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Vaduganathan M, Vardeny O, Michel T, McMurray JJV, Pfeffer MA, Solomon SD. Renin-Angiotensin-Aldosterone System Inhibitors in Patients with Covid-19. N Engl J Med 2020; 382:1653-1659. [PMID: 32227760 PMCID: PMC7121452 DOI: 10.1056/nejmsr2005760] [Citation(s) in RCA: 1521] [Impact Index Per Article: 380.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Muthiah Vaduganathan
- From the Cardiovascular Division, Brigham and Women's Hospital, and Harvard Medical School, Boston (M.V., T.M., M.A.P., S.D.S.); the Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, and University of Minnesota, Minneapolis (O.V.); and the British Heart Foundation Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom (J.J.V.M.)
| | - Orly Vardeny
- From the Cardiovascular Division, Brigham and Women's Hospital, and Harvard Medical School, Boston (M.V., T.M., M.A.P., S.D.S.); the Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, and University of Minnesota, Minneapolis (O.V.); and the British Heart Foundation Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom (J.J.V.M.)
| | - Thomas Michel
- From the Cardiovascular Division, Brigham and Women's Hospital, and Harvard Medical School, Boston (M.V., T.M., M.A.P., S.D.S.); the Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, and University of Minnesota, Minneapolis (O.V.); and the British Heart Foundation Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom (J.J.V.M.)
| | - John J V McMurray
- From the Cardiovascular Division, Brigham and Women's Hospital, and Harvard Medical School, Boston (M.V., T.M., M.A.P., S.D.S.); the Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, and University of Minnesota, Minneapolis (O.V.); and the British Heart Foundation Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom (J.J.V.M.)
| | - Marc A Pfeffer
- From the Cardiovascular Division, Brigham and Women's Hospital, and Harvard Medical School, Boston (M.V., T.M., M.A.P., S.D.S.); the Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, and University of Minnesota, Minneapolis (O.V.); and the British Heart Foundation Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom (J.J.V.M.)
| | - Scott D Solomon
- From the Cardiovascular Division, Brigham and Women's Hospital, and Harvard Medical School, Boston (M.V., T.M., M.A.P., S.D.S.); the Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, and University of Minnesota, Minneapolis (O.V.); and the British Heart Foundation Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom (J.J.V.M.)
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702
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Affiliation(s)
- Devi Sridhar
- Medical School, Edinburgh University, Edinburgh, UK
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703
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Sportelli MC, Izzi M, Kukushkina EA, Hossain SI, Picca RA, Ditaranto N, Cioffi N. Can Nanotechnology and Materials Science Help the Fight against SARS-CoV-2? NANOMATERIALS (BASEL, SWITZERLAND) 2020; 10:E802. [PMID: 32326343 PMCID: PMC7221591 DOI: 10.3390/nano10040802] [Citation(s) in RCA: 139] [Impact Index Per Article: 34.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 04/14/2020] [Accepted: 04/16/2020] [Indexed: 12/17/2022]
Abstract
Since 2004, we have been developing nanomaterials with antimicrobial properties, the so-called nanoantimicrobials. When the coronavirus disease 2019 (COVID-19) emerged, we started investigating new and challenging routes to nanoantivirals. The two fields have some important points of contact. We would like to share with the readership our vision of the role a (nano)materials scientist can play in the fight against the COVID-19 pandemic. As researchers specifically working on surfaces and nanomaterials, in this letter we underline the importance of nanomaterial-based technological solutions in several aspects of the fight against the virus. While great resources are understandably being dedicated to treatment and diagnosis, more efforts could be dedicated to limit the virus spread. Increasing the efficacy of personal protection equipment, developing synergistic antiviral coatings, are only two of the cases discussed. This is not the first nor the last pandemic: our nanomaterials community may offer several technological solutions to challenge the ongoing and future global health emergencies. Readers' feedback and suggestions are warmly encouraged.
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Affiliation(s)
- Maria Chiara Sportelli
- Chemistry Department, University of Bari “Aldo Moro”, via E. Orabona 4, 70126 Bari, Italy; (M.C.S.); (M.I.); (E.A.K.); (S.I.H.); (R.A.P.); (N.D.)
- IFN-CNR, Physics Department “M. Merlin”, Bari, Italy, via Amendola 173, 70126 Bari, Italy
- CSGI (Center for Colloid and Surface Science) c/o Dept. Chemistry, via Orabona 4, 70125 Bari, Italy
| | - Margherita Izzi
- Chemistry Department, University of Bari “Aldo Moro”, via E. Orabona 4, 70126 Bari, Italy; (M.C.S.); (M.I.); (E.A.K.); (S.I.H.); (R.A.P.); (N.D.)
| | - Ekaterina A. Kukushkina
- Chemistry Department, University of Bari “Aldo Moro”, via E. Orabona 4, 70126 Bari, Italy; (M.C.S.); (M.I.); (E.A.K.); (S.I.H.); (R.A.P.); (N.D.)
| | - Syed Imdadul Hossain
- Chemistry Department, University of Bari “Aldo Moro”, via E. Orabona 4, 70126 Bari, Italy; (M.C.S.); (M.I.); (E.A.K.); (S.I.H.); (R.A.P.); (N.D.)
| | - Rosaria Anna Picca
- Chemistry Department, University of Bari “Aldo Moro”, via E. Orabona 4, 70126 Bari, Italy; (M.C.S.); (M.I.); (E.A.K.); (S.I.H.); (R.A.P.); (N.D.)
