151
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Tharakan S, Nomoto K, Miyashita S, Ishikawa K. Body temperature correlates with mortality in COVID-19 patients. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2020; 24:298. [PMID: 32503659 PMCID: PMC7274509 DOI: 10.1186/s13054-020-03045-8] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 05/28/2020] [Indexed: 12/23/2022]
Affiliation(s)
- Serena Tharakan
- Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY, 10029-6574, USA
| | - Koichi Nomoto
- Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY, 10029-6574, USA
| | - Satoshi Miyashita
- Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY, 10029-6574, USA
| | - Kiyotake Ishikawa
- Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY, 10029-6574, USA.
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152
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Jamal M, Shah M, Almarzooqi SH, Aber H, Khawaja S, El Abed R, Alkhatib Z, Samaranayake LP. Overview of transnational recommendations for COVID-19 transmission control in dental care settings. Oral Dis 2020; 27 Suppl 3:655-664. [PMID: 32428372 PMCID: PMC7280672 DOI: 10.1111/odi.13431] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 04/28/2020] [Accepted: 05/12/2020] [Indexed: 01/08/2023]
Abstract
On 11 March 2020, the World Health Organization (WHO) declared the coronavirus disease (COVID‐19) caused by severe acute respiratory syndrome coronavirus (SARS‐CoV‐2) as a pandemic. Until an effective treatment or a vaccine is developed, the current recommendations are to contain the disease, and control its transmission. It is now clear that the primary mode of SARS‐CoV‐2 transmission is aerosol/droplet spread, and by contacting virus‐contaminated surfaces acting as fomites (inanimate vectors). Furthermore, recent data indicate that the live virus particles are present in saliva, and, more alarmingly, asymptomatic individuals may transmit the infection. By virtue of the nature of the practice of dentistry where intrinsically, a high volume of aerosols is produced, as well as the close proximity of dentists and patients during treatment, dentists and allied health staff are considered the highest risk health professional group for acquiring SARS‐CoV‐2 during patient management. Therefore, several organizations and specialty associations have proposed guidelines and recommendations for limiting the transmission of SARS‐COV‐2 from carriers to dentists and vice versa. This paper aims to provide a review of these guidelines, and concludes with a brief look at how the practice of dentistry may be impacted by COVID‐19, in the post‐pandemic era.
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Affiliation(s)
- Mohamed Jamal
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai, United Arab Emirates.,Emirates Endodontic Society, Dubai, United Arab Emirates
| | - Maanas Shah
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai, United Arab Emirates
| | - Sameeha Husain Almarzooqi
- Emirates Endodontic Society, Dubai, United Arab Emirates.,Dubai Health Authority, Dubai, United Arab Emirates
| | - Hend Aber
- Emirates Endodontic Society, Dubai, United Arab Emirates.,Dubai Health Authority, Dubai, United Arab Emirates
| | - Summayah Khawaja
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai, United Arab Emirates
| | - Rashid El Abed
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai, United Arab Emirates.,Emirates Endodontic Society, Dubai, United Arab Emirates
| | | | - Lakshman Perera Samaranayake
- Department of Preventive and Restorative Dentistry, University of Sharjah, Sharjah, United Arab Emirates.,The University of Hong Kong, Hong Kong Special Administrative Region, China
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153
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Maghzi AH, Houtchens MK, Preziosa P, Ionete C, Beretich BD, Stankiewicz JM, Tauhid S, Cabot A, Berriosmorales I, Schwartz THW, Sloane JA, Freedman MS, Filippi M, Weiner HL, Bakshi R. COVID-19 in teriflunomide-treated patients with multiple sclerosis. J Neurol 2020; 267:2790-2796. [PMID: 32494856 PMCID: PMC7268971 DOI: 10.1007/s00415-020-09944-8] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 05/18/2020] [Accepted: 05/20/2020] [Indexed: 01/08/2023]
Abstract
The outbreak of a severe acute respiratory syndrome caused by a novel coronavirus (COVID-19), has raised health concerns for patients with multiple sclerosis (MS) who are commonly on long-term immunotherapies. Managing MS during the pandemic remains challenging with little published experience and no evidence-based guidelines. We present five teriflunomide-treated patients with MS who subsequently developed active COVID-19 infection. The patients continued teriflunomide therapy and had self-limiting infection, without relapse of their MS. These observations have implications for the management of MS in the setting of the COVID-19 pandemic.
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Affiliation(s)
- Amir Hadi Maghzi
- Department of Neurology, Ann Romney Center for Neurologic Diseases, Partners Multiple Sclerosis Center, Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Road, Mailbox 9002L, Boston, MA, 02115, USA
| | - Maria K Houtchens
- Department of Neurology, Ann Romney Center for Neurologic Diseases, Partners Multiple Sclerosis Center, Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Road, Mailbox 9002L, Boston, MA, 02115, USA
| | - Paolo Preziosa
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Carolina Ionete
- Department of Neurology, University of Massachusetts, Worcester, MA, USA
| | | | - James M Stankiewicz
- Department of Neurology, Ann Romney Center for Neurologic Diseases, Partners Multiple Sclerosis Center, Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Road, Mailbox 9002L, Boston, MA, 02115, USA
| | - Shahamat Tauhid
- Department of Neurology, Ann Romney Center for Neurologic Diseases, Partners Multiple Sclerosis Center, Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Road, Mailbox 9002L, Boston, MA, 02115, USA
| | - Ann Cabot
- Department of Neurology, Concord Hospital, Concord, NH, USA
| | | | | | - Jacob A Sloane
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Mark S Freedman
- University of Ottawa and the Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Massimo Filippi
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Howard L Weiner
- Department of Neurology, Ann Romney Center for Neurologic Diseases, Partners Multiple Sclerosis Center, Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Road, Mailbox 9002L, Boston, MA, 02115, USA
| | - Rohit Bakshi
- Department of Neurology, Ann Romney Center for Neurologic Diseases, Partners Multiple Sclerosis Center, Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Road, Mailbox 9002L, Boston, MA, 02115, USA.
