HY, Shi YY, Wang K, Wu P, Shi L. Modelling and assessing the effects of medical resources on transmission of novel coronavirus (COVID-19) in Wuhan, China. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2020; 17:2936-2949. [PMID: 32987508 DOI: 10.3934/mbe.2020165] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
The coronavirus disease 2019 (COVID-2019), a newly emerging disease in China, posed a public health emergency of China. Wuhan is the most serious affected city. Some measures have been taken to control the transmission of COVID-19. From Jan. 23rd, 2020, gradually increasing medical resources (such as health workforce, protective clothing, essential medicines) were sent to Wuhan from other provinces, and the government has established the hospitals to quarantine and treat infected individuals. Under the condition of sufficient medical resources in Wuhan, late-stage of epidemic showed a downward trend. Assessing the effectiveness of medical resources is of great significance for the future response to similar disease. Based on the transmission mechanisms of COVID-19 and epidemic characteristics of Wuhan, by using time-dependent rates for some parameters, we establish a dynamical model to reflect the changes of medical resources on transmission of COVID-19 in Wuhan. Our model is applied to simulate the reported data on cumulative and new confirmed cases in Wuhan from Jan. 23rd to Mar. 6th, 2020. We estimate the basic reproduction number R0 = 2.71, which determines whether the disease will eventually die out or not under the absence of effective control measures. Moreover, we calculate the effective daily reproduction ratio Re(t), which is used to measure the 'daily reproduction number'. We obtain that Re(t) drops less than 1 since Feb. 8th. Our results show that delayed opening the 'Fire God Hill' hospital will greatly increase the magnitude of the outbreak. This shows that the government's timely establishment of hospitals and effective quarantine via quick detection prevent a larger outbreak.
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Affiliation(s)
- Li Ping Wang
- Department of Mathematics, Nanjing University of Aeronautics and Astronautics, Nanjing, 210016, China
| | - Jing Wang
- Department of Mathematics, Nanjing University of Aeronautics and Astronautics, Nanjing, 210016, China
| | - Hong Yong Zhao
- Department of Mathematics, Nanjing University of Aeronautics and Astronautics, Nanjing, 210016, China
| | - Yang Yang Shi
- Department of Mathematics, Nanjing University of Aeronautics and Astronautics, Nanjing, 210016, China
| | - Kai Wang
- Department of Mathematics, Nanjing University of Aeronautics and Astronautics, Nanjing, 210016, China
| | - Peng Wu
- Department of Mathematics, Nanjing University of Aeronautics and Astronautics, Nanjing, 210016, China
| | - Lei Shi
- Department of Mathematics, Nanjing University of Aeronautics and Astronautics, Nanjing, 210016, China
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4998
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Lescure FX, Bouadma L, Nguyen D, Parisey M, Wicky PH, Behillil S, Gaymard A, Bouscambert-Duchamp M, Donati F, Le Hingrat Q, Enouf V, Houhou-Fidouh N, Valette M, Mailles A, Lucet JC, Mentre F, Duval X, Descamps D, Malvy D, Timsit JF, Lina B, van-der-Werf S, Yazdanpanah Y. Clinical and virological data of the first cases of COVID-19 in Europe: a case series. THE LANCET. INFECTIOUS DISEASES 2020; 20:697-706. [PMID: 32224310 PMCID: PMC7156120 DOI: 10.1016/s1473-3099(20)30200-0] [Citation(s) in RCA: 750] [Impact Index Per Article: 187.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 03/11/2020] [Accepted: 03/12/2020] [Indexed: 02/07/2023]
Abstract