- CSGI (Center for Colloid and Surface Science) c/o Dept. Chemistry, via Orabona 4, 70125 Bari, Italy
| | - Nicoletta Ditaranto
- Chemistry Department, University of Bari “Aldo Moro”, via E. Orabona 4, 70126 Bari, Italy; (M.C.S.); (M.I.); (E.A.K.); (S.I.H.); (R.A.P.); (N.D.)
- CSGI (Center for Colloid and Surface Science) c/o Dept. Chemistry, via Orabona 4, 70125 Bari, Italy
| | - Nicola Cioffi
- Chemistry Department, University of Bari “Aldo Moro”, via E. Orabona 4, 70126 Bari, Italy; (M.C.S.); (M.I.); (E.A.K.); (S.I.H.); (R.A.P.); (N.D.)
- CSGI (Center for Colloid and Surface Science) c/o Dept. Chemistry, via Orabona 4, 70125 Bari, Italy
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704
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Kenyon C. Flattening-the-curve associated with reduced COVID-19 case fatality rates- an ecological analysis of 65 countries. J Infect 2020; 81:e98-e99. [PMID: 32305488 PMCID: PMC7162747 DOI: 10.1016/j.jinf.2020.04.007] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 04/10/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Chris Kenyon
- HIV/STI Unit, Institute of Tropical Medicine, Antwerp, Belgium; Division of Infectious, Diseases and HIV Medicine, University of Cape Town, Anzio Road, Observatory 7700, South Africa.
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705
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Ke R, Sanche S, Romero-Severson E, Hengartner N. Fast spread of COVID-19 in Europe and the US suggests the necessity of early, strong and comprehensive interventions. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020:2020.04.04.20050427. [PMID: 32511619 PMCID: PMC7276046 DOI: 10.1101/2020.04.04.20050427] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The COVID-19 pandemic caused more than 800,000 infections and 40,000 deaths by the end of March 2020. However, some of the basic epidemiological parameters, such as the exponential epidemic growth rate and R0 are debated. We developed an inference approach to control for confounding factors in data collection, such as underreporting and changes in surveillance intensities, and fitted a mathematical model to infection and death count data collected from eight European countries and the US. In all countries, the early epidemic grew exponentially at rates between 0.19-0.29/day (epidemic doubling times between 2.4-3.7 days). This suggests a highly infectious virus with an R0 likely between 4.0 and 7.1. We show that similar levels of intervention efforts are needed, no matter the goal is mitigation or containment. Early, strong and comprehensive intervention efforts to achieve greater than 74-86% reduction in transmission are necessary.
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Affiliation(s)
- Ruian Ke
- T-6 Theoretical Biology and Biophysics, Theoretical Division, Los Alamos National Laboratory, NM87545, USA
| | - Steven Sanche
- T-6 Theoretical Biology and Biophysics, Theoretical Division, Los Alamos National Laboratory, NM87545, USA
- T-CNLS Center for Nonlinear Studies, Los Alamos National Laboratory, NM87545, USA
| | - Ethan Romero-Severson
- T-6 Theoretical Biology and Biophysics, Theoretical Division, Los Alamos National Laboratory, NM87545, USA
| | - Nick Hengartner
- T-6 Theoretical Biology and Biophysics, Theoretical Division, Los Alamos National Laboratory, NM87545, USA
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706
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Exposure to air pollution and COVID-19 mortality in the United States: A nationwide cross-sectional study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020. [PMID: 32511651 DOI: 10.1101/2020.04.05.20054502] [Citation(s) in RCA: 389] [Impact Index Per Article: 97.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVES United States government scientists estimate that COVID-19 may kill tens of thousands of Americans. Many of the pre-existing conditions that increase the risk of death in those with COVID-19 are the same diseases that are affected by long-term exposure to air pollution. We investigated whether long-term average exposure to fine particulate matter (PM 2.5 ) is associated with an increased risk of COVID-19 death in the United States. DESIGN A nationwide, cross-sectional study using county-level data. DATA SOURCES COVID-19 death counts were collected for more than 3,000 counties in the United States (representing 98% of the population) up to April 22, 2020 from Johns Hopkins University, Center for Systems Science and Engineering Coronavirus Resource Center. MAIN OUTCOME MEASURES We fit negative binomial mixed models using county-level COVID-19 deaths as the outcome and county-level long-term average of PM 2.5 as the exposure. In the main analysis, we adjusted by 20 potential confounding factors including population size, age distribution, population density, time since the beginning of the outbreak, time since state issuance of the stay-at-home order, hospital beds, number of individuals tested, weather, and socioeconomic and behavioral variables such as obesity and smoking. We included a random intercept by state to account for potential correlation in counties within the same state. We conducted more than 68 additional sensitivity analyses. RESULTS We found that an increase of only 1 μg/m 3 in PM 2.5 is associated with an 8% increase in the COVID-19 death rate (95% confidence interval [CI]: 2%, 15%). The results were statistically significant and robust to secondary and sensitivity analyses. CONCLUSIONS A small increase in long-term exposure to PM 2.5 leads to a large increase in the COVID-19 death rate. Despite the inherent limitations of the ecological study design, our results underscore the importance of continuing to enforce existing air pollution regulations to protect human health both during and after the COVID-19 crisis. The data and code are publicly available so our analyses can be updated routinely.
