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Bibi S, Hasan MM, Wang YB, Papadakos SP, Yu H. Cordycepin as a Promising Inhibitor of SARS-CoV-2 RNA dependent RNA polymerase (RdRp). Curr Med Chem 2021; 29:152-162. [PMID: 34420502 DOI: 10.2174/0929867328666210820114025] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 06/21/2021] [Accepted: 06/28/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND SARS-CoV-2, which emerged in Wuhan, China, is a new global threat that has killed millions of people and continues to do so. This pandemic has not only threatened human life but has also triggered economic downturns across the world. Researchers have made significant strides in discovering molecular insights into SARS-CoV-2 pathogenesis and developing vaccines, but there is still no successful cure for SARS-CoV-2 infected patients. OBJECTIVE The present study has proposed a drug-repositioning pipeline for the design and discovery of an effective fungal-derived bioactive metabolite as a drug candidate against SARS-CoV-2. METHODS Fungal derivative "Cordycepin" was selected for this study to investigate the inhibitory properties against RNA-dependent RNA polymerase (RdRp) (PDB ID: 6M71) of SARS-CoV-2. The pharmacological profile, intermolecular interactions, binding energy, and stability of the compound were determined utilizing cheminformatic approaches. Subsequently, molecular dynamic simulation was performed to better understand the binding mechanism of cordycepin to RdRp. RESULTS The pharmacological data and retrieved molecular dynamics simulations trajectories suggest excellent drug-likeliness and greater structural stability of cordycepin, while the catalytic residues (Asp760, Asp761), as well as other active site residues (Trp617, Asp618, Tyr619, Trp800, Glu811) of RdRp, showed better stability during the overall simulation span. CONCLUSION Promising results of pharmacological investigation along with molecular simulations revealed that cordycepin exhibited strong inhibitory potential against SARS-CoV-2 polymerase enzyme (RdRp). Hence, cordycepin should be highly recommended to test in a laboratory to confirm its inhibitory potential against the SARS-CoV-2 polymerase enzyme (RdRp).
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Affiliation(s)
- Shabana Bibi
- Yunnan Herbal Laboratory, College of Ecology and Environmental Sciences, Yunnan University, Kunming 650091, Yunnan. China
| | - Mohammad Mehedi Hasan
- Department of Biochemistry and Molecular Biology, Faculty of Life Science, Mawlana Bhashani Science and Technology University, Tangail 1902. Bangladesh
| | - Yuan-Bing Wang
- Yunnan Herbal Laboratory, College of Ecology and Environmental Sciences, Yunnan University, Kunming 650091, Yunnan. China
| | - Stavros P Papadakos
- First Department of Pathology, School of Medicine, National and Kapodistrian University of Athens (NKUA), Athens. Greece
| | - Hong Yu
- Yunnan Herbal Laboratory, College of Ecology and Environmental Sciences, Yunnan University, Kunming 650091, Yunnan. China
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Ozdin M, Yazar H, Yaylaci S, Koroglu M, Genc AC, Kocayigit İ, Genc AB, Yıldırım İ, Kocayigit H, Karabay O. Evaluation of cardiac parameters between survivors and nonsurvivors of COVID-19 patients. ACTA ACUST UNITED AC 2021; 67Suppl 1:80-85. [PMID: 34406298 DOI: 10.1590/1806-9282.67.suppl1.20200848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 11/29/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVE The present study compares the cardiac parameters of the survivor and nonsurvivor patients with COVID-19 infection. METHODS This study was conducted in 379 patients diagnosed with COVID-19 disease. Information of 21 nonsurvivor and 358 survivor patients with COVID-19 was obtained from the hospital information management system and analyzed retrospectively. Relationship between cardiac parameters in patients categorized into the mortal and immortal groups was investigated. RESULTS Of the total 379 patients involved in this study, 155 (40.9%) were females and 224 (59.1%) were males. No statistically significant difference in mortality was found between females and males (p=0.249). The total median age was 70, the median age in the nonsurvivor group was 74 (35-89), and it was 69.5 (18-96) in the survivor group (p=0.249). The median values of high-sensitivity troponin (hs-Tn), creatine kinase MB form, and especially myoglobin in the survivor and nonsurvivor groups were 25/64.9 (p=0.028), 18/23 (p=0.02), and 105.5/322.4 (p<0.001), and the difference was statistically significant. Comparing mortality, while there was 1 (0.7%) nonsurvivor out of 134 patients in the service unit, there were 20 (8.2%) nonsurvivors out of 245 patients in the intensive care unit. This difference was statistically significant (p=0.003). The cutoff value of myoglobin, which may pose a risk of mortality, was found to be 191.4 µg/L, while it was 45.7 ng/l for hs-Tn and 60.1 U/L for creatine kinase MB. CONCLUSIONS Advanced age and increased levels of high-sensitivity troponin, creatine kinase MB, and myoglobin were found to be associated with mortality.