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154
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Gniadek TJ, Donnersberger D. COVID-19 convalescent plasma donor recruitment: beware the Faustian bargains. Transfusion 2020; 60:1643-1644. [PMID: 32428966 PMCID: PMC7280612 DOI: 10.1111/trf.15871] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/10/2020] [Accepted: 05/12/2020] [Indexed: 12/23/2022]
Affiliation(s)
- Thomas J Gniadek
- Department of Pathology and Laboratory Medicine, NorthShore University HealthSystem, Evanston, IL, USA
| | - David Donnersberger
- Department of Medicine, NorthShore University HealthSystem, Evanston, IL, USA
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155
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Brown BL, McCullough J. Treatment for emerging viruses: Convalescent plasma and COVID-19. Transfus Apher Sci 2020; 59:102790. [PMID: 32345485 PMCID: PMC7194745 DOI: 10.1016/j.transci.2020.102790] [Citation(s) in RCA: 96] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 04/13/2020] [Accepted: 04/14/2020] [Indexed: 12/28/2022]
Abstract
Use of convalescent plasma transfusions could be of great value in the current pandemic of coronavirus disease (COVID-19), given the lack of specific preventative and therapeutic options. This convalescent plasma therapy is of particular interest when a vaccine or specific therapy is not yet available for emerging viruses, such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes COVID-19. This report summarizes existing literature around convalescent plasma as a therapeutic option for COVID-19. It also includes recommendations for establishing a convalescent plasma program, enhancement considerations for convalescent plasma, and considerations around pathogen reduction treatment of convalescent plasma. Time is of the essence to set up protocols for collection, preparation, and administration of apheresis-collected convalescent plasma in response to the current pandemic. The immediate use of convalescent plasma provides prompt availability of a promising treatment while specific vaccines and treatments are evaluated and brought to scale. Further development of improved convalescent plasma, vaccines and other therapeutics depends on quick generation of additional data on pathogenesis and immune response. Additionally, given the lack of information around the natural history of this disease, PRT should be considered to add a layer of safety to protect recipients of convalescent plasma.
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MESH Headings
- Antibodies, Neutralizing/blood
- Antibodies, Neutralizing/therapeutic use
- Antibodies, Viral/blood
- Antibodies, Viral/therapeutic use
- Betacoronavirus/immunology
- Blood Safety
- COVID-19
- Communicable Diseases, Emerging/therapy
- Communicable Diseases, Emerging/virology
- Convalescence
- Coronavirus Infections/blood
- Coronavirus Infections/prevention & control
- Coronavirus Infections/therapy
- Donor Selection
- Humans
- Immunization, Passive
- Meta-Analysis as Topic
- Pandemics/prevention & control
- Plasmapheresis
- Pneumonia, Viral/blood
- Pneumonia, Viral/prevention & control
- Pneumonia, Viral/therapy
- SARS-CoV-2
- Severe Acute Respiratory Syndrome/therapy
- United States
- United States Food and Drug Administration
- Virus Inactivation
- COVID-19 Serotherapy
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156
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Murray KF, Gold BD, Shamir R, Agostoni C, Pierre-Alvarez R, Kolacek S, Hsu EK, Chen J. Coronavirus Disease 2019 and the Pediatric Gastroenterologist. J Pediatr Gastroenterol Nutr 2020; 70:720-726. [PMID: 32443019 PMCID: PMC7273939 DOI: 10.1097/mpg.0000000000002730] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 03/30/2020] [Indexed: 12/22/2022]
Affiliation(s)
- Karen F. Murray
- Pediatrics Institute, Cleveland Clinic Children's Hospital, and Cleveland Clinic Children's Hospital for Rehabilitation, Cleveland Clinic, Cleveland, OH
| | - Benjamin D. Gold
- Gi Care for Kids, LLC; Children's Center for Digestive Healthcare, LLC, Atlanta, GA
| | - Raanan Shamir
- Institute for Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center, Lea and Arieh Pickel Chair for Pediatric Research, Sackler Faculty of Medicine, Tel Aviv University, Petach Tikva, Israel
| | - Carlo Agostoni
- Pediatric Intermediate Care Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy, and Department of Clinical Sciences and Community Health, University of Milan, 20126 Milan, Italy
| | | | - Sanja Kolacek
- Department of Pediatrics, Children's Hospital Zagreb, University of Zagreb Medical School, Zagreb, Klaićeva, Croatia
| | - Evelyn K. Hsu
- Division of Gastroenterology and Hepatology, Liver Transplant Program, Seattle Children's Hospital, Seattle, WA
| | - Jie Chen
- Division of Gastroenterology, Department of Pediatrics, Children's Hospital Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
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157
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Jean SS, Lee PI, Hsueh PR. Treatment options for COVID-19: The reality and challenges. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2020; 53:436-443. [PMID: 32307245 PMCID: PMC7129535 DOI: 10.1016/j.jmii.2020.03.034] [Citation(s) in RCA: 305] [Impact Index Per Article: 76.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 03/31/2020] [Indexed: 01/08/2023]
Abstract
An outbreak related to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first reported in Wuhan, China in December 2019. An extremely high potential for dissemination resulted in the global coronavirus disease 2019 (COVID-19) pandemic in 2020. Despite the worsening trends of COVID-19, no drugs are validated to have significant efficacy in clinical treatment of COVID-19 patients in large-scale studies. Remdesivir is considered the most promising antiviral agent; it works by inhibiting the activity of RNA-dependent RNA polymerase (RdRp). A large-scale study investigating the clinical efficacy of remdesivir (200 mg on day 1, followed by 100 mg once daily) is on-going. The other excellent anti-influenza RdRp inhibitor favipiravir is also being clinically evaluated for its efficacy in COVID-19 patients. The protease inhibitor lopinavir/ritonavir (LPV/RTV) alone is not shown to provide better antiviral efficacy than standard care. However, the regimen of LPV/RTV plus ribavirin was shown to be effective against SARS-CoV in vitro. Another promising alternative is hydroxychloroquine (200 mg thrice daily) plus azithromycin (500 mg on day 1, followed by 250 mg once daily on day 2-5), which showed excellent clinical efficacy on Chinese COVID-19 patients and anti-SARS-CoV-2 potency in vitro. The roles of teicoplanin (which inhibits the viral genome exposure in cytoplasm) and monoclonal and polyclonal antibodies in the treatment of SARS-CoV-2 are under investigation. Avoiding the prescription of non-steroidal anti-inflammatory drugs, angiotensin converting enzyme inhibitors, or angiotensin II type I receptor blockers is advised for COVID-19 patients.
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Affiliation(s)
- Shio-Shin Jean
- Department of Emergency, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Emergency Medicine, Department of Emergency and Critical Care Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Ping-Ing Lee
- Department of Pediatrics, National Taiwan University Children's Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Po-Ren Hsueh
- Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
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158
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Psaltopoulou T, Sergentanis TN, Pappa V, Politou M, Terpos E, Tsiodras S, Pavlakis GN, Dimopoulos MA. The Emerging Role of Convalescent Plasma in the Treatment of COVID-19. Hemasphere 2020; 4:e409. [PMID: 32647807 PMCID: PMC7306310 DOI: 10.1097/hs9.0000000000000409] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 05/04/2020] [Indexed: 12/23/2022] Open
Abstract
Various agents are currently under evaluation as potential treatments in the fight against coronavirus disease 2019 (COVID-19). Plasma from patients that have overcome COVID-19 infection, referred to as convalescent plasma, is a treatment option with considerable background in viral diseases such as Spanish influenza, H1N1, Ebola, Severe Acute Respiratory Syndrome (SARS), and Middle East Respiratory Syndrome (MERS). Although convalescent plasma has historically proven beneficial in the treatment of some viral diseases, its use is still explorative in the context of COVID-19. To date, preliminary evidence from case series is favorable as significant clinical, biochemical improvement and hospital discharge have been reported. A detailed overview of randomized as well non-randomized trials of treatment with convalescent plasma, which have been registered worldwide, is provided in this review. Based on these studies, data from thousands of patients is anticipated in the near future. Convalescent plasma seems to be a safe option, but potential risks such as transfusion-related acute lung injury and antibody-dependent enhancement are discussed. Authorities including the Food and Drug Administration (FDA), and scientific associations such as the International Society of Blood Transfusion (ISBT) and the European Blood Alliance (EBA), have provided guidance into the selection criteria for donors and recipients. A debatable, pivotal issue pertains to the optimal timing of convalescent plasma transfusion. This treatment should be administered as early as possible to maximize efficacy, but at the same time be reserved for severe cases. Emerging risk stratification algorithms integrating clinical and biochemical markers to trace the cases at risk of significant deterioration can prove valuable in this direction.