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707
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Abstract
Infection with the severe acute respiratory syndrome novel coronavirus produces a clinical syndrome known as 2019 novel coronavirus disease (COVID-19). When severe, COVID-19 is a systemic illness characterized by hyperinflammation, cytokine storm, and elevations of cardiac injury biomarkers. Here, we review what is known about the pathophysiology of COVID-19, its cardiovascular manifestations, and emerging therapeutic prospects. In this rapidly moving field, this review was comprehensive as of April 3, 2020.
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Affiliation(s)
- Akbarshakh Akhmerov
- From the Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Eduardo Marbán
- From the Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA
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708
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Weitz JS, Beckett SJ, Coenen AR, Demory D, Dominguez-Mirazo M, Dushoff J, Leung CY, Li G, Măgălie A, Park SW, Rodriguez-Gonzalez R, Shivam S, Zhao C. Intervention Serology and Interaction Substitution: Modeling the Role of 'Shield Immunity' in Reducing COVID-19 Epidemic Spread. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020:2020.04.01.20049767. [PMID: 32511605 PMCID: PMC7276032 DOI: 10.1101/2020.04.01.20049767] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The COVID-19 pandemic has precipitated a global crisis, with more than 690,000 confirmed cases and more than 33,000 confirmed deaths globally as of March 30, 2020 [1-4]. At present two central public health control strategies have emerged: mitigation and suppression (e.g, [5]). Both strategies focus on reducing new infections by reducing interactions (and both raise questions of sustainability and long-term tactics). Complementary to those approaches, here we develop and analyze an epidemiological intervention model that leverages serological tests [6, 7] to identify and deploy recovered individuals as focal points for sustaining safer interactions via interaction substitution, i.e., to develop what we term 'shield immunity' at the population scale. Recovered individuals, in the present context, represent those who have developed protective, antibodies to SARS-CoV-2 and are no longer shedding virus [8]. The objective of a shield immunity strategy is to help sustain the interactions necessary for the functioning of essential goods and services (including but not limited to tending to the elderly [9], hospital care, schools, and food supply) while decreasing the probability of transmission during such essential interactions. We show that a shield immunity approach may significantly reduce the length and reduce the overall burden of an outbreak, and can work synergistically with social distancing. The present model highlights the value of serological testing as part of intervention strategies, in addition to its well recognized roles in estimating prevalence [10, 11] and in the potential development of plasma-based therapies [12-15].
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Affiliation(s)
- Joshua S. Weitz
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, USA
- School of Physics, Georgia Institute of Technology, Atlanta, GA, USA
- Center for Microbial Dynamics and Infection, Georgia Institute of Technology, Atlanta, GA, USA
| | - Stephen J. Beckett
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, USA
| | - Ashley R. Coenen
- School of Physics, Georgia Institute of Technology, Atlanta, GA, USA
| | - David Demory
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, USA
| | - Marian Dominguez-Mirazo
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, USA
- Interdisciplinary Graduate Program in Quantitative Biosciences, Georgia Institute of Technology, Atlanta, GA, USA
| | - Jonathan Dushoff
- Department of Biology, McMaster University, Hamilton, ON, Canada
- DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, ON, Canada
| | - Chung-Yin Leung
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, USA
- School of Physics, Georgia Institute of Technology, Atlanta, GA, USA
| | - Guanlin Li
- School of Physics, Georgia Institute of Technology, Atlanta, GA, USA
- Interdisciplinary Graduate Program in Quantitative Biosciences, Georgia Institute of Technology, Atlanta, GA, USA
| | - Andreea Măgălie
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, USA
- Interdisciplinary Graduate Program in Quantitative Biosciences, Georgia Institute of Technology, Atlanta, GA, USA
| | - Sang Woo Park
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA
| | - Rogelio Rodriguez-Gonzalez
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, USA
- Interdisciplinary Graduate Program in Quantitative Biosciences, Georgia Institute of Technology, Atlanta, GA, USA
| | - Shashwat Shivam
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Conan Zhao
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, USA
- Interdisciplinary Graduate Program in Quantitative Biosciences, Georgia Institute of Technology, Atlanta, GA, USA
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709
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Choy KT, Wong AYL, Kaewpreedee P, Sia SF, Chen D, Hui KPY, Chu DKW, Chan MCW, Cheung PPH, Huang X, Peiris M, Yen HL. Remdesivir, lopinavir, emetine, and homoharringtonine inhibit SARS-CoV-2 replication in vitro. Antiviral Res 2020; 178:104786. [PMID: 32251767 PMCID: PMC7127386 DOI: 10.1016/j.antiviral.2020.104786] [Citation(s) in RCA: 609] [Impact Index Per Article: 152.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 03/28/2020] [Accepted: 03/29/2020] [Indexed: 01/11/2023]
Abstract
An escalating pandemic by the novel SARS-CoV-2 virus is impacting global health and effective therapeutic options are urgently needed. We evaluated the in vitro antiviral effect of compounds that were previously reported to inhibit coronavirus replication and compounds that are currently under evaluation in clinical trials for SARS-CoV-2 patients. We report the antiviral effect of remdesivir, lopinavir, homorringtonine, and emetine against SARS-CoV-2 virus in Vero E6 cells with the estimated 50% effective concentration at 23.15 μM, 26.63 μM, 2.55 μM and 0.46 μM, respectively. Ribavirin or favipiravir that are currently evaluated under clinical trials showed no inhibition at 100 μM. Synergy between remdesivir and emetine was observed, and remdesivir at 6.25 μM in combination with emetine at 0.195 μM may achieve 64.9% inhibition in viral yield. Combinational therapy may help to reduce the effective concentration of compounds below the therapeutic plasma concentrations and provide better clinical benefits.
