101
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Català M, Pino D, Marchena M, Palacios P, Urdiales T, Cardona PJ, Alonso S, López-Codina D, Prats C, Alvarez-Lacalle E. Robust estimation of diagnostic rate and real incidence of COVID-19 for European policymakers. PLoS One 2021; 16:e0243701. [PMID: 33411737 PMCID: PMC7790392 DOI: 10.1371/journal.pone.0243701] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 11/27/2020] [Indexed: 12/22/2022] Open
Abstract
Policymakers need clear, fast assessment of the real spread of the COVID-19 epidemic in each of their respective countries. Standard measures of the situation provided by the governments include reported positive cases and total deaths. While total deaths indicate immediately that countries like Italy and Spain had the worst situation as of mid-April, 2020, reported cases alone do not provide a complete picture of the situation. Different countries diagnose differently and present very distinctive reported case fatality ratios. Similar levels of reported incidence and mortality might hide a very different underlying pictures. Here we present a straightforward and robust estimation of the diagnostic rate in each European country. From that estimation we obtain a uniform, unbiased incidence of the epidemic. The method to obtain the diagnostic rate is transparent and empirical. The key assumption of the method is that the infection fatality ratio of COVID-19 in Europe is not strongly country-dependent. We show that this number is not expected to be biased due to demography nor to the way total deaths are reported. The estimation protocol is dynamic, and it has been yielding converging numbers for diagnostic rates in all European countries as from mid-April, 2020. Using this diagnostic rate, policy makers can obtain Effective Potential Growth updated every day, providing an unbiased assessment of the countries at greater risk of experiencing an uncontrolled situation. The method developed has been and will be used to track possible improvements in the diagnostic rate in European countries as the epidemic evolves.
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Affiliation(s)
- Martí Català
- Department of Physics, Universitat Politècnica de Catalunya (UPC ⋅ BarcelonaTech), Barcelona, Spain
- Comparative Medicine and Bioimage Centre of Catalonia (CMCiB), Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Catalonia, Spain
| | - David Pino
- Department of Physics, Universitat Politècnica de Catalunya (UPC ⋅ BarcelonaTech), Barcelona, Spain
| | - Miquel Marchena
- Department of Physics, Universitat Politècnica de Catalunya (UPC ⋅ BarcelonaTech), Barcelona, Spain
| | - Pablo Palacios
- Department of Physics, Universitat Politècnica de Catalunya (UPC ⋅ BarcelonaTech), Barcelona, Spain
| | - Tomás Urdiales
- Department of Physics, Universitat Politècnica de Catalunya (UPC ⋅ BarcelonaTech), Barcelona, Spain
| | - Pere-Joan Cardona
- Comparative Medicine and Bioimage Centre of Catalonia (CMCiB), Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Catalonia, Spain
- Experimental Tuberculosis Unit (UTE), Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Universitat Autònoma de Barcelona (UAB), Badalona, Catalonia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Sergio Alonso
- Department of Physics, Universitat Politècnica de Catalunya (UPC ⋅ BarcelonaTech), Barcelona, Spain
| | - David López-Codina
- Department of Physics, Universitat Politècnica de Catalunya (UPC ⋅ BarcelonaTech), Barcelona, Spain
| | - Clara Prats
- Department of Physics, Universitat Politècnica de Catalunya (UPC ⋅ BarcelonaTech), Barcelona, Spain
- Comparative Medicine and Bioimage Centre of Catalonia (CMCiB), Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Catalonia, Spain
| | - Enrique Alvarez-Lacalle
- Department of Physics, Universitat Politècnica de Catalunya (UPC ⋅ BarcelonaTech), Barcelona, Spain
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102
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Eryarsoy E, Delen D, Davazdahemami B, Topuz K. A novel diffusion-based model for estimating cases, and fatalities in epidemics: The case of COVID-19. JOURNAL OF BUSINESS RESEARCH 2021; 124:163-178. [PMID: 33281248 PMCID: PMC7706427 DOI: 10.1016/j.jbusres.2020.11.054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 11/24/2020] [Accepted: 11/25/2020] [Indexed: 05/03/2023]
Abstract
While the COVID-19 pandemic is still ongoing in a majority of countries, a wealth of literature published in reputable journals attempted to model the spread of the disease. A vast majority of these studies dealt with compartmental models such as susceptible-infected-recovered (SIR) model. Although these models are rather simple, intuitive, and insightful, we argue that they do not necessarily provide a good enough fit to the reported data, which are usually reported in the form of daily fatalities and cases during pandemics. This study proposes an alternative analytics approach that relies on diffusion models to predict the number of cases and fatalities in epidemics. After evaluating several of the well-known and widely used diffusion models in business literature, including ADBUDG, Gompertz, and Bass models, we developed and used a modified/improved version of the original Bass diffusion model to address the shortcomings of the ordinary compartmental models such as SIR and demonstrated its applicability on the portrayal of the COVID-19 pandemic incident data. The proposed model differentiates itself from other similar models by fitting the data without the need for preprocessing, requiring no initial conditions and assumptions, not involving in heavy parameterization, and also properly addressing the pressing issues such as undocumented cases, length of infectious or recovery periods.
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Affiliation(s)
| | - Dursun Delen
- Spears School of Business, Oklahoma State University, United States
- School of Management, Department of MIS, Halic University, Istanbul, Turkey
| | - Behrooz Davazdahemami
- University of Wisconsin-Whitewater, Department of IT and Supply Chain Management, United States
| | - Kazim Topuz
- The University of Tulsa, School of Finance, Operations Management, and International Business, United States
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103
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Grund S, Caljouw MAA, Haaksma ML, Gordon AL, van Balen R, Bauer JM, Schols JMGA, Achterberg WP. Pan-European Study on Functional and Medical Recovery and Geriatric Rehabilitation Services of Post-COVID-19 Patients: Protocol of the EU-COGER Study. J Nutr Health Aging 2021; 25:668-674. [PMID: 33949635 PMCID: PMC7938690 DOI: 10.1007/s12603-021-1607-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 12/03/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVES There is insufficient knowledge about the functional and medical recovery of older people infected with SARS-CoV-2. This study aims to gain insight into the course of functional and medical recovery of persons who receive geriatric rehabilitation (GR) following SARS-CoV-2 infection across Europe. Special attention will be paid to the recovery of activities of daily living (ADL) and to the GR services offered to these patients. DESIGN A multi-center observational cohort study. SETTING AND PARTICIPANTS This study will include several European countries (EuGMS member states) each providing at least 52 comparable routine datasets (core dataset) of persons recovering from a SARS-CoV-2 infection and receiving geriatric rehabilitation. The routine data will be anonymously collected in an online CASTOR database. The ethical regulations of each participating country will be followed. PRIMARY OUTCOME ADL functioning. SECONDARY OUTCOMES length of stay, discharge destination, hospital readmission and mortality. Other variables that will be collected are quality of life, treatment modalities, complications, cognition, frailty, mood/anxiety, BMI, nutrition and pain. All variables will be reported at admission and compared with follow-up scores (discharge, 6 weeks and 6 months follow-up). CONCLUSION This study will explore the effect of geriatric rehabilitation on post-COVID-19 patients, especially on ADL recovery, and the variety of geriatric rehabilitation services across Europe. Information from this study may help improve recovery of older persons infected with SARS-CoV-2 and improve geriatric rehabilitation services in the ongoing COVID-19 pandemic.
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Affiliation(s)
- S Grund
- Stefan Grund, MD, MaHM, Center for Geriatric Medicine, Agaplesion Bethanien Hospital Heidelberg, Geriatric Center at the Heidelberg University, Rohrbacher Straße 149, 69126 Heidelberg, Germany, Phone 004962213191730, FAX 004962213191513,
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104
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Wibbens PD, Koo WWY, McGahan AM. Which COVID policies are most effective? A Bayesian analysis of COVID-19 by jurisdiction. PLoS One 2020; 15:e0244177. [PMID: 33373384 PMCID: PMC7771876 DOI: 10.1371/journal.pone.0244177] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 12/04/2020] [Indexed: 12/21/2022] Open
Abstract
This paper reports the results of a Bayesian analysis on large-scale empirical data to assess the effectiveness of eleven types of COVID-control policies that have been implemented at various levels of intensity in 40 countries and U.S. states since the onset of the pandemic. The analysis estimates the marginal impact of each type and level of policy as implemented in concert with other policies. The purpose is to provide policymakers and the general public with an estimate of the relative effectiveness of various COVID-control strategies. We find that a set of widely implemented core policies reduces the spread of virus but not by enough to contain the pandemic except in a few highly compliant jurisdictions. The core policies include the cancellation of public events, restriction of gatherings to fewer than 100 people, recommendation to stay at home, recommended restrictions on internal movement, implementation of a partial international travel ban, and coordination of information campaigns. For the median jurisdiction, these policies reduce growth rate in new infections from an estimated 270% per week to approximately 49% per week, but this impact is insufficient to prevent eventual transmission throughout the population because containment occurs only when a jurisdiction reduces growth in COVID infection to below zero. Most jurisdictions must also implement additional policies, each of which has the potential to reduce weekly COVID growth rate by 10 percentage points or more. The slate of these additional high-impact policies includes targeted or full workplace closings for all but essential workers, stay-at-home requirements, and targeted school closures.
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105
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Fagre AC, Manhard J, Adams R, Eckley M, Zhan S, Lewis J, Rocha SM, Woods C, Kuo K, Liao W, Li L, Corper A, Challa D, Mount E, Tumanut C, Tjalkens RB, Aboellail T, Fan X, Schountz T. A Potent SARS-CoV-2 Neutralizing Human Monoclonal Antibody That Reduces Viral Burden and Disease Severity in Syrian Hamsters. Front Immunol 2020; 11:614256. [PMID: 33391285 PMCID: PMC7775388 DOI: 10.3389/fimmu.2020.614256] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 11/23/2020] [Indexed: 01/08/2023] Open
Abstract
The emergence of COVID-19 has led to a pandemic that has caused millions of cases of disease, variable morbidity and hundreds of thousands of deaths. Currently, only remdesivir and dexamethasone have demonstrated limited efficacy, only slightly reducing disease burden, thus novel approaches for clinical management of COVID-19 are needed. We identified a panel of human monoclonal antibody clones from a yeast display library with specificity to the SARS-CoV-2 spike protein receptor binding domain that neutralized the virus in vitro. Administration of the lead antibody clone to Syrian hamsters challenged with SARS-CoV-2 significantly reduced viral load and histopathology score in the lungs. Moreover, the antibody interrupted monocyte infiltration into the lungs, which may have contributed to the reduction of disease severity by limiting immunopathological exacerbation. The use of this antibody could provide an important therapy for treatment of COVID-19 patients.
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Affiliation(s)
- Anna C. Fagre
- Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
| | | | | | - Miles Eckley
- Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
| | - Shijun Zhan
- Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
| | - Juliette Lewis
- Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
| | - Savannah M. Rocha
- Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
| | | | - Karina Kuo
- AvantGen, Inc. San Diego, CA, United States
| | | | - Lin Li
- AvantGen, Inc. San Diego, CA, United States
| | | | | | | | | | - Ronald B. Tjalkens
- Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
| | - Tawfik Aboellail
- Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
| | | | - Tony Schountz
- Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
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106
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Mobasseri K, Azami-Aghdash S, Khanijahani A, Khodayari-Zarnaq R. The Main Issues and Challenges Older Adults Face in the SARS-CoV-2 Pandemic: A Scoping Review of Literature. IRANIAN JOURNAL OF PUBLIC HEALTH 2020; 49:2295-2307. [PMID: 34178736 PMCID: PMC8215059 DOI: 10.18502/ijph.v49i12.4810] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background The Severe Acute Respiratory Syndrome Coronavirus Disease 2019 (SARS-CoV-2) severely affects those above the age of 60 yr and those with other conditions. This study aimed to review the available evidence on older adult's issues in facing the COVID-19 pandemic. Methods The framework is based on scoping review of literature published from Jan 10 to Jul 31, 2020. Medline, Scopus, Web of Science, and Google Scholar databases and other sources of information, to identify grey literature, were selected for data collection. Two researchers independently screened all studies and extracted data. All types of studies published about SARS-CoV-2 and related to older adults' issues were eligible. Results Overall, 210 documents were included in the final analysis. Letter to the editor was the most frequent article format (20.95%). Most of the papers were from the United States (38.09%) and published in Jun 2020 (29.52%). After content analysis, six following themes were extracted: Supporting and information sources, e-health services, access to essential supplies, Long Term Care Facilities (LTCFs), physical and mental consequences of self-isolation, neglect of older adults, ageism and age discrimination. Conclusion In the pandemic, there is an urgent need for interventional research and innovational implementations to address issues related to providing services for older adults. This can help older adults to maintain their physical and mental health, and reduce the spread of infection in nursing homes. Further studies focusing on the rights of the older adults are needed on all issues associated with COVID-19.
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Affiliation(s)
- Khorshid Mobasseri
- Department of Health Education and Promotion, School of Health, Tabriz University of Medical Sciences, Tabriz, Iran.,Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saber Azami-Aghdash
- Department of Health Policy and Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.,Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ahmad Khanijahani
- Department of Health Administration and Public Health, John G. Rangos School of Health Sciences, Duquesne University, Pittsburgh, PA, USA
| | - Rahim Khodayari-Zarnaq
- Department of Health Policy and Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.,Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
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107
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de Las Heras B, Saini KS, Boyle F, Ades F, de Azambuja E, Bozovic-Spasojevic I, Romano M, Capelan M, Prasad R, Pattu P, Massard C, Portera C, Saini ML, Singh BP, Venkitaraman R, McNally R, Leone M, Grande E, Gupta S. Cancer Treatment and Research During the COVID-19 Pandemic: Experience of the First 6 Months. Oncol Ther 2020; 8:171-182. [PMID: 32749634 PMCID: PMC7402077 DOI: 10.1007/s40487-020-00124-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Indexed: 02/07/2023] Open
Abstract
The coronavirus disease-2019 (COVID-19) pandemic has had a significant impact on patients with underlying malignancy. In this article, we summarize emerging data related to patients with cancer and COVID-19. Among patients with COVID-19, a higher proportion have an underlying diagnosis of cancer than seen in the general population. Also, patients with malignancy are likely to be more vulnerable than the general population to contracting COVID-19. Mortality is significantly higher in patients with both cancer and COVID-19 compared with the overall COVID-19-positive population. The early months of the pandemic saw a decrease in cancer screening and diagnosis, as well as postponement of standard treatments, which could lead to excess deaths from cancer in the future.
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Affiliation(s)
- Begoña de Las Heras
- Covance Inc., Princeton, NJ, USA
- Madrid Medical Doctors Association, Madrid, Spain
| | - Kamal S Saini
- Covance Inc., Princeton, NJ, USA.
- East Suffolk and North Essex NHS Foundation Trust, Ipswich, UK.
| | | | - Felipe Ades
- Hospital Alemão Oswaldo Cruz, São Paulo, Brazil
| | - Evandro de Azambuja
- Institut Jules Bordet, Brussels, Belgium
- Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | | | | | | | - Rajeev Prasad
- Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK
| | | | | | | | | | | | | | | | | | | | - Sudeep Gupta
- Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
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108
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Henkel M, Weikert T, Marston K, Schwab N, Sommer G, Haslbauer J, Franzeck F, Anastasopoulos C, Stieltjes B, Michel A, Bremerich J, Menter T, Mertz KD, Tzankov A, Sauter AW. Lethal COVID-19: Radiologic-Pathologic Correlation of the Lungs. Radiol Cardiothorac Imaging 2020; 2:e200406. [PMID: 33778642 PMCID: PMC7681778 DOI: 10.1148/ryct.2020200406] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 10/23/2020] [Accepted: 11/06/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE The purpose of this retrospective study was to correlate CT patterns of fatal cases of coronavirus disease 2019 (COVID-19) with postmortem pathology observations. MATERIALS AND METHODS The study included 70 lung lobes of 14 patients who died of reverse-transcription polymerase chain reaction-confirmed COVID-19. All patients underwent antemortem CT and autopsy between March 9 and April 30, 2020. Board-certified radiologists and pathologists performed lobewise correlations of pulmonary observations. In a consensus reading, 267 radiologic and 257 histopathologic observations of the lungs were recorded and systematically graded according to severity. These observations were matched and evaluated. RESULTS Predominant CT observations were ground-glass opacities (GGO) (59/70 lobes examined) and areas of consolidation (33/70). The histopathologic observations were consistent with diffuse alveolar damage (70/70) and capillary dilatation and congestion (70/70), often accompanied by microthrombi (27/70), superimposed acute bronchopneumonia (17/70), and leukocytoclastic vasculitis (7/70). Four patients had pulmonary emboli. Bronchial wall thickening at CT histologically corresponded with acute bronchopneumonia. GGOs and consolidations corresponded with mixed histopathologic observations, including capillary dilatation and congestion, interstitial edema, diffuse alveolar damage, and microthrombosis. Vascular alterations were prominent observations at both CT and histopathology. CONCLUSION A significant proportion of GGO correlated with the pathologic processes of diffuse alveolar damage, capillary dilatation and congestion, and microthrombosis. Our results confirm the presence and underline the importance of vascular alterations as key pathophysiologic drivers in lethal COVID-19.Supplemental material is available for this article.© RSNA, 2020.