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Affiliation(s)
- Mehmet Ozdin
- Sakarya University Education and Research Hospital, Medical Biochemistry Laboratory - Sakarya, Turkey
| | - Hayrullah Yazar
- Sakarya University Education and Research Hospital, Medical Biochemistry Laboratory - Sakarya, Turkey.,Sakarya University, Faculty of Medicine, Department of Medical Biochemistry - Sakarya, Turkey
| | - Selcuk Yaylaci
- Sakarya University, Faculty of Medicine, Department of Internal Medicine - Sakarya, Turkey
| | - Mehmet Koroglu
- Sakarya University, Faculty of Medicine, Department of Medical Microbiology - Sakarya, Turkey
| | - Ahmed Cihad Genc
- Sakarya University, Faculty of Medicine, Department of Internal Medicine - Sakarya, Turkey
| | - İbrahim Kocayigit
- Sakarya University, Faculty of Medicine, Department of Cardiology - Sakarya, Turkey
| | - Ahmed Bilal Genc
- Sakarya University, Faculty of Medicine, Department of Internal Medicine - Sakarya, Turkey
| | - İlhan Yıldırım
- Sakarya University, Faculty of Medicine, Department of Internal Medicine - Sakarya, Turkey
| | - Havva Kocayigit
- Sakarya University, Faculty of Medicine, Department of Anesthesiology and Reanimation - Sakarya, Turkey
| | - Oguz Karabay
- Sakarya University, Faculty of Medicine, Department of Infectious Disease and Clinical Microbiology - Sakarya, Turkey
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253
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Biochemical composition, transmission and diagnosis of SARS-CoV-2. Biosci Rep 2021; 41:229295. [PMID: 34291285 PMCID: PMC8350435 DOI: 10.1042/bsr20211238] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/19/2021] [Accepted: 07/21/2021] [Indexed: 01/08/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is a life-threatening respiratory infection caused by severe acute respiratory syndrome virus (SARS-CoV-2), a novel human coronavirus. COVID-19 was declared a pandemic by World Health Organization in March 2020 for its continuous and rapid spread worldwide. Rapidly emerging COVID-19 epicenters and mutants of concerns have created mammoth chaos in healthcare sectors across the globe. With over 185 million infections and approximately 4 million deaths globally, COVID-19 continues its unchecked spread despite all mitigation measures. Until effective and affordable antiretroviral drugs are made available and the population at large is vaccinated, timely diagnosis of the infection and adoption of COVID-appropriate behavior remains major tool available to curtail the still escalating COVID-19 pandemic. This review provides an updated overview of various techniques of COVID-19 testing in human samples and also discusses, in brief, the biochemical composition and mode of transmission of the SARS-CoV-2. Technological advancement in various molecular, serological and immunological techniques including mainly the reverse-transcription polymerase chain reaction (RT-PCR), CRISPR, lateral flow assays (LFAs), and immunosensors are reviewed.
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254
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Littera R, Chessa L, Deidda S, Angioni G, Campagna M, Lai S, Melis M, Cipri S, Firinu D, Santus S, Lai A, Porcella R, Rassu S, Meloni F, Schirru D, Cordeddu W, Kowalik MA, Ragatzu P, Vacca M, Cannas F, Alba F, Carta MG, Del Giacco S, Restivo A, Deidda S, Palimodde A, Congera P, Perra R, Orrù G, Pes F, Loi M, Murru C, Urru E, Onali S, Coghe F, Giglio S, Perra A. Natural killer-cell immunoglobulin-like receptors trigger differences in immune response to SARS-CoV-2 infection. PLoS One 2021; 16:e0255608. [PMID: 34352002 PMCID: PMC8341547 DOI: 10.1371/journal.pone.0255608] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 07/20/2021] [Indexed: 12/23/2022] Open
Abstract
Background The diversity in the clinical course of COVID-19 has been related to differences in innate and adaptative immune response mechanisms. Natural killer (NK) lymphocytes are critical protagonists of human host defense against viral infections. It would seem that reduced circulating levels of these cells have an impact on COVID-19 progression and severity. Their activity is strongly regulated by killer-cell immuno-globulin-like receptors (KIRs) expressed on the NK cell surface. The present study’s focus was to investigate the impact of KIRs and their HLA Class I ligands on SARS-CoV-2 infection. Methods KIR gene frequencies, KIR haplotypes, KIR ligands and combinations of KIRs and their HLA Class I ligands were investigated in 396 Sardinian patients with SARS-CoV-2 infection. Comparisons were made between 2 groups of patients divided according to disease severity: 240 patients were symptomatic or paucisymptomatic (Group A), 156 hospitalized patients had severe disease (Group S). The immunogenetic characteristics of patients were also compared to a population group of 400 individuals from the same geographical areas. Results Substantial differences were obtained for KIR genes, KIR haplotypes and KIR-HLA ligand combinations when comparing patients of Group S to those of Group A. Patients in Group S had a statistically significant higher frequency of the KIR A/A haplotype compared to patients in Group A [34.6% vs 23.8%, OR = 1.7 (95% CI 1.1–2.6); P = 0.02, Pc = 0.04]. Moreover, the KIR2DS2/HLA C1 combination was poorly represented in the group of patients with severe symptoms compared to those of the asymptomatic-paucisymptomatic group [33.3% vs 50.0%, OR = 0.5 (95% CI 0.3–0.8), P = 0.001, Pc = 0.002]. Multivariate analysis confirmed that, regardless of the sex and age of the patients, the latter genetic variable correlated with a less severe disease course [ORM = 0.4 (95% CI 0.3–0.7), PM = 0.0005, PMC = 0.005]. Conclusions The KIR2DS2/HLA C1 functional unit resulted to have a strong protective effect against the adverse outcomes of COVID-19. Combined to other well known factors such as advanced age, male sex and concomitant autoimmune diseases, this marker could prove to be highly informative of the disease course and thus enable the timely intervention needed to reduce the mortality associated with the severe forms of SARS-CoV-2 infection. However, larger studies in other populations as well as experimental functional studies will be needed to confirm our findings and further pursue the effect of KIR receptors on NK cell immune-mediated response to SARS-Cov-2 infection.