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Affiliation(s)
- Theodora Psaltopoulou
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Theodoros N. Sergentanis
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Vasiliki Pappa
- Hematology Division, Second Department of Internal Medicine, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Marianna Politou
- Hematology Laboratory-Blood Bank, Aretaieio Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelos Terpos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Sotirios Tsiodras
- National Public Health Organization, Athens, Greece
- Fourth Department of Internal Medicine, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - George N. Pavlakis
- Human Retrovirus Section, Vaccine Branch, Center for Cancer Research, National Cancer Institute, Frederick, Maryland, USA
| | - Meletios A. Dimopoulos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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159
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Choudhury S, Moulick D, Saikia P, Mazumder MK. Evaluating the potential of different inhibitors on RNA-dependent RNA polymerase of severe acute respiratory syndrome coronavirus 2: A molecular modeling approach. Med J Armed Forces India 2020; 77:S373-S378. [PMID: 32836709 PMCID: PMC7261222 DOI: 10.1016/j.mjafi.2020.05.005] [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: 04/15/2020] [Accepted: 05/08/2020] [Indexed: 12/20/2022] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) has already affected 2883603 and killed 198842 people, as of April 27, 2020. Because there is no specific therapeutic drug, drug repurposing has been proposed. RNA-dependent RNA polymerase (RdRp) is a promising drug against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to control its replication, and several compounds have been suggested. The present study predicts relative efficacies of thirty known or repurposed compounds in inhibiting the RdRp. Methods The three-dimensional structure of the target enzyme was loaded into Molegro virtual docker software, followed by chemical structures of the test compounds. The docking was performed between the compounds and the active site of the enzyme to determine docking scores, and the energy liberated when the two dock. Thus, docking scores signify the affinity of ligand(s) with the active site of enzyme(s) and thus its inhibitory potential. Results Among known inhibitors, remdesivir was found to have the highest affinity for the active site of the RdRp. Among all compounds, chlorhexidine was predicted as the most potent inhibitor. Furthermore, the results predict the relative efficacy of different drugs as inhibitors of the drug target. Conclusion While the study identifies several compounds as inhibitors of RdRp of SARS-CoV-2, the prediction of their relative efficacies may be useful in future studies. While nucleoside analogs compete with the natural substrate of RdRp, thereby terminating RNA replication, other compounds would physically block entry of the natural substrates into the active site. Thus, based on the findings, we recommend in vitro and in vivo studies and clinical trials to determine their effectiveness against COVID-19.
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Affiliation(s)
- Shuvasish Choudhury
- Assistant Professor (Life Science & Bioinformatics), Assam University, Silchar, Assam 788011, India
| | - Debojyoti Moulick
- Research Associate, Central Instrumentation Laboratory, Assam University, Silchar, Assam 788011, India
| | - Purbajyoti Saikia
- Assistant Professor (Zoology), Dhemaji College, Dhemaji, Assam 787057, India
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160
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Hung IFN, Lung KC, Tso EYK, Liu R, Chung TWH, Chu MY, Ng YY, Lo J, Chan J, Tam AR, Shum HP, Chan V, Wu AKL, Sin KM, Leung WS, Law WL, Lung DC, Sin S, Yeung P, Yip CCY, Zhang RR, Fung AYF, Yan EYW, Leung KH, Ip JD, Chu AWH, Chan WM, Ng ACK, Lee R, Fung K, Yeung A, Wu TC, Chan JWM, Yan WW, Chan WM, Chan JFW, Lie AKW, Tsang OTY, Cheng VCC, Que TL, Lau CS, Chan KH, To KKW, Yuen KY. Triple combination of interferon beta-1b, lopinavir-ritonavir, and ribavirin in the treatment of patients admitted to hospital with COVID-19: an open-label, randomised, phase 2 trial. Lancet 2020; 395:1695-1704. [PMID: 32401715 PMCID: PMC7211500 DOI: 10.1016/s0140-6736(20)31042-4] [Citation(s) in RCA: 1023] [Impact Index Per Article: 255.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 04/21/2020] [Accepted: 04/23/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Effective antiviral therapy is important for tackling the coronavirus disease 2019 (COVID-19) pandemic. We assessed the efficacy and safety of combined interferon beta-1b, lopinavir-ritonavir, and ribavirin for treating patients with COVID-19. METHODS This was a multicentre, prospective, open-label, randomised, phase 2 trial in adults with COVID-19 who were admitted to six hospitals in Hong Kong. Patients were randomly assigned (2:1) to a 14-day combination of lopinavir 400 mg and ritonavir 100 mg every 12 h, ribavirin 400 mg every 12 h, and three doses of 8 million international units of interferon beta-1b on alternate days (combination group) or to 14 days of lopinavir 400 mg and ritonavir 100 mg every 12 h (control group). The primary endpoint was the time to providing a nasopharyngeal swab negative for severe acute respiratory syndrome coronavirus 2 RT-PCR, and was done in the intention-to-treat population. The study is registered with ClinicalTrials.gov, NCT04276688. FINDINGS Between Feb 10 and March 20, 2020, 127 patients were recruited; 86 were randomly assigned to the combination group and 41 were assigned to the control group. The median number of days from symptom onset to start of study treatment was 5 days (IQR 3-7). The combination group had a significantly shorter median time from start of study treatment to negative nasopharyngeal swab (7 days [IQR 5-11]) than the control group (12 days [8-15]; hazard ratio 4·37 [95% CI 1·86-10·24], p=0·0010). Adverse events included self-limited nausea and diarrhoea with no difference between the two groups. One patient in the control group discontinued lopinavir-ritonavir because of biochemical hepatitis. No patients died during the study. INTERPRETATION Early triple antiviral therapy was safe and superior to lopinavir-ritonavir alone in alleviating symptoms and shortening the duration of viral shedding and hospital stay in patients with mild to moderate COVID-19. Future clinical study of a double antiviral therapy with interferon beta-1b as a backbone is warranted. FUNDING The Shaw-Foundation, Richard and Carol Yu, May Tam Mak Mei Yin, and Sanming Project of Medicine.
