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Connecting clusters of COVID-19: an epidemiological and serological investigation. THE LANCET. INFECTIOUS DISEASES 2020; 20:809-815. [PMID: 32330439 PMCID: PMC7173813 DOI: 10.1016/s1473-3099(20)30273-5] [Citation(s) in RCA: 161] [Impact Index Per Article: 40.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 03/27/2020] [Accepted: 03/27/2020] [Indexed: 01/17/2023]
Abstract
Background Elucidation of the chain of disease transmission and identification of the source of coronavirus disease 2019 (COVID-19) infections are crucial for effective disease containment. We describe an epidemiological investigation that, with use of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serological assays, established links between three clusters of COVID-19. Methods In Singapore, active case-finding and contact tracing were undertaken for all COVID-19 cases. Diagnosis for acute disease was confirmed with RT-PCR testing. When epidemiological information suggested that people might have been nodes of disease transmission but had recovered from illness, SARS-CoV-2 IgG serology testing was used to establish past infection. Findings Three clusters of COVID-19, comprising 28 locally transmitted cases, were identified in Singapore; these clusters were from two churches (Church A and Church B) and a family gathering. The clusters in Church A and Church B were linked by an individual from Church A (A2), who transmitted SARS-CoV-2 infection to the primary case from Church B (F1) at a family gathering they both attended on Jan 25, 2020. All cases were confirmed by RT-PCR testing because they had active disease, except for A2, who at the time of testing had recovered from their illness and tested negative. This individual was eventually diagnosed with past infection by serological testing. ELISA assays showed an optical density of more than 1·4 for SARS-CoV-2 nucleoprotein and receptor binding domain antigens in titres up to 1/400, and viral neutralisation was noted in titres up to 1/320. Interpretation Development and application of a serological assay has helped to establish connections between COVID-19 clusters in Singapore. Serological testing can have a crucial role in identifying convalescent cases or people with milder disease who might have been missed by other surveillance methods. Funding National Research Foundation (Singapore), National Natural Science Foundation (China), and National Medical Research Council (Singapore).
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Wolkewitz M, Puljak L. Methodological challenges of analysing COVID-19 data during the pandemic. BMC Med Res Methodol 2020; 20:81. [PMID: 32290816 PMCID: PMC7154065 DOI: 10.1186/s12874-020-00972-6] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2020] [Indexed: 01/09/2023] Open
Affiliation(s)
- Martin Wolkewitz
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, 79104 Freiburg, Germany
| | - Livia Puljak
- Center for Evidence-Based Medicine and Health Care, Catholic University of Croatia, Ilica 242, 10000 Zagreb, Croatia
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Naserghandi A, Allameh SF, Saffarpour R. All about COVID-19 in brief. New Microbes New Infect 2020; 35:100678. [PMID: 32292590 PMCID: PMC7152908 DOI: 10.1016/j.nmni.2020.100678] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 04/01/2020] [Accepted: 04/06/2020] [Indexed: 12/23/2022] Open
Affiliation(s)
- A Naserghandi
- Shahid Beheshti University of Medical Sciences, Iran
| | | | - R Saffarpour
- Shahid Beheshti University of Medical Sciences, Iran
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Balla M, Merugu GP, Patel M, Koduri NM, Gayam V, Adapa S, Naramala S, Konala VM. COVID-19, Modern Pandemic: A Systematic Review From Front-Line Health Care Providers' Perspective. J Clin Med Res 2020; 12:215-229. [PMID: 32362969 PMCID: PMC7188368 DOI: 10.14740/jocmr4142] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 03/25/2020] [Indexed: 02/07/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) caused infection in 168,000 cases worldwide in about 148 countries and killed more than 6,610 people around the world as of March 16, 2020, as per the World Health Organization (WHO). Compared to severe acute respiratory syndrome and Middle East respiratory syndrome, there is the rapid transmission, long incubation period, and disease containment is becoming extremely difficult. The main aim of this systematic review is to provide a comprehensive clinical summary of all the available data from high-quality research articles relevant to the epidemiology, demographics, trends in hospitalization and outcomes, clinical signs and symptoms, diagnostic methods and treatment methods of COVID-19, thus increasing awareness in health care providers. We also discussed various preventive measures to combat COVID-19 effectively. A systematic and protocol-driven approach is needed to contain this disease, which was declared as a global pandemic on March 11, 2020, by the WHO.