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Affiliation(s)
- Maurice Henkel
- From the Department of Radiology (M.H., T.W., G.S., C.A., B.S., J.B., A.W.S.), Department of Research & Analytic Services (M.H., T.W., F.F., B.S.), and Division of Histopathology and Autopsy, Institute of Pathology (K.M., J.H., T.M., A.T.), University Hospital Basel, University of Basel, Petersgraben 4, 4031 Basel, Switzerland; and Department of Pathology, Cantonal Hospital Baselland, Liestal, Switzerland (M.H., N.S., A.M., K.D.M.)
| | - Thomas Weikert
- From the Department of Radiology (M.H., T.W., G.S., C.A., B.S., J.B., A.W.S.), Department of Research & Analytic Services (M.H., T.W., F.F., B.S.), and Division of Histopathology and Autopsy, Institute of Pathology (K.M., J.H., T.M., A.T.), University Hospital Basel, University of Basel, Petersgraben 4, 4031 Basel, Switzerland; and Department of Pathology, Cantonal Hospital Baselland, Liestal, Switzerland (M.H., N.S., A.M., K.D.M.)
| | - Katharina Marston
- From the Department of Radiology (M.H., T.W., G.S., C.A., B.S., J.B., A.W.S.), Department of Research & Analytic Services (M.H., T.W., F.F., B.S.), and Division of Histopathology and Autopsy, Institute of Pathology (K.M., J.H., T.M., A.T.), University Hospital Basel, University of Basel, Petersgraben 4, 4031 Basel, Switzerland; and Department of Pathology, Cantonal Hospital Baselland, Liestal, Switzerland (M.H., N.S., A.M., K.D.M.)
| | - Nathalie Schwab
- From the Department of Radiology (M.H., T.W., G.S., C.A., B.S., J.B., A.W.S.), Department of Research & Analytic Services (M.H., T.W., F.F., B.S.), and Division of Histopathology and Autopsy, Institute of Pathology (K.M., J.H., T.M., A.T.), University Hospital Basel, University of Basel, Petersgraben 4, 4031 Basel, Switzerland; and Department of Pathology, Cantonal Hospital Baselland, Liestal, Switzerland (M.H., N.S., A.M., K.D.M.)
| | - Gregor Sommer
- From the Department of Radiology (M.H., T.W., G.S., C.A., B.S., J.B., A.W.S.), Department of Research & Analytic Services (M.H., T.W., F.F., B.S.), and Division of Histopathology and Autopsy, Institute of Pathology (K.M., J.H., T.M., A.T.), University Hospital Basel, University of Basel, Petersgraben 4, 4031 Basel, Switzerland; and Department of Pathology, Cantonal Hospital Baselland, Liestal, Switzerland (M.H., N.S., A.M., K.D.M.)
| | - Jasmin Haslbauer
- From the Department of Radiology (M.H., T.W., G.S., C.A., B.S., J.B., A.W.S.), Department of Research & Analytic Services (M.H., T.W., F.F., B.S.), and Division of Histopathology and Autopsy, Institute of Pathology (K.M., J.H., T.M., A.T.), University Hospital Basel, University of Basel, Petersgraben 4, 4031 Basel, Switzerland; and Department of Pathology, Cantonal Hospital Baselland, Liestal, Switzerland (M.H., N.S., A.M., K.D.M.)
| | - Fabian Franzeck
- From the Department of Radiology (M.H., T.W., G.S., C.A., B.S., J.B., A.W.S.), Department of Research & Analytic Services (M.H., T.W., F.F., B.S.), and Division of Histopathology and Autopsy, Institute of Pathology (K.M., J.H., T.M., A.T.), University Hospital Basel, University of Basel, Petersgraben 4, 4031 Basel, Switzerland; and Department of Pathology, Cantonal Hospital Baselland, Liestal, Switzerland (M.H., N.S., A.M., K.D.M.)
| | - Constantin Anastasopoulos
- From the Department of Radiology (M.H., T.W., G.S., C.A., B.S., J.B., A.W.S.), Department of Research & Analytic Services (M.H., T.W., F.F., B.S.), and Division of Histopathology and Autopsy, Institute of Pathology (K.M., J.H., T.M., A.T.), University Hospital Basel, University of Basel, Petersgraben 4, 4031 Basel, Switzerland; and Department of Pathology, Cantonal Hospital Baselland, Liestal, Switzerland (M.H., N.S., A.M., K.D.M.)
| | - Bram Stieltjes
- From the Department of Radiology (M.H., T.W., G.S., C.A., B.S., J.B., A.W.S.), Department of Research & Analytic Services (M.H., T.W., F.F., B.S.), and Division of Histopathology and Autopsy, Institute of Pathology (K.M., J.H., T.M., A.T.), University Hospital Basel, University of Basel, Petersgraben 4, 4031 Basel, Switzerland; and Department of Pathology, Cantonal Hospital Baselland, Liestal, Switzerland (M.H., N.S., A.M., K.D.M.)
| | - Anne Michel
- From the Department of Radiology (M.H., T.W., G.S., C.A., B.S., J.B., A.W.S.), Department of Research & Analytic Services (M.H., T.W., F.F., B.S.), and Division of Histopathology and Autopsy, Institute of Pathology (K.M., J.H., T.M., A.T.), University Hospital Basel, University of Basel, Petersgraben 4, 4031 Basel, Switzerland; and Department of Pathology, Cantonal Hospital Baselland, Liestal, Switzerland (M.H., N.S., A.M., K.D.M.)
| | - Jens Bremerich
- From the Department of Radiology (M.H., T.W., G.S., C.A., B.S., J.B., A.W.S.), Department of Research & Analytic Services (M.H., T.W., F.F., B.S.), and Division of Histopathology and Autopsy, Institute of Pathology (K.M., J.H., T.M., A.T.), University Hospital Basel, University of Basel, Petersgraben 4, 4031 Basel, Switzerland; and Department of Pathology, Cantonal Hospital Baselland, Liestal, Switzerland (M.H., N.S., A.M., K.D.M.)
| | - Thomas Menter
- From the Department of Radiology (M.H., T.W., G.S., C.A., B.S., J.B., A.W.S.), Department of Research & Analytic Services (M.H., T.W., F.F., B.S.), and Division of Histopathology and Autopsy, Institute of Pathology (K.M., J.H., T.M., A.T.), University Hospital Basel, University of Basel, Petersgraben 4, 4031 Basel, Switzerland; and Department of Pathology, Cantonal Hospital Baselland, Liestal, Switzerland (M.H., N.S., A.M., K.D.M.)
| | - Kirsten D. Mertz
- From the Department of Radiology (M.H., T.W., G.S., C.A., B.S., J.B., A.W.S.), Department of Research & Analytic Services (M.H., T.W., F.F., B.S.), and Division of Histopathology and Autopsy, Institute of Pathology (K.M., J.H., T.M., A.T.), University Hospital Basel, University of Basel, Petersgraben 4, 4031 Basel, Switzerland; and Department of Pathology, Cantonal Hospital Baselland, Liestal, Switzerland (M.H., N.S., A.M., K.D.M.)
| | - Alexandar Tzankov
- From the Department of Radiology (M.H., T.W., G.S., C.A., B.S., J.B., A.W.S.), Department of Research & Analytic Services (M.H., T.W., F.F., B.S.), and Division of Histopathology and Autopsy, Institute of Pathology (K.M., J.H., T.M., A.T.), University Hospital Basel, University of Basel, Petersgraben 4, 4031 Basel, Switzerland; and Department of Pathology, Cantonal Hospital Baselland, Liestal, Switzerland (M.H., N.S., A.M., K.D.M.)
| | - Alexander W. Sauter
- From the Department of Radiology (M.H., T.W., G.S., C.A., B.S., J.B., A.W.S.), Department of Research & Analytic Services (M.H., T.W., F.F., B.S.), and Division of Histopathology and Autopsy, Institute of Pathology (K.M., J.H., T.M., A.T.), University Hospital Basel, University of Basel, Petersgraben 4, 4031 Basel, Switzerland; and Department of Pathology, Cantonal Hospital Baselland, Liestal, Switzerland (M.H., N.S., A.M., K.D.M.)
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109
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Chang PC, Yang CC, Kao KC, Wen MS. Clinical outcomes of patients hospitalized for COVID-19 versus SARS: a meta-analysis. Aging (Albany NY) 2020; 12:24552-24569. [PMID: 33229624 PMCID: PMC7803544 DOI: 10.18632/aging.104139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 09/18/2020] [Indexed: 12/15/2022]
Abstract
Estimating the case-fatality rate and clinical outcomes for patients with coronavirus disease 2019 (COVID-19) is crucial because health care systems must adequately prepare for outbreaks and design appropriate policies. A systematic search of PubMed, Embase, and Medline+Journal (via OVID) were conducted for relevant journal publications from database inception to May 4, 2020. Articles that reported the fatality rates and clinical outcomes of patients hospitalized for COVID-19 or severe acute respiratory syndrome (SARS) infection were included. Nine clinical reports (four SARS reports and five COVID-19 reports) with a total of 851 patients (367 and 484 patients with SARS and COVID-19, respectively) were analyzed. A greater proportion of hospitalized patients with COVID-19 had bilateral pneumonia (90.0% [76.3%-96.2%] vs. 35.9% [21.4%-53.6%], p < 0.001) and required ventilators (23.8% [18.8%-29.6%] vs. 15.3% [11.9%-19.4%], p = 0.010) compared with hospitalized patients with SARS. The case-fatality rate was 9.5% (6.5%-13.7%) and 6.1% (3.5%-10.3%) among patients with COVID-19 and SARS, respectively (p = 0.186). The case-fatality rate among hospitalized patients with COVID-19 was comparable to that during the 2003 SARS outbreak. A higher incidence of bilateral pneumonia and increased ventilator usage were noted among patients with COVID-19 compared with patients with SARS.
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Affiliation(s)
- Po-Cheng Chang
- Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Medical School, Taoyuan, Taiwan
| | - Chien-Chang Yang
- Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Medical School, Taoyuan, Taiwan
| | - Kuo-Chin Kao
- Division of Thoracic Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Medical School, Taoyuan, Taiwan
| | - Ming-Shien Wen
- Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Medical School, Taoyuan, Taiwan
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110
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De Natale G, De Natale L, Troise C, Marchitelli V, Coviello A, Holmberg KG, Somma R. The Evolution of Covid-19 in Italy after the Spring of 2020: An Unpredicted Summer Respite Followed by a Second Wave. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8708. [PMID: 33255181 PMCID: PMC7727657 DOI: 10.3390/ijerph17238708] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 11/21/2020] [Accepted: 11/21/2020] [Indexed: 12/18/2022]
Abstract
The coronavirus (COVID-19) pandemic was particularly invasive in Italy during the period between March and late April 2020, then decreased in both the number of infections and in the seriousness of the illness throughout the summer of 2020. In this work, we measure the severity of the disease by the ratio of Intensive Care Units (ICU) spaces occupied by COVID-19 patients and the number of Active Cases (AC) each month from April to October 2020. We also use the ratio of the number of Deaths (D) to the number of Active Cases. What clearly emerges, from rigorous statistical analysis, is a progressive decrease in both ratios until August, indicating progressive mitigation of the disease. This is particularly evident when comparing March-April with July-August; during the summer period the two ratios became roughly 18 times lower. We test such sharp decreases against possible bias in counting active cases and we confirm their statistical significance. We then interpret such evidence in terms of the well-known seasonality of the human immune system and the virus-inactivating effect of stronger UV rays in the summer. Both ratios, however, increased again in October, as ICU/AC began to increase in September 2020. These ratios and the exponential growth of infections in October indicate that the virus-if not contained by strict measures-will lead to unsustainable challenges for the Italian health system in the winter of 2020-2021.
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Affiliation(s)
- Giuseppe De Natale
- INGV, Osservatorio Vesuviano, 80124 Naples, Italy; (G.D.N.); (C.T.)
- CNR-INO, 80078 Pozzuoli, Italy
| | - Lorenzo De Natale
- Medical School, Università Degli Studi di Napoli “Federico II”, 80131 Naples, Italy;
| | - Claudia Troise
- INGV, Osservatorio Vesuviano, 80124 Naples, Italy; (G.D.N.); (C.T.)
- CNR-INO, 80078 Pozzuoli, Italy
| | - Vito Marchitelli
- Department of Mobility, Public Works, Ecology, Environment, Puglia Region Government, 70100 Bari, Italy;
| | | | - Karen G. Holmberg
- Gallatin School of Individualized Study, New York University, New York, NY 10003, USA;
| | - Renato Somma
- INGV, Osservatorio Vesuviano, 80124 Naples, Italy; (G.D.N.); (C.T.)
- CNR-IRISS, 80134 Naples, Italy;
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111
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Lan FY, Filler R, Mathew S, Iliaki E, Osgood R, Bruno-Murtha LA, Kales SN. Evolving virulence? Decreasing COVID-19 complications among Massachusetts healthcare workers: a cohort study. Pathog Glob Health 2020; 115:4-6. [PMID: 33191880 DOI: 10.1080/20477724.2020.1847778] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Affiliation(s)
- Fan-Yun Lan
- Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University , Tainan, Taiwan.,Department of Environmental Health, Harvard University T.H. Chan School of Public Health , Boston, MA, USA
| | - Robert Filler
- Department of Environmental Health, Harvard University T.H. Chan School of Public Health , Boston, MA, USA
| | - Soni Mathew
- Cambridge Health Alliance, Harvard Medical School , Cambridge, MA, USA
| | - Eirini Iliaki
- Cambridge Health Alliance, Harvard Medical School , Cambridge, MA, USA
| | - Rebecca Osgood
- Cambridge Health Alliance, Harvard Medical School , Cambridge, MA, USA
| | | | - Stefanos N Kales
- Department of Environmental Health, Harvard University T.H. Chan School of Public Health , Boston, MA, USA.,Cambridge Health Alliance, Harvard Medical School , Cambridge, MA, USA
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112
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Gleicher N. The COVID-19 pandemic through eyes of a NYC fertility center: a unique learning experience with often unexpected results. Reprod Biol Endocrinol 2020; 18:105. [PMID: 33148264 PMCID: PMC7609825 DOI: 10.1186/s12958-020-00663-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 10/21/2020] [Indexed: 01/10/2023] Open
Abstract
Affecting basic tenets of human existence such as health, economic as well as personal security and, of course, reproduction, the COVID-19 pandemic transcended medical specialties and professional disciplines. Yet, six months into the pandemic, there still exists no consensus on how to combat the virus in absence of a vaccine. Facing unprecedented circumstances, and in absence of real evidence on how to proceed, our organization early in the pandemic decided to act independently from often seemingly irrational guidance and, instead, to carefully follow a quickly evolving COVID-19 literature. Here described is the, likely, unique journey of a fertility center that maintained services during peaks of COVID-19 and political unrest that followed. Closely following publicly available data, we recognized relatively early that New York City and other East Coast regions, which during the initial COVID-19 wave between March and May represented the hardest-hit areas in the country, during the second wave, beginning in June and still in progress, remained almost completely unaffected. In contrast, south western regions, almost completely unaffected by the initial wave, were severely affected in the second wave. These two distinctively different infectious phenotypes suggested two likely explanations: The country was witnessing infections with two different SARS-CoV-2 viruses and NYC (along with the East Coast) acquired during the first wave much better immunity to the virus than south western regions. Both hypotheses since have been confirmed: East and West Coasts, indeed, were initially infected by two distinctively different lineages of the virus, with the East Coast lineage being 10-times more infectious. In addition, immunologists discovered an up to this point unknown long-term anti-viral innate (cellular) immune response which offers additional and much broader anti-viral immunity than the classical adaptive immunity via immobilizing antibodies that has been known for decades. Consequently, we predict that in the U.S., even in absence of an available vaccine, COVID-19, by September-October, will be at similarly low levels as are currently seen in NYC and other East Coast regions (generally < 1% test-positivity). We, furthermore, predict that, if current mitigation measures are maintained and no newly aggressive mutation of the virus enters the country, a significant fall-wave of COVID-19, in combination with the usual fall wave of influenza, appears unlikely. To continue serving patients uninterrupted throughout the pandemic, turned for all of our center's staff into a highly rewarding experience, garnered respect and appreciation from patients, and turned into an absolutely unique learning experience.