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Affiliation(s)
- Ivan Fan-Ngai Hung
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong Special Administrative Region (SAR), China; State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, The University of Hong Kong, Hong Kong Special Administrative Region (SAR), China
| | - Kwok-Cheung Lung
- Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China
| | | | - Raymond Liu
- Department of Medicine and Geriatrics, Ruttonjee Hospital, Hong Kong SAR, China
| | - Tom Wai-Hin Chung
- Department of Microbiology, The University of Hong Kong, Hong Kong Special Administrative Region (SAR), China
| | - Man-Yee Chu
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong SAR, China
| | - Yuk-Yung Ng
- Department of Medicine, Tuen Mun Hospital, Hong Kong SAR, China
| | - Jenny Lo
- Department of Medicine and Geriatrics, Ruttonjee Hospital, Hong Kong SAR, China
| | - Jacky Chan
- Department of Medicine, Princess Margaret Hospital, Hong Kong SAR, China
| | - Anthony Raymond Tam
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong Special Administrative Region (SAR), China
| | - Hoi-Ping Shum
- Department of Intensive Care, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China
| | - Veronica Chan
- Department of Medicine, United Christian Hospital, Hong Kong SAR, China
| | - Alan Ka-Lun Wu
- Department of Microbiology, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China
| | - Kit-Man Sin
- Department of Medicine, Tuen Mun Hospital, Hong Kong SAR, China
| | - Wai-Shing Leung
- Department of Medicine, Princess Margaret Hospital, Hong Kong SAR, China
| | - Wai-Lam Law
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong SAR, China
| | | | - Simon Sin
- Department of Intensive Care, Queen Mary Hospital, The University of Hong Kong, Hong Kong Special Administrative Region (SAR), China
| | - Pauline Yeung
- Department of Intensive Care, Queen Mary Hospital, The University of Hong Kong, Hong Kong Special Administrative Region (SAR), China
| | - Cyril Chik-Yan Yip
- Department of Microbiology, The University of Hong Kong, Hong Kong Special Administrative Region (SAR), China
| | - Ricky Ruiqi Zhang
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong Special Administrative Region (SAR), China; State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, The University of Hong Kong, Hong Kong Special Administrative Region (SAR), China
| | - Agnes Yim-Fong Fung
- State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, The University of Hong Kong, Hong Kong Special Administrative Region (SAR), China
| | - Erica Yuen-Wing Yan
- State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, The University of Hong Kong, Hong Kong Special Administrative Region (SAR), China
| | - Kit-Hang Leung
- State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, The University of Hong Kong, Hong Kong Special Administrative Region (SAR), China
| | - Jonathan Daniel Ip
- State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, The University of Hong Kong, Hong Kong Special Administrative Region (SAR), China
| | - Allen Wing-Ho Chu
- State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, The University of Hong Kong, Hong Kong Special Administrative Region (SAR), China
| | - Wan-Mui Chan
- State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, The University of Hong Kong, Hong Kong Special Administrative Region (SAR), China
| | - Anthony Chin-Ki Ng
- State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, The University of Hong Kong, Hong Kong Special Administrative Region (SAR), China
| | - Rodney Lee
- Department of Microbiology, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China
| | - Kitty Fung
- Department of Microbiology, United Christian Hospital, Hong Kong SAR, China
| | - Alwin Yeung
- Department of Medicine and Geriatrics, Ruttonjee Hospital, Hong Kong SAR, China
| | - Tak-Chiu Wu
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong SAR, China
| | | | - Wing-Wah Yan
- Department of Intensive Care, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China
| | - Wai-Ming Chan
- Department of Intensive Care, Queen Mary Hospital, The University of Hong Kong, Hong Kong Special Administrative Region (SAR), China
| | - Jasper Fuk-Woo Chan
- State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, The University of Hong Kong, Hong Kong Special Administrative Region (SAR), China
| | - Albert Kwok-Wai Lie
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong Special Administrative Region (SAR), China
| | - Owen Tak-Yin Tsang
- Department of Medicine, Princess Margaret Hospital, Hong Kong SAR, China
| | - Vincent Chi-Chung Cheng
- Department of Microbiology, The University of Hong Kong, Hong Kong Special Administrative Region (SAR), China
| | - Tak-Lun Que
- Department of Microbiology, Tuen Mun Hospital, Hong Kong SAR, China
| | - Chak-Sing Lau
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong Special Administrative Region (SAR), China
| | - Kwok-Hung Chan
- State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, The University of Hong Kong, Hong Kong Special Administrative Region (SAR), China
| | - Kelvin Kai-Wang To
- State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, The University of Hong Kong, Hong Kong Special Administrative Region (SAR), China
| | - Kwok-Yung Yuen
- State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, The University of Hong Kong, Hong Kong Special Administrative Region (SAR), China.