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Affiliation(s)
- Mamtha Balla
- Department of Internal Medicine, University of Toledo and Promedica Toledo Hospital, Toledo, OH 43606, USA
| | - Ganesh Prasad Merugu
- Division of Geriatric Medicine, Department of Family Medicine, University of Toledo, OH 43614, USA
| | - Mitra Patel
- Department of Internal Medicine, University of Toledo, OH 43614, USA
| | - Narayana Murty Koduri
- Department of Psychiatry, Great Plains Health, 600 W Leota, North Platte, NE 69101, USA
| | - Vijay Gayam
- Department of Medicine, Interfaith Medical Center, Brooklyn, NY, USA
| | - Sreedhar Adapa
- Department of Internal Medicine, Division of Nephrology, Adventist Medical Center, Hanford, CA 93230, USA
| | - Srikanth Naramala
- Department of Internal Medicine, Division of Rheumatology, Adventist Medical Center, Hanford, CA 93230, USA
| | - Venu Madhav Konala
- Department of Internal Medicine, Divison of Medical Oncology, Ashland Bellefonte Cancer Center, 122 St Christopher Dr, Ashland, KY 41169, USA
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Farhoudian A, Baldacchino A, Clark N, Gerra G, Ekhtiari H, Dom G, Mokri A, Sadeghi M, Nematollahi P, Demasi M, Schütz CG, Hash-emian SM, Tabarsi P, Galea-Singer S, Carrà G, Clausen T, Kouimtsidis C, Tolomeo S, Radfar SR, Razaghi EM. COVID-19 and Substance Use Disorders: Recommendations to a Comprehensive Healthcare Response. An International Society of Addiction Medicine Practice and Policy Interest Group Position Paper. Basic Clin Neurosci 2020; 11:133-150. [PMID: 32855772 PMCID: PMC7368103 DOI: 10.32598/bcn.11.covid19.1] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 04/08/2020] [Accepted: 04/09/2020] [Indexed: 12/19/2022] Open
Abstract
Coronavirus Disease 2019 (COVID-19) is escalating all over the world and has higher morbidities and mortalities in certain vulnerable populations. People Who Use Drugs (PWUD) are a marginalized and stigmatized group with weaker immunity responses, vulnerability to stress, poor health conditions, high-risk behaviors, and lower access to health care services. These conditions put them at a higher risk of COVID-19 infection and its complications. In this paper, an international group of experts on addiction medicine, infectious diseases, and disaster psychiatry explore the possible raised concerns in this issue and provide recommendations to manage the comorbidity of COVID-19 and Substance Use Disorder (SUD).
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Affiliation(s)
- Ali Farhoudian
- Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Alexander Baldacchino
- Division of Population and Behavioral Sciences, St Andrews University Medical School, University of St Andrews, UK
| | - Nicolas Clark
- North Richmond Community Health, Victoria, Melbourne, Australia
- Royal Melbourne Hospital, Victoria, Melbourne, Australia
| | - Gilberto Gerra
- Drug Prevention and Health Branch, Division for Operations, United Nations Office on Drugs and Crime, Vienna, Austria
| | - Hamed Ekhtiari
- Laureate Institute for Brain Research, Tulsa, Oklahoma, USA
| | - Geert Dom
- Collaborative Antwerp Psychiatric Research Institute, University of Antwerp, Antwerp, Belgium
| | - Azarakhsh Mokri
- Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran
| | - Mandana Sadeghi
- Aftab Mehrvarzi Substance Abuse Treatment Center, Tehran, Iran
| | - Pardis Nematollahi
- Cancer Prevention Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryanne Demasi
- North Richmond Community Health, Victoria, Melbourne, Australia
| | - Christian G. Schütz
- Department of Psychiatry, University of British Columbia, Vancouver BC, Canada
| | - Seyed Mohammadreza Hash-emian
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Payam Tabarsi
- Clinical Tuberculosis and Epidemiology Research Center, National Research Institute for Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Susanna Galea-Singer
- Institute for Innovation and Improvement, IWaitematâ DHB, Centre for Addictions Research, University of Auckland, Auckland, New Zealand
| | - Giuseppe Carrà
- Department of Medicine and Surgery, Section of Psychiatry, University of Milan Bicocca, Milan, Italy
| | - Thomas Clausen
- Norwegian Centre for Addiction Research (SERAF); University of Oslo, Oslo, Norway
| | | | - Serenella Tolomeo
- Department of Psychology, National University of Singapore (NUS), Singapore
| | - Seyed Ramin Radfar
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- Integrated Substance Abuse Programs, University of California, Los Angeles, California, USA
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Garg S, Garg M, Prabhakar N, Malhotra P, Agarwal R. Unraveling the mystery of Covid-19 cytokine storm: From skin to organ systems. Dermatol Ther 2020; 33:e13859. [PMID: 32559324 PMCID: PMC7323083 DOI: 10.1111/dth.13859] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 06/14/2020] [Accepted: 06/15/2020] [Indexed: 01/07/2023]
Abstract
COVID-19 is a global pandemic that emerged from Wuhan, China. Besides pneumonia and acute respiratory distress syndrome, the disease leads to multisystem involvement in the form of myocarditis, arrhythmias, cardiac arrest, gastrointestinal symptoms, hypoxemic brain injury, acute liver, and renal function impairment. There are also reports of cutaneous lesions in form of urticarial and maculopapular rashes, chilblain like fingers and toes (covid feet), livedoid vasculopathy, and chicken-pox like or varicelliform vesicles. Clinically, many of these skin lesions are likely secondary to occlusion of small to medium blood vessels due to microthrombi formation or due to viral laden antigen-antibody immune complexes; and same explanation may hold true for possible hypoxemic injury simultaneously occurring in other vital organs like lungs, heart, brain, and kidneys. The histopathology, immunoflorescence and RT-PCR analysis of skin biopsies can provide useful insights for ascertaining the pathogenesis of this complex viral syndrome. Apparently, it is interplay of disarmed cellular immunity and over-activated humoral immunity that culminates in end-organ changes. The morbidity and mortality can be significantly reduced by upgrading the cellular immunity and downgrading the humoral response; along with prevention of hypoxemic and reperfusion injuries by using antivirals, immunomodulators, antioxidants, anti-platelets, and anticoagulants in judicious and phased manner.