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Affiliation(s)
- Roberto Littera
- Complex Structure of Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Sardinian Regional Company for the Protection of Health (ATS Sardegna), Cagliari, Italy
- Association for the Advancement of Research on Transplantation O.d.V., Non Profit Organisation, Cagliari, Italy
- * E-mail: (RL); (LC); (SG); (AP)
| | - Luchino Chessa
- Association for the Advancement of Research on Transplantation O.d.V., Non Profit Organisation, Cagliari, Italy
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Liver Unit, Department of Internal Medicine, University Hospital of Cagliari, Cagliari, Italy
- * E-mail: (RL); (LC); (SG); (AP)
| | - Silvia Deidda
- Complex Structure of Pneumology, SS Trinità Hospital, ASSL Cagliari, ATS Sardegna, Cagliari, Italy
| | - Goffredo Angioni
- Complex Structure of Infectious Diseases, SS Trinità Hospital, ASSL Cagliari, ATS Sardegna, Cagliari, Italy
| | - Marcello Campagna
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Sara Lai
- Complex Structure of Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Sardinian Regional Company for the Protection of Health (ATS Sardegna), Cagliari, Italy
| | - Maurizio Melis
- Association for the Advancement of Research on Transplantation O.d.V., Non Profit Organisation, Cagliari, Italy
| | - Selene Cipri
- Complex Structure of Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Sardinian Regional Company for the Protection of Health (ATS Sardegna), Cagliari, Italy
| | - Davide Firinu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | | | - Alberto Lai
- Local Crisis Unit (UCL), ATS Sardegna, Cagliari, Italy
| | - Rita Porcella
- Complex Structure of Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Sardinian Regional Company for the Protection of Health (ATS Sardegna), Cagliari, Italy
| | - Stefania Rassu
- Complex Structure of Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Sardinian Regional Company for the Protection of Health (ATS Sardegna), Cagliari, Italy
| | - Federico Meloni
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Daniele Schirru
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - William Cordeddu
- Complex Structure of Infectious Diseases, SS Trinità Hospital, ASSL Cagliari, ATS Sardegna, Cagliari, Italy
| | - Marta Anna Kowalik
- Unit of Oncology and Molecular Pathology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Paola Ragatzu
- Complex Structure of Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Sardinian Regional Company for the Protection of Health (ATS Sardegna), Cagliari, Italy
| | - Monica Vacca
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Federica Cannas
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Francesco Alba
- Complex Structure of Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Sardinian Regional Company for the Protection of Health (ATS Sardegna), Cagliari, Italy
| | - Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Stefano Del Giacco
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Angelo Restivo
- Colorectal Surgery Unit, Department of Surgical Science, University of Cagliari, Cagliari, Italy
| | - Simona Deidda
- Colorectal Surgery Unit, Department of Surgical Science, University of Cagliari, Cagliari, Italy
| | - Antonella Palimodde
- Complex Structure of Pneumology, SS Trinità Hospital, ASSL Cagliari, ATS Sardegna, Cagliari, Italy
| | - Paola Congera
- Complex Structure of Pneumology, SS Trinità Hospital, ASSL Cagliari, ATS Sardegna, Cagliari, Italy
| | - Roberto Perra
- Complex Structure of Pneumology, SS Trinità Hospital, ASSL Cagliari, ATS Sardegna, Cagliari, Italy
| | - Germano Orrù
- Molecular Biology Service Laboratory, Department of Surgical Science, University of Cagliari, Cagliari, Italy
| | - Francesco Pes
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Martina Loi
- Liver Unit, Department of Internal Medicine, University Hospital of Cagliari, Cagliari, Italy
| | - Claudia Murru
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Enrico Urru
- Liver Unit, Department of Internal Medicine, University Hospital of Cagliari, Cagliari, Italy
| | - Simona Onali
- Unit of Oncology and Molecular Pathology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Ferdinando Coghe
- Clinical Chemical and Microbiology Laboratory, University Hospital of Cagliari, Cagliari, Italy
| | - Sabrina Giglio
- Complex Structure of Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Sardinian Regional Company for the Protection of Health (ATS Sardegna), Cagliari, Italy
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- * E-mail: (RL); (LC); (SG); (AP)
| | - Andrea Perra
- Association for the Advancement of Research on Transplantation O.d.V., Non Profit Organisation, Cagliari, Italy
- Unit of Oncology and Molecular Pathology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
- * E-mail: (RL); (LC); (SG); (AP)
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Li J, Ye L, Zhou Y, Zhang JY, Chen Z. To Procrastinate or Not to Procrastinate: A Retrospective Study of the Optimal Timing of Containing the Global Spread of the COVID-19 Pandemic. Front Public Health 2021; 9:613980. [PMID: 34414148 PMCID: PMC8369202 DOI: 10.3389/fpubh.2021.613980] [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: 11/12/2020] [Accepted: 06/03/2021] [Indexed: 11/13/2022] Open
Abstract
As global public health is under threat by the 2019-nCoV and a potential new wave of large-scale epidemic outbreak and spread is looming, an imminent question to ask is what the optimal strategy of epidemic prevention and control (P&C) measures would be, especially in terms of the timing of enforcing aggressive policy response so as to maximize health efficacy and to contain pandemic spread. Based on the current global pandemic statistic data, here we developed a logistic probability function configured SEIR model to analyse the COVID-19 outbreak and estimate its transmission pattern under different "anticipate- or delay-to-activate" policy response scenarios in containing the pandemic. We found that the potential positive effects of stringent pandemic P&C measures would be almost canceled out in case of significantly delayed action, whereas a partially procrastinatory wait-and-see control policy may still be able to contribute to containing the degree of epidemic spread although its effectiveness may be significantly compromised compared to a scenario of early intervention coupled with stringent P&C measures. A laissez-faire policy adopted by the government and health authority to tackling the uncertainly of COVID19-type pandemic development during the early stage of the outbreak turns out to be a high risk strategy from optimal control perspective, as significant damages would be produced as a consequence.