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Affiliation(s)
- Norbert Gleicher
- The Center for Human Reproduction, 21 East 69th Street, New York, N.Y, 10021, USA.
- The Foundation for Reproductive Medicine, New York, N.Y, USA.
- Stem Cell Biology and Molecular Embryology Laboratory, The Rockefeller University, New York, N.Y, USA.
- Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria.
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113
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Na J, Tibebu H, De Silva V, Kondoz A, Caine M. Probabilistic approximation of effective reproduction number of COVID-19 using daily death statistics. CHAOS, SOLITONS, AND FRACTALS 2020; 140:110181. [PMID: 32834657 PMCID: PMC7392127 DOI: 10.1016/j.chaos.2020.110181] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 07/29/2020] [Indexed: 05/24/2023]
Abstract
The effective reproduction number (R) which signifies the number of secondary cases infected by one infectious individual, is an important measure of the spread of an infectious disease. Due to the dynamics of COVID-19 where many infected people are not showing symptoms or showing mild symptoms, and where different countries are employing different testing strategies, it is quite difficult to calculate the R, while the pandemic is still widespread. This paper presents a probabilistic methodology to evaluate the effective reproduction number by considering only the daily death statistics of a given country. The methodology utilizes a linearly constrained Quadratic Programming scheme to estimate the daily new infection cases from the daily death statistics, based on the probability distribution of delays associated with symptom onset and to reporting a death. The proposed methodology is validated in-silico by simulating an infectious disease through a Susceptible-Infectious-Recovered (SIR) model. The results suggest that with a reasonable estimate of distribution of delay to death from the onset of symptoms, the model can provide accurate estimates of R. The proposed method is then used to estimate the R values for two countries.
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114
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von Humboldt S, Mendoza-Ruvalcaba NM, Arias-Merino ED, Costa A, Cabras E, Low G, Leal I. Smart technology and the meaning in life of older adults during the Covid-19 public health emergency period: a cross-cultural qualitative study. Int Rev Psychiatry 2020; 32:713-722. [PMID: 33016790 DOI: 10.1080/09540261.2020.1810643] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The exponential increase of the older segment of the population is coinciding with the growing challenges of a digital society in different socio-cultural contexts. This exploratory study aims to analyze older adult perspectives of how smart technology influenced their meaning in life during the Covid-19 Public Health Emergency period, using qualitative research at a cross-national level. Three hundred and fifty-one community-dwelling older participants aged 65-87 years were included in the study. Participants were Italian, Mexican, Portuguese and Spanish. All the narratives went through a process of content analysis. Findings of content analysis produced six themes: Meaningful relations, rewarding activities, spirituality, health and safety-related support, self-growth, and physical activity. Smart technology was important in promoting significant relations for Mexican older adults (71.3%), rewarding activities for Portuguese older adults (57.1%), spirituality for Spanish older participants (71.6%), and physical activity for Italian older adults (29.5%). This study indicated that smart technology during the Health Emergency period was important for the meaning in life of older populations, mostly by facilitating meaningful relations, rewarding activities and spirituality. Future interventions with older adults during pandemic periods should consider the diversity of themes associated with increasing older adult well-being, from a cross-cultural perspective.
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Affiliation(s)
- Sofia von Humboldt
- William James Research Center, ISPA - Instituto Universitário, Lisbon, Portugal
| | | | | | - Andrea Costa
- ISPA - Instituto Universitário, Lisbon, Portugal
| | - Emilia Cabras
- Departamento de Educación, Universidad Antonio de Nebrija, Madrid, Spain
| | - Gail Low
- Faculty of Nursing, University of Alberta, Edmonton, Canada
| | - Isabel Leal
- William James Research Center, ISPA - Instituto Universitário, Lisbon, Portugal
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115
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Affiliation(s)
- Shalin S Patel
- Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts
| | - Jeremy Kalma
- Department of Orthopaedic Surgery, Beaumont Hospital, Royal Oak, Michigan
| | - Eric M Bluman
- Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts
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116
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Wang S, Mulier S, Jonscher C, Ye S, Chen L, Feng Y, Li Y, Ni Y. Hypothesis: What is the Best We Can Do with Hydroxychloroquine for COVID-19? Clin Epidemiol 2020; 12:1139-1144. [PMID: 33116907 PMCID: PMC7585824 DOI: 10.2147/clep.s277889] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 09/21/2020] [Indexed: 11/23/2022] Open
Abstract
There are widespread anecdotal reports of seemingly successful treatment among the early (three to seven days from symptoms) stage coronavirus disease 2019 (COVID-19) patients with the drug hydroxychloroquine (HCQ), and randomized placebo-controlled trials of HCQ in outpatient settings are underway. In this note, we (1) report observational evidence and present scientific reasoning as to why early treatment with HCQ may succeed while treatment later in the disease progression is likely to fail and (2) hypothesize a public health regime under which HCQ may be used to mitigate the impact of the current pandemic.
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Affiliation(s)
- Shuncong Wang
- Campus Gasthuisberg, Group of Biomedical Sciences, KU, Leuven, Belgium
| | - Stefaan Mulier
- Campus Gasthuisberg, Group of Biomedical Sciences, KU, Leuven, Belgium
- Department of Surgery, Delta Hospital, Brussels, Belgium
| | - Charles Jonscher
- Institute for Health Metrics & Evaluation, University of Washington, Seattle, WA, USA
| | - Sheng Ye
- Primary Care NJ, Englewood, NJ, USA
| | - Lei Chen
- Campus Gasthuisberg, Group of Biomedical Sciences, KU, Leuven, Belgium
| | - Yuanbo Feng
- Campus Gasthuisberg, Group of Biomedical Sciences, KU, Leuven, Belgium
| | - Yue Li
- Shanghai Key Laboratory of Molecular Imaging, Shanghai University of Medicine and Health Sciences, Shanghai201318, People’s Republic of China
| | - Yicheng Ni
- Campus Gasthuisberg, Group of Biomedical Sciences, KU, Leuven, Belgium
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117
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Khadke S, Ahmed N, Ahmed N, Ratts R, Raju S, Gallogly M, de Lima M, Sohail MR. Harnessing the immune system to overcome cytokine storm and reduce viral load in COVID-19: a review of the phases of illness and therapeutic agents. Virol J 2020; 17:154. [PMID: 33059711 PMCID: PMC7558250 DOI: 10.1186/s12985-020-01415-w] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 09/18/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) is caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2, previously named 2019-nCov), a novel coronavirus that emerged in China in December 2019 and was declared a global pandemic by World Health Organization by March 11th, 2020. Severe manifestations of COVID-19 are caused by a combination of direct tissue injury by viral replication and associated cytokine storm resulting in progressive organ damage. DISCUSSION We reviewed published literature between January 1st, 2000 and June 30th, 2020, excluding articles focusing on pediatric or obstetric population, with a focus on virus-host interactions and immunological mechanisms responsible for virus associated cytokine release syndrome (CRS). COVID-19 illness encompasses three main phases. In phase 1, SARS-CoV-2 binds with angiotensin converting enzyme (ACE)2 receptor on alveolar macrophages and epithelial cells, triggering toll like receptor (TLR) mediated nuclear factor kappa-light-chain-enhancer of activated B cells (NF-ƙB) signaling. It effectively blunts an early (IFN) response allowing unchecked viral replication. Phase 2 is characterized by hypoxia and innate immunity mediated pneumocyte damage as well as capillary leak. Some patients further progress to phase 3 characterized by cytokine storm with worsening respiratory symptoms, persistent fever, and hemodynamic instability. Important cytokines involved in this phase are interleukin (IL)-6, IL-1β, and tumor necrosis factor (TNF)-α. This is typically followed by a recovery phase with production of antibodies against the virus. We summarize published data regarding virus-host interactions, key immunological mechanisms responsible for virus-associated CRS, and potential opportunities for therapeutic interventions. CONCLUSION Evidence regarding SARS-CoV-2 epidemiology and pathogenesis is rapidly evolving. A better understanding of the pathophysiology and immune system dysregulation associated with CRS and acute respiratory distress syndrome in severe COVID-19 is imperative to identify novel drug targets and other therapeutic interventions.
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Affiliation(s)
- Sumanth Khadke
- Our Lady of Fatima University, 120 MacArthur Highway, 1440, Valenzuela, Metro Manila, Philippines
| | - Nayla Ahmed
- Section of Hospital Medicine, Dartmouth-Hitchcock Medical Center - Geisel School of Medicine, One Medical Center Drive, Lebanon, NH, 03766, USA
| | - Nausheen Ahmed
- Section of Hematology Oncology, Bone Marrow Transplant and Cellular Therapy, University Of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA
| | - Ryan Ratts
- Section of Hospital Medicine, Dartmouth-Hitchcock Medical Center - Geisel School of Medicine, One Medical Center Drive, Lebanon, NH, 03766, USA
- Section of Pediatric Hospital Medicine, Dartmouth-Hitchcock Medical Center - Geisel School of Medicine, One Medical Center Drive, Lebanon, NH, 03766, USA
| | - Shine Raju
- Section of Pulmonary and Critical Care, University Hospitals Cleveland Medical Center - Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH, 44106, USA
| | - Molly Gallogly
- Section of Hematology Oncology, Stem Cell Transplant and Cellular Therapeutics, University Hospitals Seidman Cancer Center - Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH, 44106, USA
| | - Marcos de Lima
- Section of Hematology Oncology, Stem Cell Transplant and Cellular Therapeutics, University Hospitals Seidman Cancer Center - Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH, 44106, USA
| | - Muhammad Rizwan Sohail
- Section of Infectious Diseases and Cardiovascular Medicine, Mayo Clinic College of Medicine and Science, 200 1st St SW, Rochester, MN, 55905, USA.
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118
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Han D, Wang C, Feng X, Wu J. Delirium During Recovery in Patients With Severe COVID-19: Two Case Reports. Front Med (Lausanne) 2020; 7:573791. [PMID: 33195323 PMCID: PMC7646517 DOI: 10.3389/fmed.2020.573791] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 09/23/2020] [Indexed: 01/13/2023] Open
Abstract
Novel coronavirus disease (COVID-19), caused by SARS-CoV-2, has rapidly evolved into a worldwide pandemic, leaving patients with life-threatening respiratory, cardiovascular, and cerebral complications. Here we reported on two patients with severe COVID-19 who experienced delirium in the early stage of recovery and mental illness including fatigue, anxiety, and post-traumatic stress disorder in the post-illness stage of COVID-19. Two patients were admitted to hospital due to clinical symptoms and features of CT and were confirmed for COVID-19 by positive results of a throat swab for SARS-CoV-2. Due to severe respiratory symptoms and a low oxygenation index, they were transferred to the ICU and received invasive mechanical ventilation and sedation. Hyperactive delirium was observed after being transferred out of the ICU. Different treatment measures were taken in time. Delirium did not occur again in hospital, but they showed mental suffering, including fatigue, anxiety, and post-traumatic stress disorder (PTSD), during the 5 month follow-up after discharge.
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Affiliation(s)
- Dong Han
- Department of Anaesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chenyang Wang
- Department of Anaesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaojing Feng
- Department of Anaesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Wu
- Department of Anaesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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119
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Verma A, Patel AB, Tio MC, Waikar SS. Caring for Dialysis Patients in a Time of COVID-19. Kidney Med 2020; 2:S2590-0595(20)30206-5. [PMID: 33073227 PMCID: PMC7553995 DOI: 10.1016/j.xkme.2020.07.006] [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: 04/21/2020] [Accepted: 07/21/2020] [Indexed: 01/10/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a pandemic and a public health emergency. The overwhelming rise in the number of cases has brought significant challenges to healthcare systems worldwide. Patients with end-stage kidney disease (ESKD) are highly vulnerable with the multiple comorbidities that make them susceptible to adverse outcomes with COVID-19. Over 2 million people worldwide receive maintenance hemodialysis (HD) at outpatient centers. Effectively preventing the spread of infection among HD centers, healthcare personnel, and patients is essential to ensure the continued delivery of dialysis to ESKD patients. This article discusses dialysis patients' care during COVID-19, addressing measures for patient and health care personnel protection and care of dialysis patients with suspected or confirmed COVID-19.
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Affiliation(s)
- Ashish Verma
- Renal Division, Department of Medicine, Brigham and Women’s Hospital,
Boston, MA
| | - Ankit B. Patel
- Renal Division, Department of Medicine, Brigham and Women’s Hospital,
Boston, MA
| | - Maria Clarissa Tio
- Renal Division, Department of Medicine, Brigham and Women’s Hospital,
Boston, MA
| | - Sushrut S. Waikar
- Renal Section, Department of Medicine, Boston University School of
Medicine, Boston, MA
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120
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Affiliation(s)
- Daniel A Solomon
- Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts
| | - Amy C Sherman
- Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts
| | - Sanjat Kanjilal
- Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Healthcare Institute, Boston, Massachusetts
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121
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Battisti V, Wieder O, Garon A, Seidel T, Urban E, Langer T. A Computational Approach to Identify Potential Novel Inhibitors against the Coronavirus SARS-CoV-2. Mol Inform 2020; 39:e2000090. [PMID: 32721082 PMCID: PMC7583376 DOI: 10.1002/minf.202000090] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 06/23/2020] [Indexed: 12/19/2022]
Abstract
The current pandemic threat of COVID-19, caused by the novel coronavirus SARS-CoV-2, not only gives rise to a high number of deaths around the world but also has immense consequences for the worldwide health systems and global economy. Given the fact that this pandemic is still ongoing and there are currently no drugs or vaccines against this novel coronavirus available, this in silico study was conducted to identify a potential novel SARS-CoV-2-inhibitor. Two different approaches were pursued: 1) The Docking Consensus Approach (DCA) is a novel approach, which combines molecular dynamics simulations with molecular docking. 2) The Common Hits Approach (CHA) in contrast focuses on the combination of the feature information of pharmacophore modeling and the flexibility of molecular dynamics simulations. The application of both methods resulted in the identification of 10 compounds with high coronavirus inhibition potential.
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Affiliation(s)
- Verena Battisti
- Department of Pharmaceutical ChemistryUniversity of ViennaAlthanstraße 14A-1090ViennaAustria
| | - Oliver Wieder
- Department of Pharmaceutical ChemistryUniversity of ViennaAlthanstraße 14A-1090ViennaAustria
| | - Arthur Garon
- Department of Pharmaceutical ChemistryUniversity of ViennaAlthanstraße 14A-1090ViennaAustria
| | - Thomas Seidel
- Department of Pharmaceutical ChemistryUniversity of ViennaAlthanstraße 14A-1090ViennaAustria
| | - Ernst Urban
- Department of Pharmaceutical ChemistryUniversity of ViennaAlthanstraße 14A-1090ViennaAustria
| | - Thierry Langer
- Department of Pharmaceutical ChemistryUniversity of ViennaAlthanstraße 14A-1090ViennaAustria
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122
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Chao DL, Sridhar J, Kuriyan AE, Leng T, Barnett BP, Carlin AF, Wykoff CC, Gayer S, Mruthyunjaya P, Yonekawa Y, Fawzi AA, Berrocal AM, Yeh S, Ting D, Modi Y, Zacks DN, Yannuzzi N, Afshari NA, Murray T. Rationale for American Society of Retina Specialists Best Practice Recommendations for Conducting Vitreoretinal Surgery during the COVID-19 Era. JOURNAL OF VITREORETINAL DISEASES 2020; 4:420-429. [PMID: 34222758 PMCID: PMC8247449 DOI: 10.1177/2474126420941707] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
PURPOSE To detail the rationale behind recommendations recently published by the American Society of Retina Specialists (ASRS) outlining best practices for safety of vitreoretinal surgeons and staff while performing vitreoretinal surgery during the coronavirus disease (COVID)-19 pandemic. METHODS The committee for ASRS Best Practices for Retinal Surgery during the COVID-19 Pandemic reviewed existing evidence and information on SARS-CoV-2 transmission, and risk factors during vitreoretinal surgery. Recommendations were based on best available published data, cumulative clinical experiences, and recommendations and policies from other organizations. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the strength of recommendations and confidence in the evidence. These serve as interim recommendations which are routinely updated given gaps of knowledge and lack of high-quality data on this evolving subject. RESULTS Relevant existing literature related to methods of transmission, and ocular manifestations of SARS-CoV-2 are summarized. The data and clinical experiences driving recommendations for pre-operative, intraoperative and post-operative surgical considerations, anesthesia choice, as well as considerations for intravitreal injections are provided. CONCLUSION Recommendations are provided with the goal of protecting vitreoretinal surgeons and associated personnel from exposure to SARS-CoV-2 during interventional vitreoretinal procedures. This is a rapidly evolving topic with numerous remaining gaps in our current knowledge. As such, recommendations will evolve and the current manuscript is intended to serve as a foundation for continued dialogue on best practices.