Background On Dec 31, 2019, China reported a cluster of cases of pneumonia in people at Wuhan, Hubei Province. The responsible pathogen is a novel coronavirus, named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We report the relevant features of the first cases in Europe of confirmed infection, named coronavirus disease 2019 (COVID-19), with the first patient diagnosed with the disease on Jan 24, 2020. Methods In this case series, we followed five patients admitted to Bichat-Claude Bernard University Hospital (Paris, France) and Pellegrin University Hospital (Bordeaux, France) and diagnosed with COVID-19 by semi-quantitative RT-PCR on nasopharyngeal swabs. We assessed patterns of clinical disease and viral load from different samples (nasopharyngeal and blood, urine, and stool samples), which were obtained once daily for 3 days from hospital admission, and once every 2 or 3 days until patient discharge. All samples were refrigerated and shipped to laboratories in the National Reference Center for Respiratory Viruses (The Institut Pasteur, Paris, and Hospices Civils de Lyon, Lyon, France), where RNA extraction, real-time RT-PCR, and virus isolation and titration procedures were done. Findings The patients were three men (aged 31 years, 48 years, and 80 years) and two women (aged 30 years and 46 years), all of Chinese origin, who had travelled to France from China around mid-January, 2020. Three different clinical evolutions are described: (1) two paucisymptomatic women diagnosed within a day of exhibiting symptoms, with high nasopharyngeal titres of SARS-CoV-2 within the first 24 h of the illness onset (5·2 and 7·4 log10 copies per 1000 cells, respectively) and viral RNA detection in stools; (2) a two-step disease progression in two young men, with a secondary worsening around 10 days after disease onset despite a decreasing viral load in nasopharyngeal samples; and (3) an 80-year-old man with a rapid evolution towards multiple organ failure and a persistent high viral load in lower and upper respiratory tract with systemic virus dissemination and virus detection in plasma. The 80-year-old patient died on day 14 of illness (Feb 14, 2020); all other patients had recovered and been discharged by Feb 19, 2020. Interpretation We illustrated three different clinical and biological types of evolution in five patients infected with SARS-CoV-2 with detailed and comprehensive viral sampling strategy. We believe that these findings will contribute to a better understanding of the natural history of the disease and will contribute to advances in the implementation of more efficient infection control strategies. Funding REACTing (Research & Action Emerging Infectious Diseases).
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Affiliation(s)
- Francois-Xavier Lescure
- Department of Infectious and Tropical Diseases, Assistance Publique-Hôpitaux de Paris, Bichat-Claude Bernard University Hospital, Paris, France; Infections Antimicrobials Modelling Evolution (IAME) UMR 1137, University of Paris, Paris, France
| | - Lila Bouadma
- Medical and Infectious Diseases Intensive Care Unit, Assistance Publique-Hôpitaux de Paris, Bichat-Claude Bernard University Hospital, Paris, France; Infections Antimicrobials Modelling Evolution (IAME) UMR 1137, University of Paris, Paris, France
| | - Duc Nguyen
- Department of Infectious Diseases and Tropical Medicine, University Hospital of Bordeaux, Bordeaux, France; INSERM U1219, University of Bordeaux, Bordeaux, France
| | - Marion Parisey
- Department of Infectious and Tropical Diseases, Assistance Publique-Hôpitaux de Paris, Bichat-Claude Bernard University Hospital, Paris, France
| | - Paul-Henri Wicky
- Medical and Infectious Diseases Intensive Care Unit, Assistance Publique-Hôpitaux de Paris, Bichat-Claude Bernard University Hospital, Paris, France; Infections Antimicrobials Modelling Evolution (IAME) UMR 1137, University of Paris, Paris, France
| | - Sylvie Behillil
- National Reference Center for Respiratory Viruses, Molecular Genetics of RNA Viruses, CNRS-UMR 3569, The Institut Pasteur, Paris, France
| | - Alexandre Gaymard
- National Reference Center for Respiratory Viruses, Department of Virology, Infective Agents Institute, North Hospital Network, Lyon, France; Virpath Laboratory, International Center of Research in Infectiology, INSERM U1111, CNRS-UMR 5308, École Normale Supérieure de Lyon, Université Claude Bernard Lyon, Lyon University, Lyon, France
| | - Maude Bouscambert-Duchamp
- National Reference Center for Respiratory Viruses, Department of Virology, Infective Agents Institute, North Hospital Network, Lyon, France; Virpath Laboratory, International Center of Research in Infectiology, INSERM U1111, CNRS-UMR 5308, École Normale Supérieure de Lyon, Université Claude Bernard Lyon, Lyon University, Lyon, France