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Treatment algorithm for COVID-19: a multidisciplinary point of view. Clin Rheumatol 2020; 39:2077-2084. [PMID: 32472459 PMCID: PMC7255973 DOI: 10.1007/s10067-020-05179-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 05/05/2020] [Accepted: 05/15/2020] [Indexed: 01/08/2023]
Abstract
The novel coronavirus (Sars-CoV-2) pandemic has spread rapidly, from December to the end of March, to 185 countries, and there have been over 3,000,000 cases identified and over 200,000 deaths. For a proportion of hospitalized patients, death can occur within a few days, mainly for adult respiratory distress syndrome or multi-organ dysfunction syndrome. In these patients, clinical signs and symptoms, as well as laboratory abnormalities, suggest a cytokine storm syndrome in response to the viral infection. No current targeted treatment is yet available for COVID-19, an unknown disease up to 2 months ago, which challenges doctors and researchers to find new drugs or reallocate other treatments for these patients. Since the beginning of the COVID-19 outbreak, a growing body of information on diagnostic and therapeutic strategies has emerged, mainly based on preliminary experience on retrospective studies or small case series. Antivirals, antimalarials, corticosteroids, biotechnological and small molecules, convalescent plasma and anticoagulants are among the drugs proposed for the treatment or in tested for COVID-19. Given the complexity of this new condition, a multidisciplinary management seems to be the best approach. Sharing and integrating knowledge between specialists, to evaluate the correct timing and setting of every treatment, could greatly benefit our patients. We reviewed the literature, combining it with our experiences and our specialist knowledge, to propose a management algorithm, correlating the clinical features with laboratory and imaging findings to establish the right timing for each treatment.Key Points • Critically ill COVID-19 patients show signs of cytokine storm syndrome. • No current targeted therapy is available, but a lot of drugs are in tested. • A multidisciplinary approach is crucial to manage COVID-19. • Choosing the correct timing of treatment is of pivotal importance to avoid the most severe complications. |
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162
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Bilbul M, Paparone P, Kim AM, Mutalik S, Ernst CL. Psychopharmacology of COVID-19. PSYCHOSOMATICS 2020. [PMID: 32425246 DOI: 10.1016/j.psym.2020.05.006.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 09/30/2022]
Abstract
Background With the rapid, global spread of severe acute respiratory syndrome coronavirus 2, hospitals have become inundated with patients suffering from coronavirus disease 2019. Consultation-liaison psychiatrists are actively involved in managing these patients and should familiarize themselves with how the virus and its proposed treatments can affect psychotropic management. The only Food and Drug Administration-approved drug to treat COVID-19 is remdesivir, and other off-label medications used include chloroquine and hydroxychloroquine, tocilizumab, lopinavir/ritonavir, favipiravir, convalescent plasma therapy, azithromycin, vitamin C, corticosteroids, interferon, and colchicine. Objective To provide an overview of the major safety considerations relevant to clinicians who prescribe psychotropics to patients with COVID-19, both related to the illness and its proposed treatments. Methods In this targeted review, we performed structured literature searches in PubMed to identify articles describing the impacts of COVID-19 on different organ systems, the neuropsychiatric adverse effects of treatments, and any potential drug interactions with psychotropics. The articles most relevant to this one were included. Results COVID-19 impacts multiple organ systems, including gastrointestinal, renal, cardiovascular, pulmonary, immunological, and hematological systems. This may lead to pharmacokinetic changes that impact psychotropic medications and increase sensitivity to psychotropic-related adverse effects. In addition, several proposed treatments for COVID-19 have neuropsychiatric effects and potential interactions with commonly used psychotropics. Conclusions Clinicians should be aware of the need to adjust existing psychotropics or avoid using certain medications in some patients with COVID-19. They should also be familiar with neuropsychiatric effects of medications being used to treat this disease. Further research is needed to identify strategies to manage psychiatric issues in this population.
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Affiliation(s)
- Melanie Bilbul
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Patricia Paparone
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Anna M Kim
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Shruti Mutalik
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Carrie L Ernst
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY.
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163
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Acanfora D, Ciccone MM, Scicchitano P, Acanfora C, Casucci G. Neprilysin inhibitor-angiotensin II receptor blocker combination (sacubitril/valsartan): rationale for adoption in SARS-CoV-2 patients. EUROPEAN HEART JOURNAL. CARDIOVASCULAR PHARMACOTHERAPY 2020; 6:135-136. [PMID: 32282032 PMCID: PMC7184416 DOI: 10.1093/ehjcvp/pvaa028] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 04/01/2020] [Accepted: 04/08/2020] [Indexed: 01/08/2023]
Affiliation(s)
- Domenico Acanfora
- Unit of Internal Medicine, San Francesco Hospital, Viale Europa 21, 82037 Telese Terme (BN), Italy
| | - Marco Matteo Ciccone
- Section of Cardiovascular Diseases, Department of Emergency and Organ Transplantation, University of Bari, School of Medicine, Bari, Italy
| | - Pietro Scicchitano
- Section of Cardiovascular Diseases, Department of Emergency and Organ Transplantation, University of Bari, School of Medicine, Bari, Italy.,Cardiology Unit, Hospital 'F. Perinei' ASL BA, Altamura, Bari, Italy
| | - Chiara Acanfora
- Unit of Internal Medicine, San Francesco Hospital, Viale Europa 21, 82037 Telese Terme (BN), Italy.,Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Gerardo Casucci
- Unit of Internal Medicine, San Francesco Hospital, Viale Europa 21, 82037 Telese Terme (BN), Italy
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164
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Bilbul M, Paparone P, Kim AM, Mutalik S, Ernst CL. Psychopharmacology of COVID-19. PSYCHOSOMATICS 2020; 61:411-427. [PMID: 32425246 PMCID: PMC7232075 DOI: 10.1016/j.psym.2020.05.006] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 05/11/2020] [Accepted: 05/12/2020] [Indexed: 12/17/2022]
Abstract
Background With the rapid, global spread of severe acute respiratory syndrome coronavirus 2, hospitals have become inundated with patients suffering from coronavirus disease 2019. Consultation-liaison psychiatrists are actively involved in managing these patients and should familiarize themselves with how the virus and its proposed treatments can affect psychotropic management. The only Food and Drug Administration–approved drug to treat COVID-19 is remdesivir, and other off-label medications used include chloroquine and hydroxychloroquine, tocilizumab, lopinavir/ritonavir, favipiravir, convalescent plasma therapy, azithromycin, vitamin C, corticosteroids, interferon, and colchicine. Objective To provide an overview of the major safety considerations relevant to clinicians who prescribe psychotropics to patients with COVID-19, both related to the illness and its proposed treatments. Methods In this targeted review, we performed structured literature searches in PubMed to identify articles describing the impacts of COVID-19 on different organ systems, the neuropsychiatric adverse effects of treatments, and any potential drug interactions with psychotropics. The articles most relevant to this one were included. Results COVID-19 impacts multiple organ systems, including gastrointestinal, renal, cardiovascular, pulmonary, immunological, and hematological systems. This may lead to pharmacokinetic changes that impact psychotropic medications and increase sensitivity to psychotropic-related adverse effects. In addition, several proposed treatments for COVID-19 have neuropsychiatric effects and potential interactions with commonly used psychotropics. Conclusions Clinicians should be aware of the need to adjust existing psychotropics or avoid using certain medications in some patients with COVID-19. They should also be familiar with neuropsychiatric effects of medications being used to treat this disease. Further research is needed to identify strategies to manage psychiatric issues in this population.
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Affiliation(s)
- Melanie Bilbul
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Patricia Paparone
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Anna M Kim
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Shruti Mutalik
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Carrie L Ernst
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY.
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165
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Salamanna F, Maglio M, Landini MP, Fini M. Platelet functions and activities as potential hematologic parameters related to Coronavirus Disease 2019 (Covid-19). Platelets 2020; 31:627-632. [PMID: 32397915 DOI: 10.1080/09537104.2020.1762852] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Coronavirus disease 2019 (COVID-19) is a new infectious disease that currently lacks standardized and established laboratory markers to evaluate its severity. In COVID-19 patients, the number of platelets (PLTs) and dynamic changes of PLT-related parameters are currently a concern. The present paper discusses the potential link between PLT parameters and COVID-19. Several studies have identified a link between severe COVID-19 patients and specific coagulation index, in particular, high D-dimer level, prolonged prothrombin time, and low PLT count. These alterations reflect the hypercoagulable state present in severe COVID-19 patients, which could promote microthrombosis in the lungs, as well as in other organs. Further information and more advanced hematological parameters related to PLTs are needed to better estimate this link, also considering COVID-19 patients at different disease stages and stratified in different cohorts based on preexisting co-morbidity, age, and gender. Increasing the understanding of PLT functions in COVID-19 will undoubtedly improve our knowledge on disease pathogenesis, clinical management, and therapeutic options, but could also lead to the development of more precise therapeutic strategies for COVID-19 patients.