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Affiliation(s)
- Daniel L. Chao
- Viterbi Family Department of Ophthalmology, Shiley Eye Institute,
University of California San Diego, La Jolla, CA, USA
| | - Jayanth Sridhar
- Bascom Palmer Eye Institute, University of Miami, Miami, FL,
USA
| | - Ajay E. Kuriyan
- Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson
University, Philadelphia, PA, USA
| | - Theodore Leng
- Department of Ophthalmology, Byers Eye Institute at Stanford,
Stanford University, Palo Alto, CA, USA
| | - Brad P. Barnett
- Department of Ophthalmology, Duke Eye Center, Duke University,
Durham, NC, USA
| | - Aaron F. Carlin
- Department of Medicine, Division of Infectious Diseases and Global
Public Health, University, of California, San Diego, La Jolla, CA, USA
| | - Charles C. Wykoff
- Retina Consultants of Houston, Retina Consultants of America;
Blanton Eye Institute, Houston Methodist Hospital & Weill Cornell Medical
College, Houston, TX, USA
| | - Stephen Gayer
- Department of Anesthesia, University of Miami, Miami, FL, USA
| | - Prithvi Mruthyunjaya
- Department of Ophthalmology, Byers Eye Institute at Stanford,
Stanford University, Palo Alto, CA, USA
| | - Yoshihiro Yonekawa
- Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson
University, Philadelphia, PA, USA
| | - Amani A. Fawzi
- Department of Ophthalmology, Northwestern University, Chicago, IL,
USA
| | | | - Steven Yeh
- Department of Ophthalmology, Emory Eye Center, Emory University,
Atlanta, GA, USA
| | - Daniel Ting
- Singapore National Eye Center, Singapore, Singapore
| | - Yasha Modi
- Department of Ophthalmology, New York University, New York, NY,
USA
| | - David N. Zacks
- Department of Ophthalmology, Kellogg Eye Center, University of
Michigan, Ann Arbor, MI, USA
| | | | - Natalie A. Afshari
- Viterbi Family Department of Ophthalmology, Shiley Eye Institute,
University of California San Diego, La Jolla, CA, USA
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Abdelrahman T, Ansell J, Brown C, Egan R, Evans T, Ryan Harper E, Harries RL, Hopkins L, James O, Lewis S, Lewis WG, Luton O, Mellor K, Powell AG, Robinson D, Thomas R, Williams A, Beamish AJ. Recommended operating room practice during the COVID-19 pandemic: systematic review. BJS Open 2020; 4:748-756. [PMID: 32395909 PMCID: PMC7272923 DOI: 10.1002/bjs5.50304] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 05/04/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic poses a critical global public health crisis. Operating room (OR) best practice in this crisis is poorly defined. This systematic review was performed to identify contemporary evidence relating to OR practice in the context of COVID-19. METHODS MEDLINE was searched systematically using PubMed (search date 19 March 2020) for relevant studies in accordance with PRISMA guidelines. Documented practices and guidance were assessed to determine Oxford Centre for Evidence-Based Medicine (OCEBM) levels of evidence, and recommendations for practice within five domains were extracted: physical OR, personnel, patient, procedure, and other factors. RESULTS Thirty-five articles were identified, of which 11 met eligibility criteria. Nine articles constituted expert opinion and two were retrospective studies. All articles originated from the Far East (China, 9; Singapore, 2); eight of the articles concerned general surgery. Common themes were identified within each domain, but all recommendations were based on low levels of evidence (median OCEBM level 5 (range 4-5)). The highest number of overlapping recommendations related to physical OR (8 articles) and procedural factors (13). Although few recommendations related to personnel factors, consensus was high in this domain, with all studies mandating the use of personal protective equipment. CONCLUSION There was little evidence to inform this systematic review, but there was consensus regarding many aspects of OR practice. Within the context of a rapidly evolving pandemic, timely amalgamation of global practice and experiences is needed to inform best practice.
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Affiliation(s)
| | - T Abdelrahman
- School of Surgery, Health Education and Improvement Wales , Nantgarw, UK
| | - J Ansell
- School of Surgery, Health Education and Improvement Wales , Nantgarw, UK
| | - C Brown
- School of Surgery, Health Education and Improvement Wales , Nantgarw, UK
| | - R Egan
- School of Surgery, Health Education and Improvement Wales , Nantgarw, UK
| | - T Evans
- School of Surgery, Health Education and Improvement Wales , Nantgarw, UK
| | - E Ryan Harper
- School of Surgery, Health Education and Improvement Wales , Nantgarw, UK
| | - R L Harries
- School of Surgery, Health Education and Improvement Wales , Nantgarw, UK
| | - L Hopkins
- School of Surgery, Health Education and Improvement Wales , Nantgarw, UK
| | - O James
- School of Surgery, Health Education and Improvement Wales , Nantgarw, UK
| | - S Lewis
- School of Surgery, Health Education and Improvement Wales , Nantgarw, UK
| | - W G Lewis
- School of Surgery, Health Education and Improvement Wales , Nantgarw, UK
| | - O Luton
- School of Surgery, Health Education and Improvement Wales , Nantgarw, UK
| | - K Mellor
- School of Surgery, Health Education and Improvement Wales , Nantgarw, UK
| | - A G Powell
- School of Surgery, Health Education and Improvement Wales , Nantgarw, UK
| | - D Robinson
- School of Surgery, Health Education and Improvement Wales , Nantgarw, UK
| | - R Thomas
- School of Surgery, Health Education and Improvement Wales , Nantgarw, UK
| | - A Williams
- School of Surgery, Health Education and Improvement Wales , Nantgarw, UK
| | - A J Beamish
- School of Surgery, Health Education and Improvement Wales , Nantgarw, UK
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Vordos N, Gkika DA, Maliaris G, Tilkeridis KE, Antoniou A, Bandekas DV, Ch Mitropoulos A. How 3D printing and social media tackles the PPE shortage during Covid - 19 pandemic. SAFETY SCIENCE 2020; 130:104870. [PMID: 32536750 PMCID: PMC7275995 DOI: 10.1016/j.ssci.2020.104870] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 06/03/2020] [Indexed: 05/08/2023]
Abstract
During the recent Covid-19 pandemic, additive Technology and Social Media were used to tackle the shortage of Personal Protective Equipment. A literature review and a social media listening software were employed to explore the number of the users referring to specific keywords related to 3D printing and PPE. Additionally, the QALY model was recruited to highlight the importance of the PPE usage. More than 7 billion users used the keyword covid or similar in the web while mainly Twitter and Facebook were used as a world platform for PPE designs distribution through individuals and more than 100 different 3D printable PPE designs were developed.
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Affiliation(s)
- Nick Vordos
- Department of Physics, International Hellenic University, St. Lucas, 65404 Kavala, Greece
| | - Despina A Gkika
- Department of Physics, International Hellenic University, St. Lucas, 65404 Kavala, Greece
- Complex Systems Lab, Department of Physics, International Hellenic University, Kavala GR-654 04, Greece
- Hephaestus Advanced Laboratory, International Hellenic University, Kavala GR-654 04, Greece
| | - George Maliaris
- Department of Chemistry, International Hellenic University, St. Lucas, 65404 Kavala, Greece
| | - Konstantinos E Tilkeridis
- Orthopaedic Department, Medical School, University General Hospital of Alexandroupolis, Democritus University of Thrace, St. Niarhos 1, Dragana, 68100 Alexandroupolis, Greece
| | - Anastasia Antoniou
- Otorhinolaryngology Surgeon, President of Kavala Medical Association, Ε. Venizelou 26C, 65303 Kavala, Greece
| | - Dimitrios V Bandekas
- Department of Physics, International Hellenic University, St. Lucas, 65404 Kavala, Greece
| | - Athanasios Ch Mitropoulos
- Hephaestus Advanced Laboratory, International Hellenic University, Kavala GR-654 04, Greece
- Department of Chemistry, International Hellenic University, St. Lucas, 65404 Kavala, Greece
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125
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Vordos N, Gkika DA, Maliaris G, Tilkeridis KE, Antoniou A, Bandekas DV, Ch Mitropoulos A. How 3D printing and social media tackles the PPE shortage during Covid - 19 pandemic. SAFETY SCIENCE 2020; 130:104870. [PMID: 32536750 DOI: 10.1101/2020.04.27.20081372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 06/03/2020] [Indexed: 05/24/2023]
Abstract
During the recent Covid-19 pandemic, additive Technology and Social Media were used to tackle the shortage of Personal Protective Equipment. A literature review and a social media listening software were employed to explore the number of the users referring to specific keywords related to 3D printing and PPE. Additionally, the QALY model was recruited to highlight the importance of the PPE usage. More than 7 billion users used the keyword covid or similar in the web while mainly Twitter and Facebook were used as a world platform for PPE designs distribution through individuals and more than 100 different 3D printable PPE designs were developed.
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Affiliation(s)
- Nick Vordos
- Department of Physics, International Hellenic University, St. Lucas, 65404 Kavala, Greece
| | - Despina A Gkika
- Department of Physics, International Hellenic University, St. Lucas, 65404 Kavala, Greece
- Complex Systems Lab, Department of Physics, International Hellenic University, Kavala GR-654 04, Greece
- Hephaestus Advanced Laboratory, International Hellenic University, Kavala GR-654 04, Greece
| | - George Maliaris
- Department of Chemistry, International Hellenic University, St. Lucas, 65404 Kavala, Greece
| | - Konstantinos E Tilkeridis
- Orthopaedic Department, Medical School, University General Hospital of Alexandroupolis, Democritus University of Thrace, St. Niarhos 1, Dragana, 68100 Alexandroupolis, Greece
| | - Anastasia Antoniou
- Otorhinolaryngology Surgeon, President of Kavala Medical Association, Ε. Venizelou 26C, 65303 Kavala, Greece
| | - Dimitrios V Bandekas
- Department of Physics, International Hellenic University, St. Lucas, 65404 Kavala, Greece
| | - Athanasios Ch Mitropoulos
- Hephaestus Advanced Laboratory, International Hellenic University, Kavala GR-654 04, Greece
- Department of Chemistry, International Hellenic University, St. Lucas, 65404 Kavala, Greece
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Fulop T, Larbi A, Hirokawa K, Cohen AA, Witkowski JM. Immunosenescence is both functional/adaptive and dysfunctional/maladaptive. Semin Immunopathol 2020; 42:521-536. [PMID: 32930852 PMCID: PMC7490574 DOI: 10.1007/s00281-020-00818-9] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 08/24/2020] [Indexed: 01/08/2023]
Abstract
Alterations in the immune system with aging are considered to underlie many age-related diseases. However, many elderly individuals remain healthy until even a very advanced age. There is also an increase in numbers of centenarians and their apparent fitness. We should therefore change our unilaterally detrimental consideration of age-related immune changes. Recent data taking into consideration the immunobiography concept may allow for meaningful distinctions among various aging trajectories. This implies that the aging immune system has a homeodynamic characteristic balanced between adaptive and maladaptive aspects. The survival and health of an individual depends from the equilibrium of this balance. In this article, we highlight which parts of the aging of the immune system may be considered adaptive in contrast to those that may be maladaptive.
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Affiliation(s)
- T Fulop
- Department of Geriatrics, Faculty of Medicine, Research Center on Aging, University of Sherbrooke, Sherbrooke, QC, J1K 2R1, Canada.
- Research Center on Aging, Faculty of Medicine and Health Sciences, University of Sherbrooke, 3001, 12th Avenue North, Sherbrooke, Quebec, J1H 5N4, Canada.
| | - A Larbi
- Biology of Aging Program and Immunomonitoring Platform, Singapore Immunology Network (SIgN), Agency for Science Technology and Research (A*STAR), Immunos Building, Biopolis, Singapore, 138648, Singapore
| | - K Hirokawa
- Institute of Health and Life Science, Tokyo and Nito-memory Nakanosogo Hospital, Department of Pathology, Tokyo Med. Dent. University, Tokyo, Japan
| | - A A Cohen
- Department of Family Medicine, Faculty of Medicine, Research Center on Aging, University of Sherbrooke, Sherbrooke, QC, J1K 2R1, Canada
| | - J M Witkowski
- Department of Pathophysiology, Medical University of Gdansk, Gdansk, Poland
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127
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Chu H, Chan JFW, Wang Y, Yuen TTT, Chai Y, Hou Y, Shuai H, Yang D, Hu B, Huang X, Zhang X, Cai JP, Zhou J, Yuan S, Kok KH, To KKW, Chan IHY, Zhang AJ, Sit KY, Au WK, Yuen KY. Comparative Replication and Immune Activation Profiles of SARS-CoV-2 and SARS-CoV in Human Lungs: An Ex Vivo Study With Implications for the Pathogenesis of COVID-19. Clin Infect Dis 2020; 71:1400-1409. [PMID: 32270184 PMCID: PMC7184390 DOI: 10.1093/cid/ciaa410] [Citation(s) in RCA: 498] [Impact Index Per Article: 124.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 04/08/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an emerging coronavirus that has resulted in more than 2 000 000 laboratory-confirmed cases including over 145 000 deaths. Although SARS-CoV-2 and SARS-CoV share a number of common clinical manifestations, SARS-CoV-2 appears to be highly efficient in person-to-person transmission and frequently causes asymptomatic or presymptomatic infections. However, the underlying mechanisms that confer these viral characteristics of high transmissibility and asymptomatic infection remain incompletely understood. METHODS We comprehensively investigated the replication, cell tropism, and immune activation profile of SARS-CoV-2 infection in human lung tissues with SARS-CoV included as a comparison. RESULTS SARS-CoV-2 infected and replicated in human lung tissues more efficiently than SARS-CoV. Within the 48-hour interval, SARS-CoV-2 generated 3.20-fold more infectious virus particles than did SARS-CoV from the infected lung tissues (P < .024). SARS-CoV-2 and SARS-CoV were similar in cell tropism, with both targeting types I and II pneumocytes and alveolar macrophages. Importantly, despite the more efficient virus replication, SARS-CoV-2 did not significantly induce types I, II, or III interferons in the infected human lung tissues. In addition, while SARS-CoV infection upregulated the expression of 11 out of 13 (84.62%) representative proinflammatory cytokines/chemokines, SARS-CoV-2 infection only upregulated 5 of these 13 (38.46%) key inflammatory mediators despite replicating more efficiently. CONCLUSIONS Our study provides the first quantitative data on the comparative replication capacity and immune activation profile of SARS-CoV-2 and SARS-CoV infection in human lung tissues. Our results provide important insights into the pathogenesis, high transmissibility, and asymptomatic infection of SARS-CoV-2.