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Affiliation(s)
- Suruchi Garg
- Department of DermatologyAura Skin InstituteChandigarhIndia
| | - Mandeep Garg
- Department of Radiodiagnosis and ImagingPost Graduate Institute of Medical Education and ResearchChandigarhIndia
| | - Nidhi Prabhakar
- Department of Radiodiagnosis and ImagingPost Graduate Institute of Medical Education and ResearchChandigarhIndia
| | - Pankaj Malhotra
- Department of Internal MedicinePost Graduate Institute of Medical Education and ResearchChandigarhIndia
| | - Ritesh Agarwal
- Department of Pulmonary MedicinePost Graduate Institute of Medical Education and ResearchChandigarhIndia
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Bianconi V, Bronzo P, Banach M, Sahebkar A, Mannarino MR, Pirro M. Particulate matter pollution and the COVID-19 outbreak: results from Italian regions and provinces. Arch Med Sci 2020; 16:985-992. [PMID: 32863986 PMCID: PMC7444704 DOI: 10.5114/aoms.2020.95336] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 05/12/2020] [Indexed: 01/15/2023] Open
Abstract
INTRODUCTION Particulate matter exposure has been associated with the appearance and severity of several diseases, including viral infections. The aim of this study was to investigate whether coronavirus disease 2019 (COVID-19) cases and deaths across Italian regions and provinces in March 2020 were linked to past exposure to fine and coarse particulate matter (namely, PM2.5 and PM10, respectively). MATERIAL AND METHODS Geographical distributions of COVID-19 cases and deaths (105,792 and 12,428, respectively, up to 31st March 2020), PM2.5 and PM10 exposure, and demographic characteristics were extracted from publicly accessible databases. Adjusted regression models were performed to test the association between particulate matter exposure in different Italian regions and provinces and COVID-19 incidence proportions and death rates. RESULTS A heterogeneous distribution of COVID-19 cases/deaths and particulate matter exposure was observed in Italy, with the highest numbers in Northern Italy regions and provinces. Independent associations between regional PM2.5/PM10 exposure and COVID-19 incidence proportion and death rate were observed (COVID-19 incidence proportion: β = 0.71, p = 0.003, β = 0.61, p = 0.031, respectively; COVID-19 death rate: β = 0.68, p = 0.004 and β = 0.61, p = 0.029, respectively). Similarly, PM2.5/PM10 exposures were independently associated with COVID-19 incidence proportion (β = 0.26, p = 0.024 and β = 0.27, p = 0.006, respectively) at the provincial level. The number of days exceeding the provincial limit value of exposure to PM10 (50 µg/m3) was also independently associated with the COVID-19 incidence proportion (β = 0.30, p = 0.008). CONCLUSIONS Exposure to PM2.5 and PM10 is associated with COVID-19 cases and deaths, suggesting that particulate matter pollution may play a role in the COVID-19 outbreak and explain the heterogeneous distribution of COVID-19 in Italian regions and provinces.
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Affiliation(s)
- Vanessa Bianconi
- Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, Italy
| | - Paola Bronzo
- Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, Italy
| | - Maciej Banach
- Department of Hypertension, WAM University Hospital, Medical University of Lodz, Lodz, Poland
- Polish Mothers Memorial Hospital Research Institute (PMMHRI), Lodz, Poland
| | - Amirhossein Sahebkar
- School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
- Biotechnology Research Centre, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Massimo R. Mannarino
- Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, Italy
| | - Matteo Pirro
- Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, Italy
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