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Affiliation(s)
- Francesca Salamanna
- Laboratory of Preclinical and Surgical Studies, IRCCS Istituto Ortopedico Rizzoli , Bologna, Italy
| | - Melania Maglio
- Laboratory of Preclinical and Surgical Studies, IRCCS Istituto Ortopedico Rizzoli , Bologna, Italy
| | | | - Milena Fini
- Laboratory of Preclinical and Surgical Studies, IRCCS Istituto Ortopedico Rizzoli , Bologna, Italy
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166
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Sharma SS, Singh DK, Yadav AK, Swain J, Kumar S, Jain DK, Prakash P. Disposable customized aerosol containment chamber for oral cancer biopsy: A novel technique during COVID-19 pandemic. J Surg Oncol 2020; 122:120-121. [PMID: 32394482 PMCID: PMC7272806 DOI: 10.1002/jso.25962] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 04/18/2020] [Indexed: 01/25/2023]
Affiliation(s)
- Sudhendu S Sharma
- Department of Surgical Oncology, MPMMCC and HBCH, Tata Memorial Centre, Varanasi, India
| | - Deepak K Singh
- Department of Surgical Oncology, MPMMCC and HBCH, Tata Memorial Centre, Varanasi, India
| | - Avadhesh K Yadav
- Department of Nursing, MPMMCC and HBCH, Tata Memorial Centre, Varanasi, India
| | - Jyotiranjan Swain
- Department of Surgical Oncology, MPMMCC and HBCH, Tata Memorial Centre, Varanasi, India
| | - Sundeep Kumar
- Department of Surgical Oncology, MPMMCC and HBCH, Tata Memorial Centre, Varanasi, India
| | - Deep K Jain
- Department of Surgical Oncology, MPMMCC and HBCH, Tata Memorial Centre, Varanasi, India
| | - Puneet Prakash
- Department of Surgical Oncology, MPMMCC and HBCH, Tata Memorial Centre, Varanasi, India
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167
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Sarvepalli D. Coronavirus Disease 2019: A Comprehensive Review of Etiology, Pathogenesis, Diagnosis, and Ongoing Clinical Trials. Cureus 2020; 12:e8076. [PMID: 32542131 PMCID: PMC7292713 DOI: 10.7759/cureus.8076] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 05/12/2020] [Indexed: 01/15/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is an acute respiratory viral infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease outbreak started in China in late December 2019 and quickly spread to the rest of the world, resulting in a pandemic. The incidence of cases is increasing every day, affecting millions of people around the globe and resulting in a public health emergency. Furthermore, disease management has been challenging for the clinicians and other medical personnel in terms of treatment options and availability of personal protective equipment. The off-label use of drugs such as hydroxychloroquine and emergency use authorization of remdesivir can hopefully help the clinicians while treating critically ill patients. The use of convalescent serum has also shown some interim benefit until a definitive treatment and preventive options are uncovered, such as vaccines and other effective treatment regimens.
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168
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Lippi G, Mattiuzzi C, Bovo C, Plebani M. Current laboratory diagnostics of coronavirus disease 2019 (COVID-19). ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:137-145. [PMID: 32420937 PMCID: PMC7569648 DOI: 10.23750/abm.v91i2.9548] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 04/16/2020] [Indexed: 12/27/2022]
Abstract
Laboratory medicine provides an almost irreplaceable contribution to the diagnostic reasoning and managed care of most human pathologies. The novel coronavirus disease 2019 (COVID-19) is not an exception to this paradigm. Although the relatively recent emergence does not allow to draw definitive conclusions on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) diagnostics, some standpoints can be conveyed. First and foremost, it seems now clear that we will be living together with this virus for quite a long time, so that our vigilance and responsiveness against the emergence of new local outbreaks shall be maintained at the highest possible levels. The etiological diagnosis of COVID-19 is, and will remain for the foreseeable future, deeply based on direct identification of viral RNA by means of molecular biology techniques in biological materials, especially upper and lower respiratory tract specimens. Whether other materials, such as blood, urine, stools, saliva and throat washing, will become valid alternatives has not been unequivocally defined so far. As concerns serological testing, promising information can be garnered from preliminary investigations, showing that the vast majority of COVID-19 patients seem to develop a sustained immune response against the virus, characterized especially by emergence of anti-SARS-CoV-2 IgG and IgA, 1 to 2 weeks after the onset of fever and/or respiratory symptoms. Whether these antibodies will have persistent neutralizing activity against the virus is still to be elucidated on individual and general basis. The availability of rapid tests for detecting either viral antigens or anti-SARS-CoV-2 antibodies are a potentially viable opportunity for purposes of epidemiologic surveillance, though more information is needed on accuracy and reliability of these portable immunoassays.
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Affiliation(s)
- Giuseppe Lippi
- Section of Clinical Biochemistry, University of Verona, Verona, Italy.
| | - Camilla Mattiuzzi
- Service of Clinical Governance, Provincial Agency for Social and Sanitary Services, Trento, Italy.
| | - Chiara Bovo
- Medical Direction, University Hospital of Verona, Verona, Italy.
| | - Mario Plebani
- Department of Laboratory Medicine, University Hospital of Padova, Padova, Italy.
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169
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Brogna B, Brogna C, Martino A, Minichiello S, Romeo DM, Romano P, Bignardi E, Mazza EM, Musto L. SARS-CoV-2 Infection with Different Radiological Insights. Diagnostics (Basel) 2020; 10:E283. [PMID: 32392859 PMCID: PMC7277975 DOI: 10.3390/diagnostics10050283] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 04/29/2020] [Accepted: 05/04/2020] [Indexed: 12/12/2022] Open
Abstract
Severe acute respiratory syndrome-Coronavirus-2 (SARS-CoV-2) is a novel viral infection characterized by several symptoms range from mild to severe clinical conditions that could lead to death. We report two different radiological findings on computed tomography (CT) in two patients affected by SARS-CoV-2: a lung acute embolism (APE) in the first case and a radiological picture of acute respiratory distress syndrome (ARDS) in the second case. This is an important issue to be identified in order to provide more specific therapy earlier, including both antiviral and anti-inflammatory drugs associated with anti anticoagulant therapy.