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Affiliation(s)
- Hin Chu
- State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
| | - Jasper Fuk-Woo Chan
- State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China.,Department of Microbiology, Queen Mary Hospital, Pokfulam, Hong Kong Special Administrative Region, China.,Department of Clinical Microbiology and Infection Control, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.,Hainan Medical University-The University of Hong Kong Joint Laboratory of Tropical Infectious Diseases, Hainan Medical University, Haikou, Hainan, and The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
| | - Yixin Wang
- State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
| | - Terrence Tsz-Tai Yuen
- State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
| | - Yue Chai
- State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
| | - Yuxin Hou
- State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
| | - Huiping Shuai
- State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
| | - Dong Yang
- State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
| | - Bingjie Hu
- State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
| | - Xiner Huang
- State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
| | - Xi Zhang
- State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
| | - Jian-Piao Cai
- State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
| | - Jie Zhou
- State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
| | - Shuofeng Yuan
- State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
| | - Kin-Hang Kok
- State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
| | - Kelvin Kai-Wang To
- State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China.,Department of Microbiology, Queen Mary Hospital, Pokfulam, Hong Kong Special Administrative Region, China.,Department of Clinical Microbiology and Infection Control, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Ivy Hau-Yee Chan
- Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong Special Administrative Region, China
| | - Anna Jinxia Zhang
- State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
| | - Ko-Yung Sit
- Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong Special Administrative Region, China
| | - Wing-Kuk Au
- Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong Special Administrative Region, China
| | - Kwok-Yung Yuen
- State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China.,Department of Microbiology, Queen Mary Hospital, Pokfulam, Hong Kong Special Administrative Region, China.,Department of Clinical Microbiology and Infection Control, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.,Hainan Medical University-The University of Hong Kong Joint Laboratory of Tropical Infectious Diseases, Hainan Medical University, Haikou, Hainan, and The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
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Yang J, Gong H, Chen X, Chen Z, Deng X, Qian M, Hou Z, Ajelli M, Viboud C, Yu H. Health-seeking behaviors of patients with acute respiratory infections during the outbreak of novel coronavirus disease 2019 in Wuhan, China. Influenza Other Respir Viruses 2020; 15:188-194. [PMID: 32909400 PMCID: PMC7902258 DOI: 10.1111/irv.12804] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 08/17/2020] [Accepted: 08/18/2020] [Indexed: 12/12/2022] Open
Abstract
We conducted two surveys to evaluate the health‐seeking behaviors of individuals with acute respiratory infections (ARI) during the COVID‐19 outbreak in Wuhan, China. Among 351 participants reporting ARI (10.3%, 351/3,411), 36.5% sought medical assistance. Children were more likely to seek medical assistance than other age‐groups (66.1% vs. 28.0%‐35.1%). This population‐based study demonstrates that the majority of patients with ARI symptoms did not seek medical assistance during the COVID‐19 outbreak in Wuhan. These findings may be used to refine the estimates of disease burden and clinical severity of COVID‐19 and to plan for health resources allocation.
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Affiliation(s)
- Juan Yang
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Hui Gong
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Xinhua Chen
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Zhiyuan Chen
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Xiaowei Deng
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Mengcen Qian
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Zhiyuan Hou
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Marco Ajelli
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health, Bloomington, IN, USA
| | - Cecile Viboud
- Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | - Hongjie Yu
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
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Naeem S, Gohh R, Bayliss G, Cosgrove C, Farmakiotis D, Merhi B, Morrissey P, Osband A, Bailey JA, Sweeney J, Rogers R. Successful recovery from COVID-19 in three kidney transplant recipients who received convalescent plasma therapy. Transpl Infect Dis 2020; 23:e13451. [PMID: 32815238 PMCID: PMC7460867 DOI: 10.1111/tid.13451] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 08/10/2020] [Accepted: 08/11/2020] [Indexed: 12/28/2022]
Abstract
Novel coronavirus disease 2019 (COVID‐19) is a highly infectious, rapidly spreading viral disease that typically presents with greater severity in patients with underlying medical conditions or those who are immunosuppressed. We present a novel case series of three kidney transplant recipients with COVID‐19 who recovered after receiving COVID‐19 convalescent plasma (CCP) therapy. Physicians should be aware of this potentially useful treatment option. Larger clinical registries and randomized clinical trials should be conducted to further explore the clinical and allograft outcomes associated with CCP use in this population.
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Affiliation(s)
- Syed Naeem
- Division of Renal Transplantation, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Reginald Gohh
- Division of Renal Transplantation, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - George Bayliss
- Division of Renal Transplantation, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Christopher Cosgrove
- Division of Renal Transplantation, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Dimitrios Farmakiotis
- Division of Infectious Diseases, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Basma Merhi
- Division of Renal Transplantation, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Paul Morrissey
- Division of Renal Transplantation, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Adena Osband
- Division of Renal Transplantation, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Jeffrey A Bailey
- Department of Pathology and Transfusion Medicine, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Joseph Sweeney
- Department of Pathology and Transfusion Medicine, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Ralph Rogers
- Division of Infectious Diseases, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
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Estimation of global case fatality rate of coronavirus disease 2019 (COVID-19) using meta-analyses: Comparison between calendar date and days since the outbreak of the first confirmed case. Int J Infect Dis 2020; 100:302-308. [PMID: 32882434 PMCID: PMC7462556 DOI: 10.1016/j.ijid.2020.08.065] [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: 06/18/2020] [Revised: 08/20/2020] [Accepted: 08/22/2020] [Indexed: 11/26/2022] Open
Abstract
Objective Since the outbreak of the coronavirus disease 2019 (COVID-19) in December of 2019 in China, estimating the pandemic’s case fatality rate (CFR) has been the focus and interest of many stakeholders. In this manuscript, we prove that the method of using the cumulative CFR is static and does not reflect the trend according to the daily change per unit of time. Methods A proportion meta-analysis was carried out on the CFR in every country reporting COVID-19 cases. Based on these results, we performed a meta-analysis for a global COVID-19 CFR. Each analysis was performed using two different calculations of CFR: according to the calendar date and according to the days since the outbreak of the first confirmed case. We thus explored an innovative and original calculation of CFR, concurrently based on the date of the first confirmed case as well as on a daily basis. Results For the first time, we showed that using meta-analyses according to the calendar date and days since the outbreak of the first confirmed case, were different. Conclusion We propose that a CFR according to days since the outbreak of the first confirmed case might be a better predictor of the current CFR of COVID-19 and its kinetics.
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Tortonese S, Scriabine I, Anjou L, Loens C, Michon A, Benabdelhak M, Ouali S, Morin G, Laifi M, Dobosziewicz H, Guillet M, Dekeyser M, Luong Nguyen LB, Grünenwald A, Dang J, Desbuissons G, Becquemont L, Snanoudj R, Legendre C, Hebibi H, Lefèvre E, Beaudreuil S, Zaidan M. COVID-19 in Patients on Maintenance Dialysis in the Paris Region. Kidney Int Rep 2020; 5:1535-1544. [PMID: 32838082 PMCID: PMC7368159 DOI: 10.1016/j.ekir.2020.07.016] [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] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 07/14/2020] [Accepted: 07/15/2020] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION Coronavirus disease 2019 (COVID-19) represents a serious threat to patients on maintenance dialysis. The clinical setting, mortality rate, and prognostic factors in these patients have not been well established. METHODS We included all dialyzed patients with COVID-19 referred to our dialysis center between March 11 and April 11, 2020. Data were obtained through the review of the medical records and were censored at the time of data cutoff, on May 11, 2020. RESULTS Forty-four patients on maintenance dialysis with COVID-19 were referred to our dialysis unit during the COVID-19 epidemic. Median age was 61 years (interquartile range [IQR]: 51.5-72.5); 65.9% were men. Comorbidities included hypertension (97.7%), diabetes mellitus (50%), and chronic cardiac (38.6%) and respiratory (27.3%) diseases. Initial symptoms were fever (79.5%), shortness of breath (29.5%), cough (43.2%), and diarrhea (13.6%). Three profiles of severity were distinguished based on the World Health Organization (WHO) progression scale. Forty-one (93.2%) were hospitalized and only 3 were maintained on outpatient hemodialysis. Thirty-three (75%) patients required oxygen therapy, including 15 (45.5%) who were referred to the intensive care unit. Overall, 27.3% of patients died, and 58.5% were discharged from hospital, including only 2 (13.3%) of those admitted to the intensive care unit. By multivariate analysis, cough, thrombopenia <120 g/l, lactate dehydrogenase (LDH) level greater than 2 times the upper limit of normal, and blood C-reactive protein (CRP) >175 mg/l were significantly associated with death. CONCLUSION A major outbreak of COVID-19 occurred in the Paris region, and spread among dialyzed patients. Our study underscores the severity of COVID-19 in these patients and identified prognostic markers.
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Affiliation(s)
- Sarah Tortonese
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Le Kremlin Bicêtre, France
| | - Ivan Scriabine
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Le Kremlin Bicêtre, France
| | - Louis Anjou
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Le Kremlin Bicêtre, France
| | - Christopher Loens
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Le Kremlin Bicêtre, France
| | - Arthur Michon
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Le Kremlin Bicêtre, France
| | - Mohammed Benabdelhak
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Le Kremlin Bicêtre, France
| | - Sarah Ouali
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Le Kremlin Bicêtre, France
| | - Gabriel Morin
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Le Kremlin Bicêtre, France
| | - Marwa Laifi
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Le Kremlin Bicêtre, France
| | - Hélène Dobosziewicz
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Le Kremlin Bicêtre, France
- Université Paris Saclay, Université Paris-Sud, UVSQ, Villejuif, France
| | - Matthieu Guillet
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Le Kremlin Bicêtre, France
- Université Paris Saclay, Université Paris-Sud, UVSQ, Villejuif, France
| | - Manon Dekeyser
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Le Kremlin Bicêtre, France
- Université Paris Saclay, Université Paris-Sud, UVSQ, Villejuif, France
| | - Liem Binh Luong Nguyen
- Unité d’épidémiologie des Maladies Emergentes, Institut Pasteur, Paris, France
- Centre d’Investigation Clinique (CIC) Cochin Pasteur, Université de Paris, Hôpital Cochin, Paris, France
| | - Anne Grünenwald
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Le Kremlin Bicêtre, France
| | - Julien Dang
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Le Kremlin Bicêtre, France
| | - Geoffroy Desbuissons
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Le Kremlin Bicêtre, France
| | - Laurent Becquemont
- Université Paris Saclay, Université Paris-Sud, UVSQ, Villejuif, France
- Centre de recherche en Epidémiologie et Santé des Populations (CESP), INSERM, Villejuif, France
| | - Renaud Snanoudj
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Le Kremlin Bicêtre, France
- Université Paris Saclay, Université Paris-Sud, UVSQ, Villejuif, France
| | - Christophe Legendre
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Le Kremlin Bicêtre, France
| | - Hadia Hebibi
- Service de Néphrologie-Dialyse, Nephrocare, Villejuif, France
- Service de Néphrologie-Dialyse, Hôpital de Thiais, Thiais, France
| | - Edouard Lefèvre
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Le Kremlin Bicêtre, France
| | - Séverine Beaudreuil
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Le Kremlin Bicêtre, France
| | - Mohamad Zaidan
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Le Kremlin Bicêtre, France
- Université Paris Saclay, Université Paris-Sud, UVSQ, Villejuif, France
- Institut national de la santé et de la recherche médicale U1163, Institut des Maladies Génétiques, Hôpital Necker-Enfants malades, Paris, France
| | - AP-HP/Universities/Inserm COVID-19 research collaboration
- Service de Néphrologie, Dialyse et Transplantation, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (APHP), Le Kremlin Bicêtre, France
- Université Paris Saclay, Université Paris-Sud, UVSQ, Villejuif, France
- Unité d’épidémiologie des Maladies Emergentes, Institut Pasteur, Paris, France
- Centre d’Investigation Clinique (CIC) Cochin Pasteur, Université de Paris, Hôpital Cochin, Paris, France
- Centre de recherche en Epidémiologie et Santé des Populations (CESP), INSERM, Villejuif, France
- Service de Néphrologie-Dialyse, Nephrocare, Villejuif, France
- Service de Néphrologie-Dialyse, Hôpital de Thiais, Thiais, France
- Institut national de la santé et de la recherche médicale U1163, Institut des Maladies Génétiques, Hôpital Necker-Enfants malades, Paris, France
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Margus C, Sondheim SE, Peck NM, Storch B, Ngai KM, Ho HE, She T. Discharge in Pandemic: Suspected Covid-19 patients returning to the Emergency Department within 72 hours for admission. Am J Emerg Med 2020; 45:185-191. [PMID: 33046303 PMCID: PMC7434326 DOI: 10.1016/j.ajem.2020.08.034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 08/09/2020] [Accepted: 08/10/2020] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Coronavirus disease 2019 (Covid-19) has led to unprecedented healthcare demand. This study seeks to characterize Emergency Department (ED) discharges suspected of Covid-19 that are admitted within 72 h. METHODS We abstracted all adult discharges with suspected Covid-19 from five New York City EDs between March 2nd and April 15th. Those admitted within 72 h were then compared against those who were not using descriptive and regression analysis of background and clinical characteristics. RESULTS Discharged ED patients returning within 72 h were more often admitted if suspected of Covid-19 (32.9% vs 12.1%, p < .0001). Of 7433 suspected Covid-19 discharges, the 139 (1.9%) admitted within 72 h were older (55.4 vs. 45.6 years, OR 1.03) and more often male (1.32) or with a history of obstructive lung disease (2.77) or diabetes (1.58) than those who were not admitted (p < .05). Additional associations included non-English preference, cancer, heart failure, hypertension, renal disease, ambulance arrival, higher triage acuity, longer ED stay or time from symptom onset, fever, tachycardia, dyspnea, gastrointestinal symptoms, x-ray abnormalities, and decreased platelets and lymphocytes (p < .05 for all). On 72-h return, 91 (65.5%) subjects required oxygen, and 7 (5.0%) required mechanical ventilation in the ED. Twenty-two (15.8%) of the study group have since died. CONCLUSION Several factors emerge as associated with 72-h ED return admission in subjects suspected of Covid-19. These should be considered when assessing discharge risk in clinical practice.
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Affiliation(s)
- Colton Margus
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America.
| | - Samuel E Sondheim
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Nathan M Peck
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Bess Storch
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Ka Ming Ngai
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Hsi-En Ho
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Trent She
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
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Woolcott OO, Bergman RN. Mortality Attributed to COVID-19 in High-Altitude Populations. High Alt Med Biol 2020; 21:409-416. [PMID: 32815745 DOI: 10.1089/ham.2020.0098] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Woolcott, Orison O., and Richard N. Bergman. Mortality attributed to COVID-19 in high-altitude populations. High Alt Med Biol. 21:409-416, 2020. Background: Since partial oxygen pressure decreases as altitude increases, environmental hypoxia could worsen Coronavirus Disease 2019 (COVID-19) patient's hypoxemia. We compared COVID-19 mortality at different altitudes. Methods: Retrospective analysis of population-level data on COVID-19 deaths was conducted in the United States (1,016 counties) and Mexico (567 municipalities). Mixed-model Poisson regression analysis of the association between altitude and COVID-19 mortality was conducted using individual-level data from 40,168 Mexican subjects with COVID-19, adjusting for multiple covariates. Results: Between January 20 and April 13, 2020, mortality rates were higher in U.S. counties located at ≥2,000 m elevation versus those located <1,500 m (12.3 vs. 3.2 per 100,000; p < 0.001). In Mexico, between March 13 and May 13, 2020, mortality rates were higher in municipalities located at ≥2,000 m versus those located <1,500 m (5.3 vs. 3.9 per 100,000; p < 0.001). Among Mexican subjects younger than 65 years, the risk of death was 36% higher in those living at ≥2,000 m versus those living at <1,500 m (adjusted incidence rate ratio [IRR]: 1.36; confidence interval [95% CI], 1.05-1.78; p = 0.022). Among Mexican men, the risk of death was 31% higher at ≥2,000 m versus that at <1,500 m (adjusted IRR: 1.31; 95% CI, 1.03-1.66; p = 0.025). No association between altitude and COVID-19 mortality was found among Mexican women or among Mexican subjects 65 years of age and older. Conclusions: Altitude is associated with COVID-19 mortality in men younger than 65 years.