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Affiliation(s)
- Ka-Tim Choy
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Alvina Yin-Lam Wong
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Prathanporn Kaewpreedee
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Sin Fun Sia
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Dongdong Chen
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Kenrie Pui Yan Hui
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Daniel Ka Wing Chu
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Michael Chi Wai Chan
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Peter Pak-Hang Cheung
- Department of Chemistry, Hong Kong University of Science and Technology, Hong Kong SAR, China
| | - Xuhui Huang
- Department of Chemistry, Hong Kong University of Science and Technology, Hong Kong SAR, China
| | - Malik Peiris
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Hui-Ling Yen
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
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710
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Bein B, Bachmann M, Huggett S, Wegermann P. [SARS CoV-2/COVID-19: Evidence-Based Recommendation on Diagnosis and Therapy]. Anasthesiol Intensivmed Notfallmed Schmerzther 2020; 55:257-265. [PMID: 32274773 PMCID: PMC7295266 DOI: 10.1055/a-1146-8674] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
COVID-19, a new viral disease affecting primarily the respiratory system and the lung, has caused a pandemic with serious challenges to health systems around the world. In about 20% of patients, severe symptoms occur after a mean incubation period of 5 - 6 days; 5% of patients need intensive care therapy. Morbidity is about 1 - 2%. Protecting health care workers is of paramount importance in order to prevent hospital acquired infections. Therefore, during all procedures associated with aerosol production, a personal safety equipment consisting of a FFP2/FFP3 (N95) respiratory mask, gloves, safety glasses and a waterproof overall should be used. Therapy is based on established recommendations issued for patients with acute lung injury (ARDS). Lung protective ventilation, prone position, restrictive fluid management and an adequate management of organ failures are the mainstays of therapy. In case of fulminant lung failure, veno-venous extracorporeal membrane oxygenation may be used as a rescue in experienced centres. New, experimental therapies evolve with ever increasing frequency; currently, however, there is no evidence based recommendation possible. If off-label and compassionate use of these drugs is considered, an individual benefit-risk assessment is necessary, since serious side effects have been reported.
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Affiliation(s)
- Berthold Bein
- Korrespondenzadresse Prof. Dr. med. Berthold Bein Klinik für Anästhesiologie, Intensivmedizin, Notfallmedizin und SchmerztherapieAsklepios Klinik St. GeorgLohmühlenstraße 520099 Hamburg
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711
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Lipsitch M. Estimating case fatality rates of COVID-19. THE LANCET. INFECTIOUS DISEASES 2020; 20:775. [PMID: 32243813 PMCID: PMC7270796 DOI: 10.1016/s1473-3099(20)30245-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 03/20/2020] [Indexed: 01/08/2023]
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712
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Böttcher L, Xia M, Chou T. Why estimating population-based case fatality rates during epidemics may be misleading. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020:2020.03.26.20044693. [PMID: 32511575 PMCID: PMC7276002 DOI: 10.1101/2020.03.26.20044693] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Different ways of calculating mortality ratios during epidemics can yield widely different results, particularly during the COVID-19 pandemic. We formulate both a survival probability model and an associated infection duration-dependent SIR model to define individual- and population-based estimates of dynamic mortality ratios. The key parameters that affect the dynamics of the different mortality estimates are the incubation period and the length of time individuals were infected before confirmation of infection. We stress that none of these ratios are accurately represented by the often misinterpreted case fatality ratio (CFR), the number of deaths to date divided by the total number of infected cases to date. Using available data on the recent SARS-CoV-2 outbreaks and simple assumptions, we estimate and compare the different dynamic mortality ratios and highlight their differences. Informed by our modeling, we propose a more systematic method to determine mortality ratios during epidemic outbreaks and discuss sensitivity to confounding effects and errors in the data.