| | - Flora Donati
- National Reference Center for Respiratory Viruses, Molecular Genetics of RNA Viruses, CNRS-UMR 3569, The Institut Pasteur, Paris, France
| | - Quentin Le Hingrat
- Department of Virology, Assistance Publique-Hôpitaux de Paris, Bichat-Claude Bernard University Hospital, Paris, France; Infections Antimicrobials Modelling Evolution (IAME) UMR 1137, University of Paris, Paris, France
| | - Vincent Enouf
- National Reference Center for Respiratory Viruses, Molecular Genetics of RNA Viruses, CNRS-UMR 3569, The Institut Pasteur, Paris, France; Mutualized Platform of Microbiology, Pasteur International Bioresources Network, The Institut Pasteur, Paris, France
| | - Nadhira Houhou-Fidouh
- Department of Virology, Assistance Publique-Hôpitaux de Paris, Bichat-Claude Bernard University Hospital, Paris, France
| | - Martine Valette
- National Reference Center for Respiratory Viruses, Department of Virology, Infective Agents Institute, North Hospital Network, Lyon, France; Virpath Laboratory, International Center of Research in Infectiology, INSERM U1111, CNRS-UMR 5308, École Normale Supérieure de Lyon, Université Claude Bernard Lyon, Lyon University, Lyon, France
| | | | - Jean-Christophe Lucet
- Infection Control Unit, Assistance Publique-Hôpitaux de Paris, Bichat-Claude Bernard University Hospital, Paris, France; Infections Antimicrobials Modelling Evolution (IAME) UMR 1137, University of Paris, Paris, France
| | - France Mentre
- Department of Epidemiology, Biostatistics and Clinical Research, Assistance Publique-Hôpitaux de Paris, Bichat-Claude Bernard University Hospital, Paris, France; Infections Antimicrobials Modelling Evolution (IAME) UMR 1137, University of Paris, Paris, France
| | - Xavier Duval
- Center for Clinical Investigation, Assistance Publique-Hôpitaux de Paris, Bichat-Claude Bernard University Hospital, Paris, France; Infections Antimicrobials Modelling Evolution (IAME) UMR 1137, University of Paris, Paris, France
| | - Diane Descamps
- Department of Virology, Assistance Publique-Hôpitaux de Paris, Bichat-Claude Bernard University Hospital, Paris, France; Infections Antimicrobials Modelling Evolution (IAME) UMR 1137, University of Paris, Paris, France
| | - Denis Malvy
- Department of Infectious Diseases and Tropical Medicine, University Hospital of Bordeaux, Bordeaux, France; INSERM U1219, University of Bordeaux, Bordeaux, France
| | - Jean-François Timsit
- Medical and Infectious Diseases Intensive Care Unit, Assistance Publique-Hôpitaux de Paris, Bichat-Claude Bernard University Hospital, Paris, France; Infections Antimicrobials Modelling Evolution (IAME) UMR 1137, University of Paris, Paris, France
| | - Bruno Lina
- National Reference Center for Respiratory Viruses, Department of Virology, Infective Agents Institute, North Hospital Network, Lyon, France; Virpath Laboratory, International Center of Research in Infectiology, INSERM U1111, CNRS-UMR 5308, École Normale Supérieure de Lyon, Université Claude Bernard Lyon, Lyon University, Lyon, France
| | - Sylvie van-der-Werf
- National Reference Center for Respiratory Viruses, Molecular Genetics of RNA Viruses, CNRS-UMR 3569, The Institut Pasteur, Paris, France
| | - Yazdan Yazdanpanah
- Department of Infectious and Tropical Diseases, Assistance Publique-Hôpitaux de Paris, Bichat-Claude Bernard University Hospital, Paris, France; Infections Antimicrobials Modelling Evolution (IAME) UMR 1137, University of Paris, Paris, France.
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4999
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Affiliation(s)
- Angélica Gonçalves Silva Belasco
- Associate Professor of the Department of Clinical and Surgical Nursing at Escola Paulista de Enfermagem, Universidade Federal de São Paulo. São Paulo, São Paulo, Brazil
| | - Cassiane Dezoti da Fonseca
- Adjunct Professor of the Department of Clinical and Surgical Nursing at Escola Paulista de Enfermagem, Universidade Federal de São Paulo. São Paulo, São Paulo, Brazil
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5000
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Affiliation(s)
- B. K. Romanov
- Scientific Center for Expert Evaluation of Medical Products
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