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Affiliation(s)
- Jun Li
- School of International Relations, Sun Yat-sen University, Guangzhou, China
- School of Management, Curtin University of Technology, Perth, WA, Australia
| | - Lingjian Ye
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Yimin Zhou
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Joy Y. Zhang
- School of Social Policy, Sociology and Social Research, University of Kent, Canterbury, United Kingdom
| | - Zhuo Chen
- Institute of Communication and Global Public Opinion, Xi'an International Studies University, Xi'an, China
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Hamed DM, Belhoul KM, Al Maazmi NA, Ghayoor F, Moin M, Al Suwaidi M, Narainen M, Makki M, AbdulRahman M. Intravenous methylprednisolone with or without tocilizumab in patients with severe COVID-19 pneumonia requiring oxygen support: A prospective comparison. J Infect Public Health 2021; 14:985-989. [PMID: 34153729 PMCID: PMC8191304 DOI: 10.1016/j.jiph.2021.06.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 06/02/2021] [Accepted: 06/06/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Cytokine storm is a marker of severity and severe mortality in patients with coronavirus disease 2019 (COVID-19) pneumonia. Immunomodulatory treatments may reduce morbidity and mortality. OBJECTIVES To determine whether a 7-day course of methylprednisolone (MP) administered with and without tocilizumab improves outcomes in patients with severe COVID-19 (SARS-CoV-2) pneumonia requiring oxygen therapy, relative to historical controls. STUDY DESIGN AND METHOD In this randomized controlled study, patients hospitalized with severe COVID-19 at Rashid Hospital, Dubai, in June 2020 were randomized 1:1 to receive intravenous MP (40 mg twice daily for 7 days) with or without a single dose of intravenous tocilizumab (400 mg). While data from the control arm, consisting of patients administered usual care, were obtained through retrospective review of their electronic medical records. The patients in the three arms were matched by disease severity and inclusion and exclusion criteria. The primary outcomes were day 45 all-cause mortality after randomization, rate of admission to the intensive care unit (ICU), length of ICU stay, days on ventilators, and length of hospital stay. RESULTS In total, 76 patients were recruited, including 23 treated with MP, 26 with MP plus tocilizumab, and 27 historical controls. The rates of admission to the ICU and invasive mechanical ventilation were lowest in patients treated with MP alone, with the rates in this group being significantly lower than the rates in the control group (p = 0.04). Time on a ventilator was lowest in the MP group (1.09 ± 3.68 days) and highest in the control group (7.93 ± 14.86 days). The number of days in the ICU was significantly lower in the MP group than in the control and MP plus tocilizumab groups (p = 0.043). One patient (4.3%) in the MP group and five (18.5%) in the control arm died within 45 days. Survival was highest in patients treated with MP alone, with the addition of tocilizumab not improving survival or any of the other outcomes significantly. INTERPRETATION/CONCLUSION In patients with severe COVID-19 pneumonia on oxygen support, administration of MP daily for 7 days had reduced mortality at 45 days and was associated with significantly lower ICU admission and ventilation rates compared with usual. Adding tocilizumab to MP did not improve any of the studied outcomes significantly.
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Affiliation(s)
- Dujana Mostafa Hamed
- Department of Internal Medicine, Rashid Hospital, Dubai Health Authority, United Arab Emirates
| | | | | | - Farah Ghayoor
- Department of Internal Medicine, Rashid Hospital, Dubai Health Authority, United Arab Emirates
| | - Muneeba Moin
- Department of Internal Medicine, Rashid Hospital, Dubai Health Authority, United Arab Emirates
| | - Mahra Al Suwaidi
- Department of Internal Medicine, Rashid Hospital, Dubai Health Authority, United Arab Emirates
| | - Meeruna Narainen
- Department of Internal Medicine, Rashid Hospital, Dubai Health Authority, United Arab Emirates
| | - Maryam Makki
- Department of Internal Medicine, Rashid Hospital, Dubai Health Authority, United Arab Emirates
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Cai R, Zhang J, Zhu Y, Liu L, Liu Y, He Q. Mortality in chronic kidney disease patients with COVID-19: a systematic review and meta-analysis. Int Urol Nephrol 2021; 53:1623-1629. [PMID: 33389508 PMCID: PMC7778685 DOI: 10.1007/s11255-020-02740-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 12/02/2020] [Indexed: 12/15/2022]
Abstract
At the beginning of 2020, the outbreak of coronavirus disease 2019 (COVID-19) led to a worldwide pandemic and mass panic. The number of infected people has been increasing exponentially since, and the mortality rate has also been concomitantly increasing. At present, no study has summarized the mortality risk of COVID-19 in patients with chronic kidney disease (CKD). Therefore, the aim of the present study was to conduct a literature review and meta-analysis to understand the frequency of mortality among CKD patients infected with COVID-19. A comprehensive systematic search was conducted on the PubMed, Embase, and Cochrane databases to find articles published until May 15, 2020. Study quality was assessed using a modified version of the Newcastle-Ottawa Scale. After careful screening based on the inclusion and exclusion criteria, 3,867,367 patients from 12 studies were included. The mortality rate was significantly higher among CKD patients with COVID-19 infection than among CKD patients without COVID-19 infection, as indicated by a pooled OR of 5.81 (95% CI 3.78-8.94, P < 0.00001, I2 = 30%). The patients were then stratified into ≥ 70 and < 70 years, and subgroup analysis revealed that among CKD patients with COVID-19 infection, the mortality rate was higher in the < 70 years group (OR 8.69, 95% CI 7.56-9.97, P < 0.0001) than in the ≥ 70 years group (OR 2.44, 95% CI 0.75-6.63, P = 0.15). Thus, COVID-19 patients with CKD have a high mortality risk and require a comprehensive multidisciplinary management strategy.
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Affiliation(s)
- Ruyi Cai
- School of Medicine, Hangzhou Normal University, Hangzhou, Zhejiang, 310018, People's Republic of China
- Department of Nephrology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, 310014, People's Republic of China
- People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, 310014, People's Republic of China
- Chinese Medical Nephrology Key Laboratory of Zhejiang Province, Hangzhou, Zhejiang, 310014, People's Republic of China
| | - Jinshi Zhang
- School of Medicine, Hangzhou Normal University, Hangzhou, Zhejiang, 310018, People's Republic of China
- Department of Nephrology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, 310014, People's Republic of China
- People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, 310014, People's Republic of China
- Chinese Medical Nephrology Key Laboratory of Zhejiang Province, Hangzhou, Zhejiang, 310014, People's Republic of China
| | - Yifan Zhu
- Department of Nephrology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, 310014, People's Republic of China
- People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, 310014, People's Republic of China
- Chinese Medical Nephrology Key Laboratory of Zhejiang Province, Hangzhou, Zhejiang, 310014, People's Republic of China
| | - Lin Liu
- Department of Nephrology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, 310014, People's Republic of China
- People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, 310014, People's Republic of China
- Chinese Medical Nephrology Key Laboratory of Zhejiang Province, Hangzhou, Zhejiang, 310014, People's Republic of China
| | - Yueming Liu
- Department of Nephrology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, 310014, People's Republic of China
- People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, 310014, People's Republic of China
- Chinese Medical Nephrology Key Laboratory of Zhejiang Province, Hangzhou, Zhejiang, 310014, People's Republic of China
| | - Qiang He
- Department of Nephrology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, 310014, People's Republic of China.
- People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, 310014, People's Republic of China.
- Chinese Medical Nephrology Key Laboratory of Zhejiang Province, Hangzhou, Zhejiang, 310014, People's Republic of China.