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Affiliation(s)
- Orison O Woolcott
- Sports Spectacular Diabetes and Obesity Wellness and Research Center, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Richard N Bergman
- Sports Spectacular Diabetes and Obesity Wellness and Research Center, Cedars-Sinai Medical Center, Los Angeles, California, USA
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Quirch M, Lee J, Rehman S. Hazards of the Cytokine Storm and Cytokine-Targeted Therapy in Patients With COVID-19: Review. J Med Internet Res 2020; 22:e20193. [PMID: 32707537 PMCID: PMC7428145 DOI: 10.2196/20193] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 07/03/2020] [Accepted: 07/22/2020] [Indexed: 12/18/2022] Open
Abstract
Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has challenged medicine and health care on a global scale. Its impact and frightening mortality rate are in large part attributable to the fact that there is a lack of available treatments. It has been shown that in patients who are severely ill, SARS-CoV-2 can lead to an inflammatory response known as cytokine storm, which involves activation and release of inflammatory cytokines in a positive feedback loop of pathogen-triggered inflammation. Currently, cytokine storm is one of the leading causes of morbidity and mortality in SARS-CoV-2, but there is no proven treatment to combat this systemic response. Objective The aim of this paper is to study the cytokine storm response in SARS-CoV-2 and to explore the early treatment options for patients who are critically ill with the coronavirus disease (COVID-19) in the early stages of the pandemic by reviewing the literature. Methods A literature review was performed from December 1, 2000, to April 4, 2020, to explore and compare therapies that target cytokine storm among SARS-CoV-2 and prior coronavirus cases. Results A total of 38 eligible studies including 24 systematic reviews, 5 meta-analyses, 5 experimental model studies, 7 cohort studies, and 4 case reports matched the criteria. Conclusions The severity of the cytokine storm, measured by elevated levels of interleukin-1B, interferon-γ, interferon-inducible protein 10, and monocyte chemoattractant protein 1, was associated with COVID-19 disease severity. Many treatment options with different targets have been proposed during the early stages of the COVID-19 pandemic, ranging from targeting the virus itself to managing the systemic inflammation caused by the virus and the excessive cytokine response. Among the different agents to manage cytokine storm in patients with COVID-19, there is developing support for convalescent plasma therapy particularly for patients who are critically ill or mechanically ventilated and resistant to antivirals and supportive care. Treatment options that were proposed in the beginning phases of the pandemic were multidimensional, and further research is needed to develop a more established treatment guideline.
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Affiliation(s)
- Miguel Quirch
- Texas Tech University Health Sciences Center, Lubbock, TX, United States
| | - Jeannie Lee
- Texas Tech University Health Sciences Center, Lubbock, TX, United States
| | - Shabnam Rehman
- Texas Tech University Health Sciences Center, Lubbock, TX, United States
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Lindström M. The COVID-19 pandemic and the Swedish strategy: Epidemiology and postmodernism. SSM Popul Health 2020; 11:100643. [PMID: 32885019 PMCID: PMC7453138 DOI: 10.1016/j.ssmph.2020.100643] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 08/06/2020] [Accepted: 08/06/2020] [Indexed: 12/28/2022] Open
Abstract
The aim is to outline the underlying epidemiological thinking and mentality in post-materialist and postmodern Sweden behind the Swedish strategy. The aim is not to investigate the handling of the pandemic in Sweden in the long-run. Overconfidence in herd immunity, overconfidence in individual responsibility in a pandemic needing community-centered approaches, overconfidence in evidence-based medicine and neglect to coordinate with the WHO and other countries may be associated with post-materialist values and postmodernism including opposition against modern authority, rationality and science, and also an anti-traditionalist stance towards older generations. COVID-19 epidemiology and postmodernism may be a dangerous combination.
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Affiliation(s)
- Martin Lindström
- Social Medicine and Health Policy, Department of Clinical Sciences in Malmö, Lund University, S-205 02, Malmö, Sweden
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Hariri-Ardebili MA. Living in a Multi-Risk Chaotic Condition: Pandemic, Natural Hazards and Complex Emergencies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5635. [PMID: 32764245 PMCID: PMC7460117 DOI: 10.3390/ijerph17165635] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/02/2020] [Accepted: 08/03/2020] [Indexed: 12/20/2022]
Abstract
Humans are living in an uncertain world, with daily risks confronting them from various low to high hazard events, and the COVID-19 pandemic has created its own set of unique risks. Not only has it caused a significant number of fatalities, but in combination with other hazard sources, it may pose a considerably higher multi-risk. In this paper, three hazardous events are studied through the lens of a concurring pandemic. Several low-probability high-risk scenarios are developed by the combination of a pandemic situation with a natural hazard (e.g., earthquakes or floods) or a complex emergency situation (e.g., mass protests or military movements). The hybrid impacts of these multi-hazard situations are then qualitatively studied on the healthcare systems, and their functionality loss. The paper also discusses the impact of pandemic's (long-term) temporal effects on the type and recovery duration from these adverse events. Finally, the concept of escape from a hazard, evacuation, sheltering and their potential conflict during a pandemic and a natural hazard is briefly reviewed. The findings show the cascading effects of these multi-hazard scenarios, which are unseen nearly in all risk legislation. This paper is an attempt to urge funding agencies to provide additional grants for multi-hazard risk research.
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Affiliation(s)
- Mohammad Amin Hariri-Ardebili
- College of Engineering and Applied Science, University of Colorado, Boulder, CO 80309, USA; ; Tel.: +1-303-990-2451
- College of Computer, Mathematical and Natural Sciences, University of Maryland, College Park, MD 20742, USA
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Boon I, Au Yong T, Boon C. Effect of the COVID-19 Pandemic on Cancer Clinician Decision Making: Known Knowns and Known Unknowns. Clin Oncol (R Coll Radiol) 2020; 32:547-548. [PMID: 32354668 PMCID: PMC7183284 DOI: 10.1016/j.clon.2020.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 04/21/2020] [Indexed: 11/06/2022]
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Ge Y, Sun S. Estimation of Coronavirus Disease Case-Fatality Risk in Real Time. Emerg Infect Dis 2020. [DOI: 10.3201/eid2608.1093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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Abstract
We ran a simulation comparing 3 methods to calculate case-fatality risk for coronavirus disease using parameters described in previous studies. Case-fatality risk calculated from these methods all are biased at the early stage of the epidemic. When comparing real-time case-fatality risk, the current trajectory of the epidemic should be considered.
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Feehan AK, Fort D, Garcia-Diaz J, Price-Haywood EG, Velasco C, Sapp E, Pevey D, Seoane L. Seroprevalence of SARS-CoV-2 and Infection Fatality Ratio, Orleans and Jefferson Parishes, Louisiana, USA, May 2020. Emerg Infect Dis 2020; 26:2766-2769. [PMID: 32731911 PMCID: PMC7588526 DOI: 10.3201/eid2611.203029] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Using a novel recruitment method and paired molecular and antibody testing for severe acute respiratory syndrome coronavirus 2 infection, we determined seroprevalence in a racially diverse municipality in Louisiana, USA. Infections were highly variable by ZIP code and differed by race/ethnicity. Overall census-weighted seroprevalence was 6.9%, and the calculated infection fatality ratio was 1.63%.
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141
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Bukhari Q, Massaro JM, D’Agostino RB, Khan S. Effects of Weather on Coronavirus Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5399. [PMID: 32727067 PMCID: PMC7432279 DOI: 10.3390/ijerph17155399] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 07/21/2020] [Accepted: 07/24/2020] [Indexed: 11/17/2022]
Abstract
The novel coronavirus (SARS-CoV-2) has spread globally and has been declared a pandemic by the World Health Organization. While influenza virus shows seasonality, it is unknown if COVID-19 has any weather-related affect. In this work, we analyze the patterns in local weather of all the regions affected by COVID-19 globally. Our results indicate that approximately 85% of the COVID-19 reported cases until 1 May 2020, making approximately 3 million reported cases (out of approximately 29 million tests performed) have occurred in regions with temperature between 3 and 17 °C and absolute humidity between 1 and 9 g/m3. Similarly, hot and humid regions outside these ranges have only reported around 15% or approximately 0.5 million cases (out of approximately 7 million tests performed). This suggests that weather might be playing a role in COVID-19 spread across the world. However, this role could be limited in US and European cities (above 45 N), as mean temperature and absolute humidity levels do not reach these ranges even during the peak summer months. For hot and humid countries, most of them have already been experiencing temperatures >35 °C and absolute humidity >9 g/m3 since the beginning of March, and therefore the effect of weather, however little it is, has already been accounted for in the COVID-19 spread in those regions, and they must take strict social distancing measures to stop the further spread of COVID-19. Our analysis showed that the effect of weather may have only resulted in comparatively slower spread of COVID-19, but not halted it. We found that cases in warm and humid countries have consistently increased, accounting for approximately 500,000 cases in regions with absolute humidity >9 g/m3, therefore effective public health interventions must be implemented to stop the spread of COVID-19. This also means that 'summer' would not alone stop the spread of COVID-19 in any part of the world.
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Affiliation(s)
- Qasim Bukhari
- McGovern Institute for Brain Research, Massachusetts Institute of Technology (MIT), Cambridge, MA 02139, USA;
| | - Joseph M. Massaro
- Department of Biostatistics, Boston University School of Public Health, Boston, MA 02215, USA;
| | - Ralph B. D’Agostino
- Department of Mathematics and Statistics, Boston University, Boston, MA 02215, USA;
| | - Sheraz Khan
- McGovern Institute for Brain Research, Massachusetts Institute of Technology (MIT), Cambridge, MA 02139, USA;
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Massachusetts Institute of Technology, 149 13th Street, CNY-2275, Boston, MA 02129, USA
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Patel S, Kaushik A, Sharma AK. Prioritizing cardiovascular surgical care in COVID-19 pandemic: Shall we operate or defer? J Card Surg 2020; 35:2768-2772. [PMID: 32668048 PMCID: PMC7404879 DOI: 10.1111/jocs.14864] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 06/28/2020] [Accepted: 07/03/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND The coronavirus disease (COVID-19) has affected a large population across the world. Patients with cardiovascular disease have increased morbidity and mortality due to coronavirus disease. The burden over the health care system has to be reduced in this global pandemic to provide optimal care of patients with COVID-19, as well not compromising those who are in need of emergent cardiovascular care. METHODS There is a very limited data published defining which cardiovascular procedures are to be performed or to be deferred in the COVID-19 pandemic. In this article, we have reviewed a few published guidelines regarding cardiovascular surgery in COVID-19 pandemics. CONCLUSION After reviewing a few available guidelines regarding cardiovascular surgery in COVID-19, we conclude to perform only those surgeries which cannot be deferred to a certain period of time, to reduce the burden of the health care system of the country, provide optimal care to patients with COVID-19, and to protect health care workers and cardiovascular patients from COVID-19.
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Affiliation(s)
- Surendra Patel
- Department of Trauma and Emergency Cardiothoracic Surgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Atul Kaushik
- Department of Cardiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Alok Kumar Sharma
- Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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Reimer JR, Ahmed SM, Brintz B, Shah RU, Keegan LT, Ferrari MJ, Leung DT. Modeling reductions in SARS-CoV-2 transmission and hospital burden achieved by prioritizing testing using a clinical prediction rule. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020:2020.07.07.20148510. [PMID: 32676615 PMCID: PMC7359540 DOI: 10.1101/2020.07.07.20148510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Prompt identification of cases is critical for slowing the spread of COVID-19. However, many areas have faced diagnostic testing shortages, requiring difficult decisions to be made regarding who receives a test, without knowing the implications of those decisions on population-level transmission dynamics. Clinical prediction rules (CPRs) are commonly used tools to guide clinical decisions. We used data from electronic health records to develop a parsimonious 5-variable CPR to identify those who are most likely to test positive, and found that its application to prioritize testing increases the proportion of those testing positive in settings of limited testing capacity. To consider the implications of these gains in daily case detection on the population level, we incorporated testing using the CPR into a compartmentalized disease transmission model. We found that prioritized testing led to a delayed and lowered infection peak (i.e. 'flattens the curve'), with the greatest impact at lower values of the effective reproductive number (such as with concurrent social distancing measures), and when higher proportions of infectious persons seek testing. Additionally, prioritized testing resulted in reductions in overall infections as well as hospital and intensive care unit (ICU) burden. In conclusion, we present a novel approach to evidence-based allocation of limited diagnostic capacity, to achieve public health goals for COVID-19.
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Affiliation(s)
- Jody R. Reimer
- University of Utah, Department of Mathematics, Salt Lake City, UT
| | - Sharia M. Ahmed
- University of Utah School of Medicine, Department of Internal Medicine, Division of Infectious Diseases, Salt Lake City UT
| | - Benjamin Brintz
- University of Utah School of Medicine, Department of Internal Medicine, Division of Infectious Diseases, Salt Lake City UT
- University of Utah School of Medicine, Department of Internal Medicine, Division of Epidemiology, Salt Lake City UT
| | - Rashmee U. Shah
- University of Utah School of Medicine, Department of Internal Medicine, Division of Cardiovascular Medicine, Salt Lake City UT
| | - Lindsay T. Keegan
- University of Utah School of Medicine, Department of Internal Medicine, Division of Epidemiology, Salt Lake City UT
| | - Matthew J. Ferrari
- The Pennsylvania State University, Department of Biology, State College, PA
| | - Daniel T. Leung
- University of Utah School of Medicine, Department of Internal Medicine, Division of Infectious Diseases, Salt Lake City UT
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Mishra S, Wang L, Ma H, Yiu KCY, Paterson JM, Kim E, Schull MJ, Pequegnat V, Lee A, Ishiguro L, Coomes E, Chan A, Downing M, Landsman D, Straus S, Muller M. Estimated surge in hospital and intensive care admission because of the coronavirus disease 2019 pandemic in the Greater Toronto Area, Canada: a mathematical modelling study. CMAJ Open 2020; 8:E593-E604. [PMID: 32963024 PMCID: PMC7641231 DOI: 10.9778/cmajo.20200093] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND In pandemics, local hospitals need to anticipate a surge in health care needs. We examined the modelled surge because of the coronavirus disease 2019 (COVID-19) pandemic that was used to inform the early hospital-level response against cases as they transpired. METHODS To estimate hospital-level surge in March and April 2020, we simulated a range of scenarios of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spread in the Greater Toronto Area (GTA), Canada, using the best available data at the time. We applied outputs to hospital-specific data to estimate surge over 6 weeks at 2 hospitals (St. Michael's Hospital and St. Joseph's Health Centre). We examined multiple scenarios, wherein the default (R0 = 2.4) resembled the early trajectory (to Mar. 25, 2020), and compared the default model projections with observed COVID-19 admissions in each hospital from Mar. 25 to May 6, 2020. RESULTS For the hospitals to remain below non-ICU bed capacity, the default pessimistic scenario required a reduction in non-COVID-19 inpatient care by 38% and 28%, respectively, with St. Michael's Hospital requiring 40 new ICU beds and St. Joseph's Health Centre reducing its ICU beds for non-COVID-19 care by 6%. The absolute difference between default-projected and observed census of inpatients with COVID-19 at each hospital was less than 20 from Mar. 25 to Apr. 11; projected and observed cases diverged widely thereafter. Uncertainty in local epidemiological features was more influential than uncertainty in clinical severity. INTERPRETATION Scenario-based analyses were reliable in estimating short-term cases, but would require frequent re-analyses. Distribution of the city's surge was expected to vary across hospitals, and community-level strategies were key to mitigating each hospital's surge.