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Affiliation(s)
- Barbara Brogna
- Radiology Unit, “Frangipane” Hospital, ASL Avellino, Via V. Emanuele, Ariano irpino, 83031 Avellino, Italy; (A.M.); (E.M.M.); (L.M.)
| | - Claudia Brogna
- Neuropsychiatric Unit ASL Avellino, Via Degli Imbimbo 10/12, 83100 Avellino, Italy;
| | - Alberigo Martino
- Radiology Unit, “Frangipane” Hospital, ASL Avellino, Via V. Emanuele, Ariano irpino, 83031 Avellino, Italy; (A.M.); (E.M.M.); (L.M.)
| | - Stefana Minichiello
- Cardiologic Unit “Frangipane” Hospital, ASL Avellino, Via V. Emanuele, Ariano irpino, 83031 Avellino, Italy;
| | - Domenico M. Romeo
- Neuropsychiatric Unit, Catholic University of Sacred Heart, Fondazione Policlinico Agostino Gemelli IRCCS, 00168 Rome, Italy;
| | - Paolo Romano
- Radiology Unit, “Criscuoli” Hospital, ASL Avellino, Via Quadrivio, Sant’Angelo Dei Lombardi, 83054 Avellino, Italy;
| | - Elio Bignardi
- Radiology Unit, “Cotugno Hospital, Naples, Via Quagliariello 54, 80131 Naples, Italy;
| | - Emerico Maria Mazza
- Radiology Unit, “Frangipane” Hospital, ASL Avellino, Via V. Emanuele, Ariano irpino, 83031 Avellino, Italy; (A.M.); (E.M.M.); (L.M.)
| | - Lanfranco Musto
- Radiology Unit, “Frangipane” Hospital, ASL Avellino, Via V. Emanuele, Ariano irpino, 83031 Avellino, Italy; (A.M.); (E.M.M.); (L.M.)
- Radiology Unit, “Criscuoli” Hospital, ASL Avellino, Via Quadrivio, Sant’Angelo Dei Lombardi, 83054 Avellino, Italy;
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170
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Bowale A, Abayomi A, Idris J, Omilabu S, Abdus-Salam I, Adebayo B, Opawoye F, Finnih-Awokoya O, Zamba E, Abdur-Razzaq H, Erinoso O, Onasanya T, Ramadan P, Nyenyi S, Aniaku E, Balogun M, Okunromade O, Adejumo O, Adesola S, Ogunniyan T, Balogun M, Osibogun A. Clinical presentation, case management and outcomes for the first 32 COVID-19 patients in Nigeria. Pan Afr Med J 2020; 35:24. [PMID: 33623549 PMCID: PMC7875732 DOI: 10.11604/pamj.supp.2020.35.2.23262] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 05/02/2020] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Success in curtailing the pandemic coronavirus disease (COVID-19) depends largely on a sound understanding of the epidemiologic and clinical profile of cases in a population as well as the case management approach. This study documents the presenting characteristics, treatment modalities and outcomes of the first 32 COVID-19 patients in Nigeria. METHODS This retrospective study used medical records of the first 32 patients admitted and discharged from the Mainland Hospital, Lagos State, southwest Nigeria between February 27 and April 6, 2020. The outcomes of interest were death, promptness of admission process and duration of hospitalization. RESULTS The mean age of the patients was 38.1 years (SD: 15.5) and 66% were male. Three-quarters (75%) of the patients presented in moderately severe condition while 16% were asymptomatic. The most common presenting symptoms were fever (59%) and dry cough (44%). The mean time between a positive test result and admission was 1.63 days (SD: 1.31). Almost all (97%) the patients were treated with lopinavir-ritonavir with no recorded death. The median duration of hospital stay was 12 days (IQR: 9-13.5). CONCLUSION In this preliminary analysis of the first COVID-19 cases in Nigeria, clinical presentation was mild to moderate with no mortality. Processes to improve promptness of admission and reduce hospital stay are required to enhance the response to COVID-19 in Nigeria.
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Affiliation(s)
| | | | - Jide Idris
- Lagos State Ministry of Health, Lagos, Nigeria
| | | | | | - Busayo Adebayo
- Lagos State University Teaching Hospital, Lagos, Nigeria
| | | | | | | | | | | | | | | | - Sam Nyenyi
- World Health Organization, Nigerian Office, Lagos, Nigeria
| | | | | | | | | | | | | | - Mobolanle Balogun
- College of Medicine University of Lagos, Lagos, Nigeria
- Lagos University Teaching Hospital, Lagos, Nigeria
| | - Akin Osibogun
- College of Medicine University of Lagos, Lagos, Nigeria
- Lagos State Primary Health Care Board, Lagos, Nigeria
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171
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Kamani L. What gastroenterologists should know during COVID-19 Pandemic! Pak J Med Sci 2020; 36:S124-S125. [PMID: 32582330 PMCID: PMC7306942 DOI: 10.12669/pjms.36.covid19-s4.2651] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 04/22/2020] [Indexed: 12/15/2022] Open
Abstract
The WHO has declared a Pandemic due to Novel Corona virus-19 (COVID-19). Patients usually have respiratory symptoms but gastrointestinal and hepatic dysfunction are not uncommon presentations and can lead to a delay in diagnosis and management. Virus shedding can continue even after the nasopharyngeal swab gets negative and could lead to faecal-oral transmission. The effects of COVID-19 on patients with decompensated liver disease is still not clear. Managing immunosuppressive drugs in liver transplant and inflammatory bowel disease is a major challenge without clear guidelines. Only emergency endoscopy is to be done with personal protection equipment. Chloroquine and Hydroxychloroquine has shown some beneficial effects and is being used off-label. Without effective treatment, it is imperative to take precautionary measures.
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Affiliation(s)
- Lubna Kamani
- Lubna Kamani, MBBS, FCPS, MRCP (UK), FRCP (London), FACG Associate Professor and Director GI Residency Program, Department of Gastroenterology, Liaquat National Hospital, Karachi, Pakistan
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172
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Hakmi M, Bouricha EM, Kandoussi I, Harti JE, Ibrahimi A. Repurposing of known anti-virals as potential inhibitors for SARS-CoV-2 main protease using molecular docking analysis. Bioinformation 2020; 16:301-306. [PMID: 32773989 PMCID: PMC7392094 DOI: 10.6026/97320630016301] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 03/30/2020] [Accepted: 04/01/2020] [Indexed: 12/31/2022] Open
Abstract
The new SARS-CoV-2 coronavirus is the causative agent of the COVID-19 pandemic outbreak that affected more than 190 countries worldwide with more than 292,000 confirmed cases and over
12,700 deaths. There is at the moment no vaccine or effective treatment for this disease which constitutes a serious global health problem. It is of interest to use a structure based virtual
screening approach for the identification of potential inhibitors of the main protease of SARS-CoV-2 (Mpro) from antiviral drugs used to treat other viral disease such as human immunodeficiency
virus (HIV) and hepatitis C virus (HCV) infections. The crystallographic structure with PDB ID: 6LU7 of Mpro in complex with the inhibitor N3 was used as a model in the virtual screening
of 33 protease inhibitors collected from the ChEMBL chemical database. Molecular docking analysis was performed using the standard AutoDock vina protocol followed by ranking and selection
of compounds based on their binding affinity. We report 10 candidates with optimal binding features to the active site of the protease for further consideration as potential drugs to treat
patients infected with the emerging COVID-19 disease.