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Dar S, De Moraes CG, Karani R, Khan S, Chen R, Blumberg D, Harizman N, Krawitz B, Valenzuela IA, Aliancy J, Tezel T, Horowitz J, Bearelly S, Coleman DJ, Chang S, Cioffi GA, Liebmann JM. Patient Concerns Regarding Suspended Ophthalmic Care Due to COVID-19. J Glaucoma 2021; 30:750-757. [PMID: 33979109 PMCID: PMC8366515 DOI: 10.1097/ijg.0000000000001877] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 04/14/2021] [Indexed: 12/22/2022]
Abstract
PURPOSE The temporary cessation and profound changes in ophthalmic care delivery that occurred as a result of the coronavirus disease 2019 (COVID-19) pandemic have yet to be fully understood. Our objective is to assess patients' self-reported impact of health care lockdown measures on their fears and anxieties during the crisis period of the COVID-19 pandemic in New York City. METHODS We conducted a digital, self-reported, patient care survey distributed by an e-mail at Columbia University's Department of Ophthalmology outpatient faculty practice. Inclusion criteria were age greater than or equal to 18 years, a diagnosis of either retinal disease or glaucoma, and a canceled or rescheduled ophthalmology established patient appointment during the acute phase of the COVID-19 pandemic in New York City. Patients without an e-mail address listed in their electronic medical records were excluded. The survey occurred between March 2, 2020, to May 30, 2020. Primary measures were survey responses to assess key areas of patient anxiety or concern during the pandemic including the safety of care delivery in a COVID pandemic, difficulties contacting or being seen by their ophthalmologist, concern of vision loss or disease progression, and concern over missed or access to treatments. Secondary measures were correlating survey response to factors such as visual acuity, intraocular pressure, diagnosis, disease severity, follow-up urgency, recent treatments, and diagnostic testing data. RESULTS Of the 2594 surveys sent out, 510 (19.66%) were completed. Over 95% of patients were at least as concerned as in normal circumstances about their ocular health during the peak of the pandemic. Overall, 76% of respondents were more concerned than normal that they could not be seen by their ophthalmologist soon enough. Increased concern over ocular health, disease progression, and access to care all showed positive correlations (P<0.05) with worse disease severity as measured with testing such as visual fields and optical coherence tomography. In addition, 55% of patients were afraid of contracting COVID-19 during an office visit. CONCLUSION AND RELEVANCE We found a majority of our patients were concerned about limitations in access to ophthalmic care and were fearful of disease progression. In addition, we found a number of demographic and clinical factors that correlated with increased anxiety in our patients.
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Adebisi YA, Alaran AJ, Okereke M, Oke GI, Amos OA, Olaoye OC, Oladunjoye I, Olanrewaju AY, Ukor NA, Lucero-Prisno DE. COVID-19 and Antimicrobial Resistance: A Review. Infect Dis (Lond) 2021; 14:11786337211033870. [PMID: 34376994 PMCID: PMC8327234 DOI: 10.1177/11786337211033870] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 07/01/2021] [Indexed: 12/13/2022] Open
Abstract
As the world continues to respond to the coronavirus pandemic (COVID-19), there is a larger hidden threat of antimicrobial resistance (AMR) lurking behind. AMR remains worrisome in that the pathogens causing resistant infections to thrive in hospitals and medical facilities, putting all patients at risk, irrespective of the severity of their medical conditions, further compounding the management of COVID-19. This study aims to provide overview of early findings on COVID-19 and AMR as well as to provide recommendations and lesson learned toward improving antimicrobial stewardship. We conducted a rapid narrative review of published articles by searching PubMed and Google Scholar on COVID-19 and Antimicrobial Resistance with predetermined keywords. Secondary bacterial infections play crucial roles in mortality and morbidity associated with COVID-19. Research has shown that a minority of COVID-19 patients need antibiotics to treat secondary bacterial infections. Current evidence reiterates the need not to give antibiotic therapy or prophylaxis to patients with mild COVID-19 or to patients with suspected or confirmed moderate COVID-19 illness unless it is indicated. The pandemic has also brought to the fore the deficiencies in health systems around the world. This comes with a lot of lessons, one of which is that despite the advances in medicine; we remain incredibly vulnerable to infections with limited or no standard therapies. This is worth thinking in the context of AMR, as the resistant pathogens are evolving and leading us to the era of untreatable infections. There is a necessity for continuous research into understanding and controlling infectious agents, as well as the development of newer functional antimicrobials and the need to strengthen the antimicrobial stewardship programs.
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Affiliation(s)
| | | | - Melody Okereke
- Faculty of Pharmaceutical Sciences, University of Ilorin, Ilorin, Kwara State, Nigeria
| | - Gabriel Ilerioluwa Oke
- Department of Medical Laboratory Science, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria
| | | | | | - Iyiola Oladunjoye
- Department of Microbiology, University of Ilorin, Ilorin, Kwara State, Nigeria
| | | | | | - Don Eliseo Lucero-Prisno
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
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Ichkawa Y, Wada H, Ezaki M, Tanaka M, Hiromori S, Shiraki K, Moritani I, Yamamoto A, Tashiro H, Shimpo H, Shimaoka M. Elevated D-Dimer Levels Predict a Poor Outcome in Critically Ill Patients. Clin Appl Thromb Hemost 2021; 26:1076029620973084. [PMID: 33347372 PMCID: PMC7755937 DOI: 10.1177/1076029620973084] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
D-dimer is a biomarker of thrombosis and recently been considered to predict a poor outcome in patients with infectious diseases. Plasma D-dimer levels were measured in critically ill patients to examine their relationship with the poor outcome. The plasma D-dimer levels were markedly higher in the patients with various underlying disease especially venous thromboembolism in comparison to those without severe underlying diseases. The plasma D-dimer levels in non-survivors were significantly higher than those in survivors. In a receiver operating characteristic analysis, the area under the curve was high for the disseminated intravascular coagulation (DIC) score, the D-dimer value, and the prothrombin time-international normalize ratio (PT-INR). Adequate cut-off values for predicting the outcome were 3 as follows: DIC score, 3 points; D-dimer, 4.2 mg/L; and PT-INR, 1.08. D-dimer, which is a biomarker for thrombosis, is increased in various underlying diseases and predicts a poor outcome.