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Affiliation(s)
- Sharmistha Mishra
- Division of Infectious Diseases, Department of Medicine (Mishra, Coomes, Chan, Muller); MAP Centre for Urban Health Solutions (Mishra, Wang, Ma, Yiu, Landsman), Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute of Health Policy, Management and Evaluation (Paterson, Schull), University of Toronto; ICES (Paterson, Kim, Schull, Ishiguro); Decision Support (Pequegnat, Lee), Unity Health Toronto; Division of Infectious Diseases (Chan), Sunnybrook Health Sciences, University of Toronto; Infection Prevention and Control (Downing), St. Joseph's Health Centre, Unity Health Toronto; Department of Medicine (Straus), St. Michael's Hospital, University of Toronto; Infection Prevention and Control (Muller), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.
| | - Linwei Wang
- Division of Infectious Diseases, Department of Medicine (Mishra, Coomes, Chan, Muller); MAP Centre for Urban Health Solutions (Mishra, Wang, Ma, Yiu, Landsman), Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute of Health Policy, Management and Evaluation (Paterson, Schull), University of Toronto; ICES (Paterson, Kim, Schull, Ishiguro); Decision Support (Pequegnat, Lee), Unity Health Toronto; Division of Infectious Diseases (Chan), Sunnybrook Health Sciences, University of Toronto; Infection Prevention and Control (Downing), St. Joseph's Health Centre, Unity Health Toronto; Department of Medicine (Straus), St. Michael's Hospital, University of Toronto; Infection Prevention and Control (Muller), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont
| | - Huiting Ma
- Division of Infectious Diseases, Department of Medicine (Mishra, Coomes, Chan, Muller); MAP Centre for Urban Health Solutions (Mishra, Wang, Ma, Yiu, Landsman), Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute of Health Policy, Management and Evaluation (Paterson, Schull), University of Toronto; ICES (Paterson, Kim, Schull, Ishiguro); Decision Support (Pequegnat, Lee), Unity Health Toronto; Division of Infectious Diseases (Chan), Sunnybrook Health Sciences, University of Toronto; Infection Prevention and Control (Downing), St. Joseph's Health Centre, Unity Health Toronto; Department of Medicine (Straus), St. Michael's Hospital, University of Toronto; Infection Prevention and Control (Muller), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont
| | - Kristy C Y Yiu
- Division of Infectious Diseases, Department of Medicine (Mishra, Coomes, Chan, Muller); MAP Centre for Urban Health Solutions (Mishra, Wang, Ma, Yiu, Landsman), Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute of Health Policy, Management and Evaluation (Paterson, Schull), University of Toronto; ICES (Paterson, Kim, Schull, Ishiguro); Decision Support (Pequegnat, Lee), Unity Health Toronto; Division of Infectious Diseases (Chan), Sunnybrook Health Sciences, University of Toronto; Infection Prevention and Control (Downing), St. Joseph's Health Centre, Unity Health Toronto; Department of Medicine (Straus), St. Michael's Hospital, University of Toronto; Infection Prevention and Control (Muller), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont
| | - J Michael Paterson
- Division of Infectious Diseases, Department of Medicine (Mishra, Coomes, Chan, Muller); MAP Centre for Urban Health Solutions (Mishra, Wang, Ma, Yiu, Landsman), Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute of Health Policy, Management and Evaluation (Paterson, Schull), University of Toronto; ICES (Paterson, Kim, Schull, Ishiguro); Decision Support (Pequegnat, Lee), Unity Health Toronto; Division of Infectious Diseases (Chan), Sunnybrook Health Sciences, University of Toronto; Infection Prevention and Control (Downing), St. Joseph's Health Centre, Unity Health Toronto; Department of Medicine (Straus), St. Michael's Hospital, University of Toronto; Infection Prevention and Control (Muller), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont
| | - Eliane Kim
- Division of Infectious Diseases, Department of Medicine (Mishra, Coomes, Chan, Muller); MAP Centre for Urban Health Solutions (Mishra, Wang, Ma, Yiu, Landsman), Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute of Health Policy, Management and Evaluation (Paterson, Schull), University of Toronto; ICES (Paterson, Kim, Schull, Ishiguro); Decision Support (Pequegnat, Lee), Unity Health Toronto; Division of Infectious Diseases (Chan), Sunnybrook Health Sciences, University of Toronto; Infection Prevention and Control (Downing), St. Joseph's Health Centre, Unity Health Toronto; Department of Medicine (Straus), St. Michael's Hospital, University of Toronto; Infection Prevention and Control (Muller), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont
| | - Michael J Schull
- Division of Infectious Diseases, Department of Medicine (Mishra, Coomes, Chan, Muller); MAP Centre for Urban Health Solutions (Mishra, Wang, Ma, Yiu, Landsman), Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute of Health Policy, Management and Evaluation (Paterson, Schull), University of Toronto; ICES (Paterson, Kim, Schull, Ishiguro); Decision Support (Pequegnat, Lee), Unity Health Toronto; Division of Infectious Diseases (Chan), Sunnybrook Health Sciences, University of Toronto; Infection Prevention and Control (Downing), St. Joseph's Health Centre, Unity Health Toronto; Department of Medicine (Straus), St. Michael's Hospital, University of Toronto; Infection Prevention and Control (Muller), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont
| | - Victoria Pequegnat
- Division of Infectious Diseases, Department of Medicine (Mishra, Coomes, Chan, Muller); MAP Centre for Urban Health Solutions (Mishra, Wang, Ma, Yiu, Landsman), Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute of Health Policy, Management and Evaluation (Paterson, Schull), University of Toronto; ICES (Paterson, Kim, Schull, Ishiguro); Decision Support (Pequegnat, Lee), Unity Health Toronto; Division of Infectious Diseases (Chan), Sunnybrook Health Sciences, University of Toronto; Infection Prevention and Control (Downing), St. Joseph's Health Centre, Unity Health Toronto; Department of Medicine (Straus), St. Michael's Hospital, University of Toronto; Infection Prevention and Control (Muller), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont
| | - Anthea Lee
- Division of Infectious Diseases, Department of Medicine (Mishra, Coomes, Chan, Muller); MAP Centre for Urban Health Solutions (Mishra, Wang, Ma, Yiu, Landsman), Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute of Health Policy, Management and Evaluation (Paterson, Schull), University of Toronto; ICES (Paterson, Kim, Schull, Ishiguro); Decision Support (Pequegnat, Lee), Unity Health Toronto; Division of Infectious Diseases (Chan), Sunnybrook Health Sciences, University of Toronto; Infection Prevention and Control (Downing), St. Joseph's Health Centre, Unity Health Toronto; Department of Medicine (Straus), St. Michael's Hospital, University of Toronto; Infection Prevention and Control (Muller), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont
| | - Lisa Ishiguro
- Division of Infectious Diseases, Department of Medicine (Mishra, Coomes, Chan, Muller); MAP Centre for Urban Health Solutions (Mishra, Wang, Ma, Yiu, Landsman), Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute of Health Policy, Management and Evaluation (Paterson, Schull), University of Toronto; ICES (Paterson, Kim, Schull, Ishiguro); Decision Support (Pequegnat, Lee), Unity Health Toronto; Division of Infectious Diseases (Chan), Sunnybrook Health Sciences, University of Toronto; Infection Prevention and Control (Downing), St. Joseph's Health Centre, Unity Health Toronto; Department of Medicine (Straus), St. Michael's Hospital, University of Toronto; Infection Prevention and Control (Muller), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont
| | - Eric Coomes
- Division of Infectious Diseases, Department of Medicine (Mishra, Coomes, Chan, Muller); MAP Centre for Urban Health Solutions (Mishra, Wang, Ma, Yiu, Landsman), Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute of Health Policy, Management and Evaluation (Paterson, Schull), University of Toronto; ICES (Paterson, Kim, Schull, Ishiguro); Decision Support (Pequegnat, Lee), Unity Health Toronto; Division of Infectious Diseases (Chan), Sunnybrook Health Sciences, University of Toronto; Infection Prevention and Control (Downing), St. Joseph's Health Centre, Unity Health Toronto; Department of Medicine (Straus), St. Michael's Hospital, University of Toronto; Infection Prevention and Control (Muller), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont
| | - Adrienne Chan
- Division of Infectious Diseases, Department of Medicine (Mishra, Coomes, Chan, Muller); MAP Centre for Urban Health Solutions (Mishra, Wang, Ma, Yiu, Landsman), Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute of Health Policy, Management and Evaluation (Paterson, Schull), University of Toronto; ICES (Paterson, Kim, Schull, Ishiguro); Decision Support (Pequegnat, Lee), Unity Health Toronto; Division of Infectious Diseases (Chan), Sunnybrook Health Sciences, University of Toronto; Infection Prevention and Control (Downing), St. Joseph's Health Centre, Unity Health Toronto; Department of Medicine (Straus), St. Michael's Hospital, University of Toronto; Infection Prevention and Control (Muller), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont
| | - Mark Downing
- Division of Infectious Diseases, Department of Medicine (Mishra, Coomes, Chan, Muller); MAP Centre for Urban Health Solutions (Mishra, Wang, Ma, Yiu, Landsman), Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute of Health Policy, Management and Evaluation (Paterson, Schull), University of Toronto; ICES (Paterson, Kim, Schull, Ishiguro); Decision Support (Pequegnat, Lee), Unity Health Toronto; Division of Infectious Diseases (Chan), Sunnybrook Health Sciences, University of Toronto; Infection Prevention and Control (Downing), St. Joseph's Health Centre, Unity Health Toronto; Department of Medicine (Straus), St. Michael's Hospital, University of Toronto; Infection Prevention and Control (Muller), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont
| | - David Landsman
- Division of Infectious Diseases, Department of Medicine (Mishra, Coomes, Chan, Muller); MAP Centre for Urban Health Solutions (Mishra, Wang, Ma, Yiu, Landsman), Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute of Health Policy, Management and Evaluation (Paterson, Schull), University of Toronto; ICES (Paterson, Kim, Schull, Ishiguro); Decision Support (Pequegnat, Lee), Unity Health Toronto; Division of Infectious Diseases (Chan), Sunnybrook Health Sciences, University of Toronto; Infection Prevention and Control (Downing), St. Joseph's Health Centre, Unity Health Toronto; Department of Medicine (Straus), St. Michael's Hospital, University of Toronto; Infection Prevention and Control (Muller), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont
| | - Sharon Straus
- Division of Infectious Diseases, Department of Medicine (Mishra, Coomes, Chan, Muller); MAP Centre for Urban Health Solutions (Mishra, Wang, Ma, Yiu, Landsman), Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute of Health Policy, Management and Evaluation (Paterson, Schull), University of Toronto; ICES (Paterson, Kim, Schull, Ishiguro); Decision Support (Pequegnat, Lee), Unity Health Toronto; Division of Infectious Diseases (Chan), Sunnybrook Health Sciences, University of Toronto; Infection Prevention and Control (Downing), St. Joseph's Health Centre, Unity Health Toronto; Department of Medicine (Straus), St. Michael's Hospital, University of Toronto; Infection Prevention and Control (Muller), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont
| | - Matthew Muller
- Division of Infectious Diseases, Department of Medicine (Mishra, Coomes, Chan, Muller); MAP Centre for Urban Health Solutions (Mishra, Wang, Ma, Yiu, Landsman), Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute of Health Policy, Management and Evaluation (Paterson, Schull), University of Toronto; ICES (Paterson, Kim, Schull, Ishiguro); Decision Support (Pequegnat, Lee), Unity Health Toronto; Division of Infectious Diseases (Chan), Sunnybrook Health Sciences, University of Toronto; Infection Prevention and Control (Downing), St. Joseph's Health Centre, Unity Health Toronto; Department of Medicine (Straus), St. Michael's Hospital, University of Toronto; Infection Prevention and Control (Muller), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont
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145
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Chaganti S, Grenier P, Balachandran A, Chabin G, Cohen S, Flohr T, Georgescu B, Grbic S, Liu S, Mellot F, Murray N, Nicolaou S, Parker W, Re T, Sanelli P, Sauter AW, Xu Z, Yoo Y, Ziebandt V, Comaniciu D. Automated Quantification of CT Patterns Associated with COVID-19 from Chest CT. Radiol Artif Intell 2020; 2:e200048. [PMID: 33928255 PMCID: PMC7392373 DOI: 10.1148/ryai.2020200048] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
PURPOSE To present a method that automatically segments and quantifies abnormal CT patterns commonly present in coronavirus disease 2019 (COVID-19), namely ground glass opacities and consolidations. MATERIALS AND METHODS In this retrospective study, the proposed method takes as input a non-contrasted chest CT and segments the lesions, lungs, and lobes in three dimensions, based on a dataset of 9749 chest CT volumes. The method outputs two combined measures of the severity of lung and lobe involvement, quantifying both the extent of COVID-19 abnormalities and presence of high opacities, based on deep learning and deep reinforcement learning. The first measure of (PO, PHO) is global, while the second of (LSS, LHOS) is lobe-wise. Evaluation of the algorithm is reported on CTs of 200 participants (100 COVID-19 confirmed patients and 100 healthy controls) from institutions from Canada, Europe and the United States collected between 2002-Present (April 2020). Ground truth is established by manual annotations of lesions, lungs, and lobes. Correlation and regression analyses were performed to compare the prediction to the ground truth. RESULTS Pearson correlation coefficient between method prediction and ground truth for COVID-19 cases was calculated as 0.92 for PO (P < .001), 0.97 for PHO (P < .001), 0.91 for LSS (P < .001), 0.90 for LHOS (P < .001). 98 of 100 healthy controls had a predicted PO of less than 1%, 2 had between 1-2%. Automated processing time to compute the severity scores was 10 seconds per case compared to 30 minutes required for manual annotations. CONCLUSION A new method segments regions of CT abnormalities associated with COVID-19 and computes (PO, PHO), as well as (LSS, LHOS) severity scores.
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Affiliation(s)
- Shikha Chaganti
- From the Hôpital Foch, Suresnes, France (P.G., F.M.), Donald and Barbara Zucker School of Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA (S.C., P.S.), Siemens Healthinners, Bangalore, India (A.B.), Siemens Healthineers, Forchheim, Germany (T.F., V.Z.), Siemens Healthineers, Princeton, NJ, USA (S.C., B.G., S.G., S.L., T.R., Z.X., Y.Y., D.C.), Siemens Healthineers, Paris, France (G.C.), University Hospital Basel, Clinic of Radiology & Nuclear medicine, Basel, Switzerland (A.W.S.), Vancouver General Hospital, Vancouver, Canada (N.M., S.N., W.P.)
| | - Philippe Grenier
- From the Hôpital Foch, Suresnes, France (P.G., F.M.), Donald and Barbara Zucker School of Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA (S.C., P.S.), Siemens Healthinners, Bangalore, India (A.B.), Siemens Healthineers, Forchheim, Germany (T.F., V.Z.), Siemens Healthineers, Princeton, NJ, USA (S.C., B.G., S.G., S.L., T.R., Z.X., Y.Y., D.C.), Siemens Healthineers, Paris, France (G.C.), University Hospital Basel, Clinic of Radiology & Nuclear medicine, Basel, Switzerland (A.W.S.), Vancouver General Hospital, Vancouver, Canada (N.M., S.N., W.P.)
| | - Abishek Balachandran
- From the Hôpital Foch, Suresnes, France (P.G., F.M.), Donald and Barbara Zucker School of Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA (S.C., P.S.), Siemens Healthinners, Bangalore, India (A.B.), Siemens Healthineers, Forchheim, Germany (T.F., V.Z.), Siemens Healthineers, Princeton, NJ, USA (S.C., B.G., S.G., S.L., T.R., Z.X., Y.Y., D.C.), Siemens Healthineers, Paris, France (G.C.), University Hospital Basel, Clinic of Radiology & Nuclear medicine, Basel, Switzerland (A.W.S.), Vancouver General Hospital, Vancouver, Canada (N.M., S.N., W.P.)
| | - Guillaume Chabin
- From the Hôpital Foch, Suresnes, France (P.G., F.M.), Donald and Barbara Zucker School of Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA (S.C., P.S.), Siemens Healthinners, Bangalore, India (A.B.), Siemens Healthineers, Forchheim, Germany (T.F., V.Z.), Siemens Healthineers, Princeton, NJ, USA (S.C., B.G., S.G., S.L., T.R., Z.X., Y.Y., D.C.), Siemens Healthineers, Paris, France (G.C.), University Hospital Basel, Clinic of Radiology & Nuclear medicine, Basel, Switzerland (A.W.S.), Vancouver General Hospital, Vancouver, Canada (N.M., S.N., W.P.)
| | - Stuart Cohen
- From the Hôpital Foch, Suresnes, France (P.G., F.M.), Donald and Barbara Zucker School of Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA (S.C., P.S.), Siemens Healthinners, Bangalore, India (A.B.), Siemens Healthineers, Forchheim, Germany (T.F., V.Z.), Siemens Healthineers, Princeton, NJ, USA (S.C., B.G., S.G., S.L., T.R., Z.X., Y.Y., D.C.), Siemens Healthineers, Paris, France (G.C.), University Hospital Basel, Clinic of Radiology & Nuclear medicine, Basel, Switzerland (A.W.S.), Vancouver General Hospital, Vancouver, Canada (N.M., S.N., W.P.)