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Affiliation(s)
- Lucas Böttcher
- Dept. of Computational Medicine, UCLA, Los Angeles, CA 90095-1766
| | - Mingtao Xia
- Dept. of Mathematics, UCLA, Los Angeles, CA 90095-1555
| | - Tom Chou
- Dept. of Computational Medicine, UCLA, Los Angeles, CA 90095-1766
- Dept. of Mathematics, UCLA, Los Angeles, CA 90095-1555
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713
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Krishnakumar B, Rana S. COVID 19 in INDIA: Strategies to combat from combination threat of life and livelihood. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2020; 53:389-391. [PMID: 32253143 PMCID: PMC7141550 DOI: 10.1016/j.jmii.2020.03.024] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 03/23/2020] [Accepted: 03/24/2020] [Indexed: 12/31/2022]
Abstract
INDIA- As for reported in 360 COVID-19 cases (till March 22, 2020), seven people were died, and 23 people were treated successfully.1 This virus can easily affect who having respiratory problem and especially who all have been aged older than sixty. Most of the affected peoples had reached India from different part of the world, as like of carrier. Owing to this, India made several precautionary measures to mitigate/neglect the disease in beginning stage, however, the denser population of country will not be simple to control the same for long time (community spread), if government will not incorporate the visionary strategies. Since attacked several nations have been worried mostly for their people life (health), despite that developing country like India with huge population should consider about the livelihood (for Below Poverty Line (BPL) people), equally with the life. This article will give insights to make effective strategy to culminate the world threat COVID-19 in India.
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Affiliation(s)
- Balaji Krishnakumar
- University of Petroleum & Energy Studies (UPES), School of Engineering, Energy Acres, Bidholi, Dehradun, 248007, India.
| | - Sravendra Rana
- University of Petroleum & Energy Studies (UPES), School of Engineering, Energy Acres, Bidholi, Dehradun, 248007, India
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714
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Affiliation(s)
- Rachel E Jordan
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Peymane Adab
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - K K Cheng
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
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715
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Yu P, Qi F, Xu Y, Li F, Liu P, Liu J, Bao L, Deng W, Gao H, Xiang Z, Xiao C, Lv Q, Gong S, Liu J, Song Z, Qu Y, Xue J, Wei Q, Liu M, Wang G, Wang S, Yu H, Liu X, Huang B, Wang W, Zhao L, Wang H, Ye F, Zhou W, Zhen W, Han J, Wu G, Jin Q, Wang J, Tan W, Qin C. Age-related rhesus macaque models of COVID-19. Animal Model Exp Med 2020; 3:93-97. [PMID: 32318665 PMCID: PMC7167234 DOI: 10.1002/ame2.12108] [Citation(s) in RCA: 215] [Impact Index Per Article: 53.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 03/12/2020] [Accepted: 03/12/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Since December 2019, an outbreak of the Corona Virus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus (SARS-CoV-2) in Wuhan, China, has become a public health emergency of international concern. The high fatality of aged cases caused by SARS-CoV-2 was a need to explore the possible age-related phenomena with non-human primate models. METHODS Three 3-5 years old and two 15 years old rhesus macaques were intratracheally infected with SARS-CoV-2, and then analyzed by clinical signs, viral replication, chest X-ray, histopathological changes and immune response. RESULTS Viral replication of nasopharyngeal swabs, anal swabs and lung in old monkeys was more active than that in young monkeys for 14 days after SARS-CoV-2 challenge. Monkeys developed typical interstitial pneumonia characterized by thickened alveolar septum accompanied with inflammation and edema, notably, old monkeys exhibited diffuse severe interstitial pneumonia. Viral antigens were detected mainly in alveolar epithelial cells and macrophages. CONCLUSION SARS-CoV-2 caused more severe interstitial pneumonia in old monkeys than that in young monkeys. Rhesus macaque models infected with SARS-CoV-2 provided insight into the pathogenic mechanism and facilitated the development of vaccines and therapeutics against SARS-CoV-2 infection.
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716
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Brandenburg JE, Fogarty MJ, Sieck GC. Why individuals with cerebral palsy are at higher risk for respiratory complications from COVID-19. J Pediatr Rehabil Med 2020; 13:317-327. [PMID: 33136080 DOI: 10.3233/prm-200746] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Respiratory dysfunction is a leading cause of morbidity and mortality in individuals with cerebral palsy (CP). In children and adults with CP, movement and physical function is always affected. Yet, many clinicians overlook potential for impaired movement and function of the diaphragm muscle (DIAm) in individuals with CP. Since individuals with pre-existing respiratory disorders are at greater risk for respiratory complications if they contract COVID-19, understanding potential risks to individuals with CP is important. In this review we present research on respiratory function and DIAm force generation in children with CP. We compare this clinical work to basic science research investigating phrenic motor neuron and DIAm motor unit dysfunction in an animal model with CP symptoms, the spa mouse. Finally, we integrate the clinical and basic science work in respiratory function in CP, discussing potential for individuals with CP to have severe respiratory symptoms from COVID-19.