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Affiliation(s)
- Yuhuko Ichkawa
- Department of Central Laboratory, 36941Mie Prefectural General Medical Center, Yokkaichi, Japan
| | - Hideo Wada
- Department of Central Laboratory, 36941Mie Prefectural General Medical Center, Yokkaichi, Japan.,Associated Department with Mie Graduate School of Medicine, Tsu, Japan
| | - Minoru Ezaki
- Department of Central Laboratory, 36941Mie Prefectural General Medical Center, Yokkaichi, Japan
| | - Motoko Tanaka
- Department of Central Laboratory, 36941Mie Prefectural General Medical Center, Yokkaichi, Japan
| | - Shinya Hiromori
- Department of Central Laboratory, 36941Mie Prefectural General Medical Center, Yokkaichi, Japan
| | - Katsuya Shiraki
- Department of Central Laboratory, 36941Mie Prefectural General Medical Center, Yokkaichi, Japan.,Associated Department with Mie Graduate School of Medicine, Tsu, Japan
| | - Isao Moritani
- Department of General Medicine, 36941Mie Prefectural General Medical Center, Yokkaichi, Japan
| | - Akitaka Yamamoto
- Department of Emergency and Critical Care Center, 36941Mie Prefectural General Medical Center, Yokkaichi, Japan
| | - Haruhiko Tashiro
- Department of Emergency and Critical Care Center, 36941Mie Prefectural General Medical Center, Yokkaichi, Japan
| | - Hideto Shimpo
- 36941Mie Prefectural General Medical Center, Yokkaichi, Japan
| | - Motomu Shimaoka
- Department of Molecular Pathobiology and Cell Adhesion Biology, Mie University Graduate School of Medicine, Tsu, Japan
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261
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Ji Z, Han W, Deng Z, Lu K. Distress, Appraisal, and Coping Among the Frontline Healthcare Provider Redeployed to the Epicenter in China During COVID-19 Pandemic. Front Psychol 2021; 12:678369. [PMID: 34393905 PMCID: PMC8362893 DOI: 10.3389/fpsyg.2021.678369] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 06/30/2021] [Indexed: 12/11/2022] Open
Abstract
Objective: The central issue of this research is to evaluate the extent of cognitive appraisal and coping processes within the pandemic encounter and determines their influence on frontline healthcare providers who had been dispatched to the coronavirus disease 2019 (COVID-19) epicenter (HPDE) distress symptoms. Materials and methods: An electronic survey of the HPDE and frontline healthcare providers who worked in their original medical facility (HPOF) was conducted from March 1 to 15, 2020. Two variables, appraisal (measured with an 18-item questionnaire) and coping (measured The Brief Cope questionnaire), were used in the analysis to explain distress symptoms (Impact of Event Scale-Revised). Results: A total of 723 eligible respondents completed the survey with a response rate of 57.3% (351 HPDE and 372 HPOF). The mean IES-R scores of HPDE respondents were 26.47 ± 11.7. Of HPDE respondents, 246 (70.09%) reported distress symptoms (score 9-88). The scores of intrusion, avoidance, and hyperarousal for HPDE were 10.28 ± 4.7, 8.97 ± 4.3, and 7.20 ± 3.2, respectively. The respondents had higher scores in overall distress and three subscales than HPOF. Appraisal and coping variables explained 77% of the distress variance. Five appraisal variables (health of self, health of family/others, virus spread, vulnerability or loss of control, and general health) were positively associated with distress symptoms. Four coping variables (active coping, positive reframing, self-distraction, and behavioral disengagement) were negatively associated with distress level, whereas self-blame was positively associated with distress symptoms. Regarding the appraisal, the scores of HPDE were significantly higher than HPOF (all p-values < 0.05), whereas being isolated was not significantly different between HDPE nurses and HPOF nurses. HPDE was significantly more likely to use humor, emotional support, instrumental support, self-distractions, venting, substance use, denial, behavioral disengagement, and self-blame (P < 0.05), whereas HPOF was significantly more likely to use active coping and acceptance (P < 0.05). HPDE doctors were significantly more likely than nurses to use active coping and acceptance (P < 0.05), whereas HPDE nurses were significantly more likely to use emotional support and use self-blame (P < 0.05). Conclusion: Frontline healthcare providers who had been dispatched to the COVID-19 epicenter respondents had a higher distress level. Therefore, we should provide proactive psychological support based on specific appraisal and coping variables.