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Affiliation(s)
- Mohammed Hakmi
- Medical Biotechnology Laboratory (MedBiotech), Rabat Medical and Pharmacy School, Mohammed Vth University in Rabat, Morocco
| | - El Mehdi Bouricha
- Medical Biotechnology Laboratory (MedBiotech), Rabat Medical and Pharmacy School, Mohammed Vth University in Rabat, Morocco
| | - Ilham Kandoussi
- Medical Biotechnology Laboratory (MedBiotech), Rabat Medical and Pharmacy School, Mohammed Vth University in Rabat, Morocco
| | - Jaouad El Harti
- Therapeutic Chemistry Laboratory, Medical Biotechnology Laboratory (MedBiotech), Rabat Medical and Pharmacy School, Mohammed Vth University in Rabat, Morocco
| | - Azeddine Ibrahimi
- Medical Biotechnology Laboratory (MedBiotech), Rabat Medical and Pharmacy School, Mohammed Vth University in Rabat, Morocco
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173
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Sargin G, Yavaşoğlu Sİ, Yavasoglu I. Is Coronavirus Disease 2019 (COVID-19) seen less in countries more exposed to Malaria? Med Hypotheses 2020; 140:109756. [PMID: 32344306 PMCID: PMC7175881 DOI: 10.1016/j.mehy.2020.109756] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 04/21/2020] [Indexed: 12/23/2022]
Affiliation(s)
- Gokhan Sargin
- Department of Rheumatology, Aydın Adnan Menderes University School of Medicine, 09100 Efeler, Aydın, Turkey
| | - Sare İlknur Yavaşoğlu
- Aydın Adnan Menderes University, Faculty of Science and Letters, Department of Ecology, 09100 Efeler, Aydın, Turkey
| | - Irfan Yavasoglu
- Department of Hematology, Aydın Adnan Menderes University School of Medicine, 09100, Efeler, Aydın, Turkey
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174
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Langhi DM, Santis GCD, Bordin JO. COVID-19 convalescent plasma transfusion. Hematol Transfus Cell Ther 2020; 42:113-115. [PMID: 32313872 PMCID: PMC7164882 DOI: 10.1016/j.htct.2020.04.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 04/07/2020] [Indexed: 12/28/2022] Open
Affiliation(s)
| | | | - José Orlando Bordin
- Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil; Hospital Alemão Oswaldo Cruz, São Paulo, SP, Brazil
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175
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Garraud O. COVID-19: Is a paradigm change to be expected in health care and transfusion medicine? Transfus Clin Biol 2020; 27:59-60. [PMID: 32280061 PMCID: PMC7270865 DOI: 10.1016/j.tracli.2020.03.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- O Garraud
- Faculty of medicine, university of Lyon, Saint-Étienne, France; Palliative care, the Ruffec hospital, Ruffec, France.
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176
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Mukunya D, Tumwine JK. Challenges of tackling non COVID-19 emergencies during the unprecedent pandemic. Afr Health Sci 2020; 20:V-VI. [PMID: 33402946 PMCID: PMC7750045 DOI: 10.4314/ahs.v20i1.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Affiliation(s)
- David Mukunya
- Department of Paediatrics and Child Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - James K Tumwine
- Department of Paediatrics and Child Health, Makerere University College of Health Sciences, Kampala, Uganda
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177
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Shi J, Lu Y, Zhang Y, Xia L, Ye C, Lü Y, Chen S, Xu Q, Tang B, Yin K, Zhang J, Chen X, Yang Z. Traditional Chinese Medicine Formulation Therapy in the Treatment of Coronavirus Disease 2019 (COVID-19). THE AMERICAN JOURNAL OF CHINESE MEDICINE 2020; 48:1523-1538. [PMID: 33148005 DOI: 10.1142/s0192415x20500755] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
This study aimed to investigate the efficacy of Traditional Chinese Medicine (TCM) decoction with different intervention timepoints in the treatment of coronavirus disease 2019 (COVID-19) patients. We retrospectively collected the medical records and evaluated the outcomes of COVID-19 patients that received TCM decoction treatment at different timepoints. A total of 234 COVID-19 patients were included in this study. Patients who received TCM decoction therapy within 3 days or 7 days after admission could achieve shorter hospitalization days and disease periods compared to those who received TCM decoction [Formula: see text] 7 days after admission (all [Formula: see text]). Patients who received TCM decoction therapy within 3 days had significantly fewer days to negative SARS-CoV-2 from nasopharyngeal/oral swab and days to negative SARS-CoV-2 from urine/stool/blood samples compared to those received TCM decoction [Formula: see text] days after admission (all [Formula: see text]). Patients who received TCM decoction therapy on the 3rd to 7th day after admission had a faster achievement of negative SARS-CoV-2 from urine/stool/blood samples compared to those who received TCM decoction [Formula: see text] days after admission ([Formula: see text]). Logistic models revealed that more days from TCM decoction to admission [Formula: see text] days might be a risk factor for long hospitalization days, disease period, and slower negative-conversion of SARS-CoV-2 (all [Formula: see text]). Conclusively, our results suggest that TCM decoction therapy should be considered at the early stage of COVID-19 patients.
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Affiliation(s)
- Jia Shi
- Department of Integrative Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, P. R. China
| | - Yunfei Lu
- Department of Integrative Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, P. R. China
| | - Yuan Zhang
- Department of Integrative Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, P. R. China
| | - Lu Xia
- Department of Tuberculosis, Shanghai Public Health Clinical Center Fudan, University, Shanghai 201508, P. R. China
| | - Chen Ye
- Department of Integrative Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, P. R. China
| | - Ying Lü
- Department of Integrative Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, P. R. China
| | - Shishi Chen
- Department of Integrative Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, P. R. China
| | - Qingnian Xu
- Department of Integrative Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, P. R. China
| | - Bozong Tang
- Department of Integrative Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, P. R. China
| | - Keshan Yin
- Department of Integrative Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, P. R. China
| | - Jing Zhang
- Department of Integrative Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, P. R. China
| | - Xiaorong Chen
- Department of Integrative Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, P. R. China
| | - Zongguo Yang
- Department of Integrative Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, P. R. China
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178
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Molina GA, Rojas CL, Aguayo WG, Moyon C MA, Moyon FX, Herrera JM, Jiménez GE, Ayala AV, Fuentes G, Endara SA. COVID-19 in Ecuador, how the pandemic strained the surgical healthcare systems over the edge. INTERNATIONAL JOURNAL OF SURGERY OPEN 2020; 26:106-107. [PMID: 34568613 PMCID: PMC7467062 DOI: 10.1016/j.ijso.2020.08.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 08/25/2020] [Indexed: 12/23/2022]
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