| | - Thomas Flohr
- From the Hôpital Foch, Suresnes, France (P.G., F.M.), Donald and Barbara Zucker School of Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA (S.C., P.S.), Siemens Healthinners, Bangalore, India (A.B.), Siemens Healthineers, Forchheim, Germany (T.F., V.Z.), Siemens Healthineers, Princeton, NJ, USA (S.C., B.G., S.G., S.L., T.R., Z.X., Y.Y., D.C.), Siemens Healthineers, Paris, France (G.C.), University Hospital Basel, Clinic of Radiology & Nuclear medicine, Basel, Switzerland (A.W.S.), Vancouver General Hospital, Vancouver, Canada (N.M., S.N., W.P.)
| | - Bogdan Georgescu
- From the Hôpital Foch, Suresnes, France (P.G., F.M.), Donald and Barbara Zucker School of Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA (S.C., P.S.), Siemens Healthinners, Bangalore, India (A.B.), Siemens Healthineers, Forchheim, Germany (T.F., V.Z.), Siemens Healthineers, Princeton, NJ, USA (S.C., B.G., S.G., S.L., T.R., Z.X., Y.Y., D.C.), Siemens Healthineers, Paris, France (G.C.), University Hospital Basel, Clinic of Radiology & Nuclear medicine, Basel, Switzerland (A.W.S.), Vancouver General Hospital, Vancouver, Canada (N.M., S.N., W.P.)
| | - Sasa Grbic
- From the Hôpital Foch, Suresnes, France (P.G., F.M.), Donald and Barbara Zucker School of Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA (S.C., P.S.), Siemens Healthinners, Bangalore, India (A.B.), Siemens Healthineers, Forchheim, Germany (T.F., V.Z.), Siemens Healthineers, Princeton, NJ, USA (S.C., B.G., S.G., S.L., T.R., Z.X., Y.Y., D.C.), Siemens Healthineers, Paris, France (G.C.), University Hospital Basel, Clinic of Radiology & Nuclear medicine, Basel, Switzerland (A.W.S.), Vancouver General Hospital, Vancouver, Canada (N.M., S.N., W.P.)
| | - Siqi Liu
- From the Hôpital Foch, Suresnes, France (P.G., F.M.), Donald and Barbara Zucker School of Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA (S.C., P.S.), Siemens Healthinners, Bangalore, India (A.B.), Siemens Healthineers, Forchheim, Germany (T.F., V.Z.), Siemens Healthineers, Princeton, NJ, USA (S.C., B.G., S.G., S.L., T.R., Z.X., Y.Y., D.C.), Siemens Healthineers, Paris, France (G.C.), University Hospital Basel, Clinic of Radiology & Nuclear medicine, Basel, Switzerland (A.W.S.), Vancouver General Hospital, Vancouver, Canada (N.M., S.N., W.P.)
| | - François Mellot
- From the Hôpital Foch, Suresnes, France (P.G., F.M.), Donald and Barbara Zucker School of Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA (S.C., P.S.), Siemens Healthinners, Bangalore, India (A.B.), Siemens Healthineers, Forchheim, Germany (T.F., V.Z.), Siemens Healthineers, Princeton, NJ, USA (S.C., B.G., S.G., S.L., T.R., Z.X., Y.Y., D.C.), Siemens Healthineers, Paris, France (G.C.), University Hospital Basel, Clinic of Radiology & Nuclear medicine, Basel, Switzerland (A.W.S.), Vancouver General Hospital, Vancouver, Canada (N.M., S.N., W.P.)
| | - Nicolas Murray
- From the Hôpital Foch, Suresnes, France (P.G., F.M.), Donald and Barbara Zucker School of Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA (S.C., P.S.), Siemens Healthinners, Bangalore, India (A.B.), Siemens Healthineers, Forchheim, Germany (T.F., V.Z.), Siemens Healthineers, Princeton, NJ, USA (S.C., B.G., S.G., S.L., T.R., Z.X., Y.Y., D.C.), Siemens Healthineers, Paris, France (G.C.), University Hospital Basel, Clinic of Radiology & Nuclear medicine, Basel, Switzerland (A.W.S.), Vancouver General Hospital, Vancouver, Canada (N.M., S.N., W.P.)
| | - Savvas Nicolaou
- From the Hôpital Foch, Suresnes, France (P.G., F.M.), Donald and Barbara Zucker School of Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA (S.C., P.S.), Siemens Healthinners, Bangalore, India (A.B.), Siemens Healthineers, Forchheim, Germany (T.F., V.Z.), Siemens Healthineers, Princeton, NJ, USA (S.C., B.G., S.G., S.L., T.R., Z.X., Y.Y., D.C.), Siemens Healthineers, Paris, France (G.C.), University Hospital Basel, Clinic of Radiology & Nuclear medicine, Basel, Switzerland (A.W.S.), Vancouver General Hospital, Vancouver, Canada (N.M., S.N., W.P.)
| | - William Parker
- From the Hôpital Foch, Suresnes, France (P.G., F.M.), Donald and Barbara Zucker School of Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA (S.C., P.S.), Siemens Healthinners, Bangalore, India (A.B.), Siemens Healthineers, Forchheim, Germany (T.F., V.Z.), Siemens Healthineers, Princeton, NJ, USA (S.C., B.G., S.G., S.L., T.R., Z.X., Y.Y., D.C.), Siemens Healthineers, Paris, France (G.C.), University Hospital Basel, Clinic of Radiology & Nuclear medicine, Basel, Switzerland (A.W.S.), Vancouver General Hospital, Vancouver, Canada (N.M., S.N., W.P.)
| | - Thomas Re
- From the Hôpital Foch, Suresnes, France (P.G., F.M.), Donald and Barbara Zucker School of Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA (S.C., P.S.), Siemens Healthinners, Bangalore, India (A.B.), Siemens Healthineers, Forchheim, Germany (T.F., V.Z.), Siemens Healthineers, Princeton, NJ, USA (S.C., B.G., S.G., S.L., T.R., Z.X., Y.Y., D.C.), Siemens Healthineers, Paris, France (G.C.), University Hospital Basel, Clinic of Radiology & Nuclear medicine, Basel, Switzerland (A.W.S.), Vancouver General Hospital, Vancouver, Canada (N.M., S.N., W.P.)
| | - Pina Sanelli
- From the Hôpital Foch, Suresnes, France (P.G., F.M.), Donald and Barbara Zucker School of Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA (S.C., P.S.), Siemens Healthinners, Bangalore, India (A.B.), Siemens Healthineers, Forchheim, Germany (T.F., V.Z.), Siemens Healthineers, Princeton, NJ, USA (S.C., B.G., S.G., S.L., T.R., Z.X., Y.Y., D.C.), Siemens Healthineers, Paris, France (G.C.), University Hospital Basel, Clinic of Radiology & Nuclear medicine, Basel, Switzerland (A.W.S.), Vancouver General Hospital, Vancouver, Canada (N.M., S.N., W.P.)
| | - Alexander W. Sauter
- From the Hôpital Foch, Suresnes, France (P.G., F.M.), Donald and Barbara Zucker School of Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA (S.C., P.S.), Siemens Healthinners, Bangalore, India (A.B.), Siemens Healthineers, Forchheim, Germany (T.F., V.Z.), Siemens Healthineers, Princeton, NJ, USA (S.C., B.G., S.G., S.L., T.R., Z.X., Y.Y., D.C.), Siemens Healthineers, Paris, France (G.C.), University Hospital Basel, Clinic of Radiology & Nuclear medicine, Basel, Switzerland (A.W.S.), Vancouver General Hospital, Vancouver, Canada (N.M., S.N., W.P.)
| | - Zhoubing Xu
- From the Hôpital Foch, Suresnes, France (P.G., F.M.), Donald and Barbara Zucker School of Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA (S.C., P.S.), Siemens Healthinners, Bangalore, India (A.B.), Siemens Healthineers, Forchheim, Germany (T.F., V.Z.), Siemens Healthineers, Princeton, NJ, USA (S.C., B.G., S.G., S.L., T.R., Z.X., Y.Y., D.C.), Siemens Healthineers, Paris, France (G.C.), University Hospital Basel, Clinic of Radiology & Nuclear medicine, Basel, Switzerland (A.W.S.), Vancouver General Hospital, Vancouver, Canada (N.M., S.N., W.P.)
| | - Youngjin Yoo
- From the Hôpital Foch, Suresnes, France (P.G., F.M.), Donald and Barbara Zucker School of Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA (S.C., P.S.), Siemens Healthinners, Bangalore, India (A.B.), Siemens Healthineers, Forchheim, Germany (T.F., V.Z.), Siemens Healthineers, Princeton, NJ, USA (S.C., B.G., S.G., S.L., T.R., Z.X., Y.Y., D.C.), Siemens Healthineers, Paris, France (G.C.), University Hospital Basel, Clinic of Radiology & Nuclear medicine, Basel, Switzerland (A.W.S.), Vancouver General Hospital, Vancouver, Canada (N.M., S.N., W.P.)
| | - Valentin Ziebandt
- From the Hôpital Foch, Suresnes, France (P.G., F.M.), Donald and Barbara Zucker School of Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA (S.C., P.S.), Siemens Healthinners, Bangalore, India (A.B.), Siemens Healthineers, Forchheim, Germany (T.F., V.Z.), Siemens Healthineers, Princeton, NJ, USA (S.C., B.G., S.G., S.L., T.R., Z.X., Y.Y., D.C.), Siemens Healthineers, Paris, France (G.C.), University Hospital Basel, Clinic of Radiology & Nuclear medicine, Basel, Switzerland (A.W.S.), Vancouver General Hospital, Vancouver, Canada (N.M., S.N., W.P.)
| | - Dorin Comaniciu
- From the Hôpital Foch, Suresnes, France (P.G., F.M.), Donald and Barbara Zucker School of Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA (S.C., P.S.), Siemens Healthinners, Bangalore, India (A.B.), Siemens Healthineers, Forchheim, Germany (T.F., V.Z.), Siemens Healthineers, Princeton, NJ, USA (S.C., B.G., S.G., S.L., T.R., Z.X., Y.Y., D.C.), Siemens Healthineers, Paris, France (G.C.), University Hospital Basel, Clinic of Radiology & Nuclear medicine, Basel, Switzerland (A.W.S.), Vancouver General Hospital, Vancouver, Canada (N.M., S.N., W.P.)
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146
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Basu A. Estimating The Infection Fatality Rate Among Symptomatic COVID-19 Cases In The United States. Health Aff (Millwood) 2020; 39:1229-1236. [DOI: 10.1377/hlthaff.2020.00455] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Anirban Basu
- Anirban Basu is the Stergachis Family Endowed Director and Professor of Health Economics at the Comparative Health Outcomes, Policy, and Economics Institute in the School of Pharmacy, University of Washington, in Seattle
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147
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Deming ME, Chen WH. COVID-19 and Lessons to Be Learned from Prior Coronavirus Outbreaks. Ann Am Thorac Soc 2020; 17:790-794. [PMID: 32267164 PMCID: PMC7328171 DOI: 10.1513/annalsats.202002-149ps] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 04/08/2020] [Indexed: 12/28/2022] Open
Affiliation(s)
- Meagan E. Deming
- Department of Medicine, Institute of Human Virology, Baltimore, Maryland; and
- University of Maryland Center for Vaccine Development, Baltimore, Maryland
| | - Wilbur H. Chen
- University of Maryland Center for Vaccine Development, Baltimore, Maryland
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148
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Ardura M, Hartley D, Dandoy C, Lehmann L, Jaglowski S, Auletta JJ. Addressing the Impact of the Coronavirus Disease 2019 (COVID-19) Pandemic on Hematopoietic Cell Transplantation: Learning Networks as a Means for Sharing Best Practices. Biol Blood Marrow Transplant 2020; 26:e147-e160. [PMID: 32339662 PMCID: PMC7194714 DOI: 10.1016/j.bbmt.2020.04.018] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 04/14/2020] [Accepted: 04/15/2020] [Indexed: 02/07/2023]
Abstract
The full impact of the coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), on the field of hematopoietic cell transplantation (HCT) is unknown. This perspective paper reviews the following: current COVID-19 epidemiology, diagnosis, and potential therapies; care considerations unique to HCT recipients; and the concept of a learning network to assimilate emerging guidelines and best practices and to optimize patient outcomes through facilitating shared learning and experience across transplantation centers.
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Affiliation(s)
- Monica Ardura
- Host Defense Program, Division of Infectious Diseases, Nationwide Children's Hospital, Columbus, Ohio; Department of Pediatrics, The Ohio University College of Medicine, Columbus, Ohio
| | - David Hartley
- James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Christopher Dandoy
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital, Cincinnati, Ohio
| | - Leslie Lehmann
- Pediatric Stem Cell Transplant Center, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts
| | - Samantha Jaglowski
- Division of Hematology, The Ohio State University, Columbus, Ohio; The Ohio State University Comprehensive Cancer Center, Columbus, Ohio
| | - Jeffery J Auletta
- Host Defense Program, Division of Infectious Diseases, Nationwide Children's Hospital, Columbus, Ohio; Department of Pediatrics, The Ohio University College of Medicine, Columbus, Ohio; The Ohio State University Comprehensive Cancer Center, Columbus, Ohio; Blood and Marrow Transplant Program, Division of Hematology/Oncology/BMT, Nationwide Children's Hospital, Columbus, Ohio.
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149
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Odor PM, Neun M, Bampoe S, Clark S, Heaton D, Hoogenboom EM, Patel A, Brown M, Kamming D. Anaesthesia and COVID-19: infection control. Br J Anaesth 2020; 125:16-24. [PMID: 32307115 PMCID: PMC7142687 DOI: 10.1016/j.bja.2020.03.025] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 03/30/2020] [Accepted: 03/30/2020] [Indexed: 02/09/2023] Open
Abstract
The world is currently facing an unprecedented healthcare crisis caused by a pandemic novel beta coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The pathogen is spread by human-to-human transmission via droplets exposure and contact transfer, causing mild symptoms in the majority of cases, but critical illness, bilateral viral pneumonia, and acute respiratory distress syndrome (ARDS) in a minority. Currently, controlling infection to prevent the spread of SARS-CoV-2 is the primary public healthcare intervention used. The pace of transmission and global scale of SARS-CoV-2 infections has implications for strategic oversight, resource management, and responsiveness in infection control. This article presents a summary of learning points in epidemiological infection control from the SARS epidemic, alongside a review of evidence connecting current understanding of the virologic and environmental contamination properties of SARS-CoV-2. We present suggestions for how personal protective equipment policies relate to the viral pandemic context and how the risk of transmission by and to anaesthetists, intensivists, and other healthcare workers can be minimised.
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Affiliation(s)
- Peter M Odor
- Department of Anaesthesia and Perioperative Medicine, University College London Hospitals NHS Foundation Trust, UK
| | - Maximilian Neun
- Department of Anaesthesia and Perioperative Medicine, University College London Hospitals NHS Foundation Trust, UK
| | - Sohail Bampoe
- Department of Anaesthesia and Perioperative Medicine, University College London Hospitals NHS Foundation Trust, UK
| | - Sam Clark
- Department of Critical Care, University College London Hospitals NHS Foundation Trust, UK
| | - Daniel Heaton
- Department of Anaesthesia and Perioperative Medicine, University College London Hospitals NHS Foundation Trust, UK
| | - Emilie M Hoogenboom
- Department of Anaesthesia and Perioperative Medicine, University College London Hospitals NHS Foundation Trust, UK
| | - Anil Patel
- Department of Anaesthesia and Perioperative Medicine, Royal National Throat Nose and Ear Hospital, University College London Hospitals, NHS Foundation Trust, London, UK
| | - Michael Brown
- Division of Infection, Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, London, UK
| | - Damon Kamming
- Department of Anaesthesia and Perioperative Medicine, University College London Hospitals NHS Foundation Trust, UK.
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150
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Sominsky L, Walker DW, Spencer SJ. One size does not fit all - Patterns of vulnerability and resilience in the COVID-19 pandemic and why heterogeneity of disease matters. Brain Behav Immun 2020; 87:1-3. [PMID: 32205119 PMCID: PMC7102615 DOI: 10.1016/j.bbi.2020.03.016] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 03/18/2020] [Indexed: 01/28/2023] Open
Affiliation(s)
- Luba Sominsky
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia.
| | - David W Walker
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
| | - Sarah J Spencer
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia; ARC Centre of Excellence for Nanoscale Biophotonics, RMIT University, Melbourne, VIC, Australia
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