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Affiliation(s)
- Zhongliang Ji
- Department of Emergency Medicine, Shenzhen University General Hospital, Shenzhen, China
| | - Wei Han
- Department of Emergency Medicine, Shenzhen University General Hospital, Shenzhen, China
| | - Zhe Deng
- Department of Emergency Medicine, the First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Kailin Lu
- Shenzhen Hospital, University of Hong Kong, Shenzhen, China
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262
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Requião-Moura LR, de Sandes-Freitas TV, Viana LA, Cristelli MP, de Andrade LGM, Garcia VD, de Oliveira CMC, Esmeraldo RDM, Abbud Filho M, Pacheco-Silva A, Sousa KC, Vicari AR, Costa KMAH, Simão DR, de Sousa MV, Campos JB, Almeida RAMDB, Deboni LM, Neto MM, Zanocco JA, Tedesco-Silva H, Medina-Pestana J. High mortality among kidney transplant recipients diagnosed with coronavirus disease 2019: Results from the Brazilian multicenter cohort study. PLoS One 2021; 16:e0254822. [PMID: 34320005 PMCID: PMC8318290 DOI: 10.1371/journal.pone.0254822] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 07/02/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Kidney transplant (KT) recipients are considered a high-risk group for unfavorable outcomes in the course of coronavirus disease 2019 (COVID-19). AIM To describe the clinical aspects and outcomes of COVID-19 among KT recipients. METHODS This multicenter cohort study enrolled 1,680 KT recipients diagnosed with COVID-19 between March and November 2020, from 35 Brazilian centers. The main outcome was the 90-day cumulative incidence of death, for the entire cohort and according to acute kidney injury (AKI) and renal replacement therapy (RRT) requirement. Fatality rates were analyzed according to hospitalization, intensive care unit (ICU) admission, and mechanical ventilation (MV) requirement. Multivariable analysis was performed by logistic regression for the probability of hospitalization and death. RESULTS The median age of the recipients was 51.3 years, 60.4% were men and 11.4% were Afro-Brazilian. Comorbidities were reported in 1,489 (88.6%), and the interval between transplantation and infection was 5.9 years. The most frequent symptoms were cough (54%), myalgia (40%), dyspnea (37%), and diarrhea (31%), whereas the clinical signs were fever (61%) and hypoxemia (13%). Hospitalization was required in 65.1%, and immunosuppressive drugs adjustments were made in 74.4% of in-hospital patients. ICU admission was required in 34.6% and MV in 24.9%. In the multivariable modeling, the variables related with the probability of hospitalization were age, hypertension, previous cardiovascular disease, recent use of high dose of steroid, and fever, dyspnea, diarrhea, and nausea or vomiting as COVID-19 symptoms. On the other hand, the variables that reduced the probability of hospitalization were time of COVID-19 symptoms, and nasal congestion, headache, arthralgia and anosmia as COVID-19 symptoms. The overall 90-day cumulative incidence of death was 21.0%. The fatality rates were 31.6%, 58.2%, and 75.5% in those who were hospitalized, admitted to the ICU, and required MV, respectively. At the time of infection, 23.2% had AKI and 23.4% required RRT in the follow-up. The cumulative incidence of death was significantly higher among recipients with AKI (36.0% vs. 19.1%, P < 0.0001) and in those who required RRT (70.8% vs. 10.1%, P < 0.0001). The variables related with the probability of death within 90 days after COVID-19 were age, time after transplantation, presence of hypertension, previous cardiovascular disease, use of tacrolimus and mycophenolate, recent use of high dose of steroids, and dyspnea as COVID-19 symptom. On the other hand, the variables that reduced the risk of death were time of symptoms, and headache and anosmia as COVID-19 symptoms. CONCLUSION The patients diagnosed with COVID-19 were long-term KT recipients and most of them had some comorbidities. One in every five patients died, and the rate of death was significantly higher in those with AKI, mainly when RRT was required.
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Affiliation(s)
- Lúcio R. Requião-Moura
- Department of Medicine, Nephrology Division, Federal University of São Paulo, São Paulo, SP, Brazil
- Department of Transplantation, Hospital do Rim, Fundação Oswaldo Ramos, São Paulo, SP, Brazil
- Renal Transplant Unit, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Tainá Veras de Sandes-Freitas
- Department of Clinical Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
- Hospital Universitário Walter Cantídio, Fortaleza, CE, Brazil
- Hospital Geral de Fortaleza, Fortaleza, CE, Brazil
| | - Laila Almeida Viana
- Department of Transplantation, Hospital do Rim, Fundação Oswaldo Ramos, São Paulo, SP, Brazil
| | | | | | | | | | | | - Mario Abbud Filho
- Hospital de Base, Medical School FAMERP, São José do Rio Preto, SP, Brazil
| | - Alvaro Pacheco-Silva
- Renal Transplant Unit, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | | | - Alessandra Rosa Vicari
- Hospital de Clínicas de Porto Alegre, Federal Univertisy of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | | | - Marcos Vinicius de Sousa
- Division of Nephrology, Renal Transplant Unit, Renal Transplant Research Laboratory, School of Medical Sciences, University of Campinas–UNICAP, Campinas, SP, Brazil
| | | | | | | | - Miguel Moysés Neto
- Division of Nephrology, School of Medicine of Ribeirão Preto, University of Sao Paulo, Ribeirão Preto, SP, Brazil
| | | | - Helio Tedesco-Silva
- Department of Medicine, Nephrology Division, Federal University of São Paulo, São Paulo, SP, Brazil
- Department of Transplantation, Hospital do Rim, Fundação Oswaldo Ramos, São Paulo, SP, Brazil
| | - José Medina-Pestana
- Department of Medicine, Nephrology Division, Federal University of São Paulo, São Paulo, SP, Brazil
- Department of Transplantation, Hospital do Rim, Fundação Oswaldo Ramos, São Paulo, SP, Brazil
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Mohamadi Yarijani Z, Najafi H. Kidney injury in COVID-19 patients, drug development and their renal complications: Review study. Biomed Pharmacother 2021; 142:111966. [PMID: 34333286 PMCID: PMC8313500 DOI: 10.1016/j.biopha.2021.111966] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/15/2021] [Accepted: 07/23/2021] [Indexed: 01/08/2023] Open
Abstract
Since December 2019, the world was encountered a new disease called coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although SARS-CoV-2 initially causes lung damage, it also affects many other organs, including the kidneys, and on average, 5–23% of people with COVID-19 develop the symptoms of acute kidney injury (AKI), including elevated blood creatinine and urea, hematuria, proteinuria, and histopathological damages. The exact mechanism is unknown, but the researchers believe that SARS-CoV-2 directly and indirectly affects the kidneys. The direct pathway is by binding the virus to ACE2 receptor in the kidney, damage to cells, the renin-angiotensin system disturbances, activating coagulation pathways, and damaging the renal vascular endothelium. The initial evidence from studying the kidney tissue in postmortem patients is more in favor of the direct pathway. The indirect pathway is created by increased cytokines and cytokine storm, sepsis, circulatory disturbances, hypoxemia, as well as using the nephrotoxic drugs. Using renal tissue biopsy and autopsy in the patients with COVID-19, recent studies found evidence for a predominant indirect pathway in AKI induction by SARS-CoV-2. Besides, some studies showed that the degree of acute tubular injury (ATI) in autopsies from COVID-19 victims is milder compared to AKI degree. We review the mechanism of AKI induction and the renal side effects of the most common drugs used to treat COVID-19 after the overview of the latest findings on SARS-CoV-2 pathogenicity.