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Affiliation(s)
- Joline E Brandenburg
- Department of Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine, Rochester, MN, USA.,Department of Pediatric and Adolescent Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Matthew J Fogarty
- Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Gary C Sieck
- Department of Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine, Rochester, MN, USA.,Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, MN, USA
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717
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Brandenburg JE, Holman LK, Apkon SD, Houtrow AJ, Rinaldi R, Sholas MG. School reopening during COVID-19 pandemic: Considering students with disabilities. J Pediatr Rehabil Med 2020; 13:425-431. [PMID: 33136082 DOI: 10.3233/prm-200789] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Over 80% of the children in the world have had their education impacted by COVID-19. For children with disabilities who receive special education services, access to in-person education and other resources at school is particularly important. The American Academy of Pediatrics advocates for students to attend school in person, without specifics for how children with disabilities can safely return to school. To appropriately plan and accommodate children with disabilities we must prioritize safety, allow for adherence to the Individuals with Disabilities Education Act, and preserve essential school staff. The less cumbersome default of confining students with disabilities to home is not acceptable. We provide an outline describing why Individual Education Plans and 504 plans are important, how they are related to the COVID-19 pandemic, and recommendations for measures to help with safe return to school for children with disabilities.
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Affiliation(s)
- Joline E Brandenburg
- Department of Physical Medicine and Rehabilitation, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - Lainie K Holman
- Department of Pediatric Physical Medicine and Rehabilitation, Department of Pediatrics, Cleveland Clinic Children's Hospital for Rehabilitation, Cleveland, OH, USA
| | - Susan D Apkon
- Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Aurora, CO, USA
| | - Amy J Houtrow
- Department of Physical Medicine and Rehabilitation, Department of Pediatrics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Robert Rinaldi
- Department of Physical Medicine and Rehabilitation, Department of Pediatrics, University of Texas- Southwestern Medical Center, Dallas, TX, USA
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718
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Dudel C, Riffe T, Acosta E, van Raalte A, Strozza C, Myrskylä M. Monitoring trends and differences in COVID-19 case-fatality rates using decomposition methods: Contributions of age structure and age-specific fatality. PLoS One 2020. [PMID: 32913365 DOI: 10.1101/2020.03.31.20048397] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
Abstract
The population-level case-fatality rate (CFR) associated with COVID-19 varies substantially, both across countries at any given time and within countries over time. We analyze the contribution of two key determinants of the variation in the observed CFR: the age-structure of diagnosed infection cases and age-specific case-fatality rates. We use data on diagnosed COVID-19 cases and death counts attributable to COVID-19 by age for China, Germany, Italy, South Korea, Spain, the United States, and New York City. We calculate the CFR for each population at the latest data point and also for Italy, Germany, Spain, and New York City over time. We use demographic decomposition to break the difference between CFRs into unique contributions arising from the age-structure of confirmed cases and the age-specific case-fatality. In late June 2020, CFRs varied from 2.2% in South Korea to 14.0% in Italy. The age-structure of detected cases often explains more than two-thirds of cross-country variation in the CFR. In Italy, the CFR increased from 4.2% to 14.0% between March 9 and June 30, 2020, and more than 90% of the change was due to increasing age-specific case-fatality rates. The importance of the age-structure of confirmed cases likely reflects several factors, including different testing regimes and differences in transmission trajectories; while increasing age-specific case-fatality rates in Italy could indicate other factors, such as the worsening health outcomes of those infected with COVID-19. Our findings lend support to recommendations for data to be disaggregated by age, and potentially other variables, to facilitate a better understanding of population-level differences in CFRs. They also show the need for well-designed seroprevalence studies to ascertain the extent to which differences in testing regimes drive differences in the age-structure of detected cases.
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Affiliation(s)
- Christian Dudel
- Max Planck Institute for Demographic Research, Rostock, Germany
| | - Tim Riffe
- Max Planck Institute for Demographic Research, Rostock, Germany
| | - Enrique Acosta
- Max Planck Institute for Demographic Research, Rostock, Germany
| | | | - Cosmo Strozza
- Sapienza University of Rome, Rome, Italy
- Interdisciplinary Centre on Population Dynamics, University of Southern Denmark, Odense, Denmark
| | - Mikko Myrskylä
- Max Planck Institute for Demographic Research, Rostock, Germany
- Population Research Unit, University of Helsinki, Helsinki, Finland
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719
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Naughton SX, Raval U, Pasinetti GM. Potential Novel Role of COVID-19 in Alzheimer's Disease and Preventative Mitigation Strategies. J Alzheimers Dis 2020; 76:21-25. [PMID: 32538855 PMCID: PMC8057202 DOI: 10.3233/jad-200537] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
There are a number of potential implications for the field of Alzheimer's disease (AD) stemming from the global spread of SARS-CoV-2. Neuroinflammation is known to be a prominent feature of neurodegeneration and plays a major role in AD pathology. Immune response and excessive inflammation in COVID-19 may also accelerate the progression of brain inflammatory neurodegeneration, and elderly individuals are more susceptible to severe outcomes after SARS-CoV-2 infection. Individuals with type 2 diabetes (T2D) are at an increased risk for AD as well as severe outcomes after SARS-CoV-2 infection. Genetic and socioeconomic factors influencing the rates of T2D, AD, and COVID-19 severity may create an exceptionally high-risk profile for certain demographics such as African Americans and Hispanic Americans. Type I interferon response plays an important role in both host response to viral infection, as well as AD pathology and may be a sensible therapeutic target in both AD and COVID-19.
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Affiliation(s)
- Sean X. Naughton
- Department of Neurology, Mount Sinai School of Medicine,
New York, NY, USA
| | - Urdhva Raval
- Department of Neurology, Mount Sinai School of Medicine,
New York, NY, USA
| | - Giulio M. Pasinetti
- Department of Neurology, Mount Sinai School of Medicine,
New York, NY, USA
- James J. Peters Veterans Affairs Medical Center, Bronx, NY,
USA
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720
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Huang J, Qi G. Effects of control measures on the dynamics of COVID-19 and double-peak behavior in Spain. NONLINEAR DYNAMICS 2020; 101:1889-1899. [PMID: 32874016 PMCID: PMC7450964 DOI: 10.1007/s11071-020-05901-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 08/14/2020] [Indexed: 05/03/2023]
Abstract
The COVID-19 disease significantly has threatened the human lives and economy. It is a dynamic system with transmission and control as factors. Modeling the dynamics of the spread of COVID-19 based on the reported data can predict the growing trend of such a disease. In this paper, the dynamic evolution of COVID-19 in Spain is studied, and a comprehensive SEIR model is adopted to fit the obtained clinical progressive data of COVID-19 in Spain. The transmission rate between the susceptible and the self-quarantine susceptible is made to be time-variant, which is reasonable. The equilibria are found, and the stability condition is given using the basic reproduction number and eigenvalues at the points. The effect on daily confirmed cases for the transmission rate from susceptible to the exposed population due to the currently exposed and infectious is extensively investigated. The risk of the easing of the control measure is investigated. The double-peak dynamic behavior of the COVID-19 system is observed. The second wave rebound shows that the daily confirmed cases of the second peak even much higher than the first peak.
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Affiliation(s)
- Jianzhe Huang
- School of Aeronautics and Astronautics, Shanghai Jiao Tong University, Shanghai, 200240 China
| | - Guoyuan Qi
- Tianjin Key Laboratory of Advanced Technology of Electrical Engineering and Energy, Tiangong University, Tianjin, 300387 China
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721
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Melik-Huseynov DV, Karyakin NN, Blagonravova AS, Klimko VI, Bavrina AP, Drugova OV, Saperkin NV, Kovalishena OV. Regression Models Predicting the Number of Deaths from the New Coronavirus Infection. Sovrem Tekhnologii Med 2020; 12:6-11. [PMID: 34513048 PMCID: PMC8353679 DOI: 10.17691/stm2020.12.2.01] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Indexed: 11/14/2022] Open
Abstract
Predicting the development of epidemic infection caused by the COVID-19 coronavirus is a matter of the utmost urgency for health care and effective anti-epidemic measures. Given the rapidly changing initial information and the ambiguous quality of data coming from various sources, it is important to quickly optimize the existing prognostic models by using more sophisticated algorithms. The aim of the study is to test the originally developed mathematical algorithms for predicting the development of the COVID-19 epidemic process.
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Affiliation(s)
- D V Melik-Huseynov
- Deputy Governor for Social Policy, Government of the Nizhny Novgorod Region, 1 Kremlin, Nizhny Novgorod, 603082, Russia
| | - N N Karyakin
- Rector, Privolozhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
| | - A S Blagonravova
- Vice-Rector for Science, Privolozhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
| | - V I Klimko
- Chief Specialist, GC "MedInvestGroup", 27 Alexander Solzhenitsyn St., Moscow, 109004, Russia
| | - A P Bavrina
- Associate Professor, Department of Medical Physics and Informatics, Privolozhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
| | - O V Drugova
- Associate Professor, Department of Medical Physics and Informatics, Privolozhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
| | - N V Saperkin
- Associate Professor, Department of Epidemiology, Microbiology and Evidence-Based Medicine, Privolozhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
| | - O V Kovalishena
- Professor, Head of Department of Epidemiology, Microbiology and Evidence-Based Medicine, Privolozhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
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722
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Wong PW, Lam Y, Lau JS, Fok H. The Resilience of Social Service Providers and Families of Children With Autism or Development Delays During the COVID-19 Pandemic-A Community Case Study in Hong Kong. Front Psychiatry 2020; 11:561657. [PMID: 33551857 PMCID: PMC7862762 DOI: 10.3389/fpsyt.2020.561657] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 12/15/2020] [Indexed: 12/15/2022] Open
Abstract
Background: Hong Kong is one of the earliest cities to have hampered by the COVID-19. When preventive public health measures are enforced, specific groups, who have already been facing inequality before the outbreak, are likely to become more overlooked and vulnerable. Aim: This community case study aims to describe the additional needs of families of children with autism spectrum disorder and other developmental issues, as well as unexpected difficulties and challenges social service professionals encountered when delivering service and their solutions toward these challenges. Methods: A focus group with 10 professionals providing the Caregiver Skills Training Program was conducted. Results: Poor families of vulnerable children were found to be challenged, more than average, in finding daily necessities during the initial stage of the outbreak. Most vulnerable children displayed additional problematic behaviors and emotional problems during the quarantine. The social service professionals addressed the family needs by providing tangible resources and offering online training, workshops, and programs to meet their needs. Several important lessons were learned. First, technology know-how on conducting online training, workshop, and program could be a challenge to some social service professionals and the parents. Second, the professionals reported that they made huge efforts to produce guidelines in protecting services users' privacy, to equip themselves with necessary skills in executing privacy-protection measures, and to keep exploring for safer alternatives. Third, providing tele-services in online mode represented a different interaction pattern between social service professionals and service users, especially in the recruitment processes and group dynamics. Conclusion: In comparison with other cities, Hong Kong has responded to the COVID-19 efficiently and effectively based on the citizen's strict adherence to behavioral advice and the innovative altruistic efforts from the multi-sectors in the community.
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Affiliation(s)
- Paul Waiching Wong
- The Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China.,The Faculty of Social Sciences, The University of Hong Kong, Hong Kong, China
| | - Yanyin Lam
- The Faculty of Social Sciences, The University of Hong Kong, Hong Kong, China
| | - Janet Siuping Lau
- The Faculty of Social Sciences, The University of Hong Kong, Hong Kong, China
| | - Hungkit Fok
- The Faculty of Social Sciences, The University of Hong Kong, Hong Kong, China
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723
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Saxena SK. Coronavirus Infection Among Children and Adolescents. MEDICAL VIROLOGY: FROM PATHOGENESIS TO DISEASE CONTROL 2020. [PMCID: PMC7189390 DOI: 10.1007/978-981-15-4814-7_7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Coronavirus infection is a global emergency. Over the past few months, there is a rapid increase in the number of cases and deaths due to coronavirus infection. It has been observed that elderly individuals and those with medical co-morbidities are maximally affected. In children and adolescents, coronavirus infection has low mortality as well as the severity of symptoms are less. Children and adolescents with immunocompromised state, malnutrition, medical co-morbidities and poor hygiene are at higher risk of contracting coronavirus infection. Minimizing this risk factors and adopting appropriate prevention measures will be helpful in limiting the spread of infection as there is no specific treatment and immunization available to date to address this serious issue. This chapter highlights the issues and challenges of coronavirus infection in children and adolescents.
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724
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Saha S, Samanta GP, Nieto JJ. Epidemic model of COVID-19 outbreak by inducing behavioural response in population. NONLINEAR DYNAMICS 2020; 102:455-487. [PMID: 32863581 PMCID: PMC7447616 DOI: 10.1007/s11071-020-05896-w] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 08/12/2020] [Indexed: 05/05/2023]
Abstract
COVID-19 has spread around the world since December 2019, creating one of the greatest pandemics ever witnessed. According to the current reports, this is a situation when people need to be more careful and take the precaution measures more seriously, unless the condition may become even worse. Maintaining social distances and proper hygiene, staying at isolation or adopting the self-quarantine method are some of the common practices that people should use to avoid the infection. And the growing information regarding COVID-19 and its symptoms help the people to take proper precautions. In this present study, we consider an SEIRS epidemiological model on COVID-19 transmission which accounts for the effect of an individual's behavioural response due to the information regarding proper precautions. Our results indicate that if people respond to the growing information regarding awareness at a higher rate and start to take the protective measures, then the infected population decreases significantly. The disease fatality can be controlled only if a large proportion of individuals become immune, either by natural immunity or by a proper vaccine. In order to apply the latter option, we need to wait until a safe and proper vaccine is developed and it is a time-taking process. Hence, in the latter part of the work, an optimal control problem is considered by implementing control strategies to reduce the disease burden. Numerical figures show that the control denoting behavioural response works with higher intensity immediately after implementation and then gradually decreases with time. Further, the control policy denoting hospitalisation of infected individuals works with its maximum intensity for quite a long time period following a sudden decrease. As, the implementation of the control strategies reduce the infected population and increase the recovered population, so, it may help to reduce the disease transmission at this current epidemic situation.
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Affiliation(s)
- Sangeeta Saha
- Department of Mathematics, Indian Institute of Engineering Science and Technology, Shibpur, Howrah, 711103 India
| | - G. P. Samanta
- Department of Mathematics, Indian Institute of Engineering Science and Technology, Shibpur, Howrah, 711103 India
| | - Juan J. Nieto
- Instituto de Matematicas, Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain
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