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Affiliation(s)
- Zeynab Mohamadi Yarijani
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran; Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Houshang Najafi
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran; Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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264
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Deep Transfer Learning-Based Framework for COVID-19 Diagnosis Using Chest CT Scans and Clinical Information. ACTA ACUST UNITED AC 2021; 2:390. [PMID: 34337433 PMCID: PMC8308084 DOI: 10.1007/s42979-021-00785-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 07/19/2021] [Indexed: 11/25/2022]
Abstract
The Coronavirus Disease 2019 (COVID-19) which first emerged in Wuhan, China in late December, 2019, has now spread to all the countries in the world. Conventional testing methods such as the antigen test, serology tests, and polymerase chain reaction tests are widely used. However, the test results can take anything from a few hours to a few days to reach the patient. Chest CT scan images have been used as alternatives for the detection of COVID-19 infection. Use of CT scan images alone might have limited capabilities, which calls attention to incorporating clinical features. In this paper, deep learning algorithms have been utilized to integrate the chest CT scan images obtained from patients with their clinical characteristics for fast and accurate diagnosis of COVID-19 patients. The framework uses an ANN to obtain the probability of the patient being infected with COVID-19 using their clinical information. Beyond a certain threshold, the chest CT scan of the patient is classified using a deep learning model which has been trained to classify the CT scan with 99% accuracy.
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Al-Rahamneh H, Arafa L, Al Orani A, Baqleh R. Long-Term Psychological Effects of COVID-19 Pandemic on Children in Jordan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7795. [PMID: 34360086 PMCID: PMC8345684 DOI: 10.3390/ijerph18157795] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/13/2021] [Accepted: 07/18/2021] [Indexed: 11/17/2022]
Abstract
Millions of children and adolescents have been affected worldwide by quarantine, school closures, and social distancing measures which have been implemented by many countries to control the spread of COVID-19. However, the long-term consequences of such procedures on children's well-being are not clear. Therefore, this study investigated the psychological impacts of COVID-19 on Jordanian children between the ages of 5-11 years old. A total of 1309 parents with children between the ages of 5 and 11 years old filled in an online survey that included a set of questions to measure their children's behaviour and emotions before and during the COVID-19 pandemic. Being bored (77.5%), irritable (66%), likely to argue with the rest of the family (60.7%), nervous (54.8%), reluctant (54.2%), and lonely (52.4%) were the most frequently reported symptoms compared to the pre-COVID-19 period. Parents reported that screen use of ≥120 min a day was shown among 48.9% of children and 42% of children did <30 min a day of physical activity. ≤8 h of sleep per night was reported among 42.5% of children compared to pre COVID-19. The results emphasized the importance of developing preventative psychological programs to minimize the impact of the COVID-19 pandemic on children's psychological well-being.
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Affiliation(s)
- Harran Al-Rahamneh
- School of Sport Sciences, The University of Jordan, Amman 11942, Jordan; (L.A.); (A.A.); (R.B.)
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Lizana PA, Vega-Fernadez G. Teacher Teleworking during the COVID-19 Pandemic: Association between Work Hours, Work-Family Balance and Quality of Life. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147566. [PMID: 34300015 PMCID: PMC8304294 DOI: 10.3390/ijerph18147566] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 07/08/2021] [Accepted: 07/09/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Teachers worldwide had to reinvent their work routine according to teleworking during the COVID-19 pandemic, a work format that negatively impacts individuals' physical and mental health. This study evaluates the association between work hours, work-family balance and quality of life (QoL) among teachers during the Chilean health emergency of the COVID-19 pandemic. Teachers from across Chile were contacted via email and social media to answer an online survey. QoL was evaluated via the SF-36 questionnaire, work hours and work-family balance in the pandemic. A total of 336 teachers from across Chile participated in this study. Teachers had a low QoL score, associated with age (p < 0.05). Teachers who were ≤44 showed lower deterioration risks in the Physical Component Summary (OR: 0.54) than the ≥45-year-old age group; simultaneously, the younger group (≤44 years) had a greater risk (OR: 2.46) of deterioration in the Mental Component Summary than teachers over 45 years. A total of 78.7% of teachers reported having increased their work hours during the COVID-19 pandemic due to teleworking and 86% indicated negative effects on their work-family balance. Pandemic work hours and negative work-family balance increase the risk of reducing the Mental Component Summary (OR: 1.902; OR: 3.996, respectively). Teachers presented low median QoL scores, especially in the Mental Component Summary, suggesting that it would be beneficial to promote a better workload distribution for teachers in emergency contexts, considering the adverse effects of teleworking.
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267
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Scandurra C, Bochicchio V, Dolce P, Valerio P, Muzii B, Maldonato NM. Why people were less compliant with public health regulations during the second wave of the Covid-19 outbreak: The role of trust in governmental organizations, future anxiety, fatigue, and Covid-19 risk perception. CURRENT PSYCHOLOGY 2021; 42:7403-7413. [PMID: 34276170 PMCID: PMC8276685 DOI: 10.1007/s12144-021-02059-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2021] [Indexed: 01/13/2023]
Abstract
Trust in governmental organizations is a crucial factor in terms of encouraging people to conform to public health regulations, such as those recommended to slow down the spread of SARS-CoV-2. However, trust in governmental organizations tends to decline over time, reducing the compliance with public health regulations. This study aimed at exploring, first, the role of future anxiety and fatigue as serial mediators of the relationship between trust in governmental organizations and protective behaviors, and, secondly, the role of Covid-19 risk perception as a moderator between fatigue and protective behaviors. A total of 948 Italian participants (302 males and 646 females), ranged from 18 to 80 years (M = 27.20, SD = 11.01), answered an online survey during the second wave of the Covid-19 outbreak. A moderated serial mediation model was performed using a structural equation modeling. The results indicate that: (1) a higher trust in Italian governmental organizations was associated with a greater compliance in terms of adopting protective behaviors; (2) a lower trust in Italian governmental organizations increased anxiety about the future which, in turn, raised levels of fatigue, leading, finally, to a reduction in the levels of protective behaviors; and (3) as the perceived risk related to Covid-19 increased, the effect of fatigue on protective behaviors decreased. The findings of the current study may provide indications for public health policy on how to increase compliance with the recommended behaviors to be adopted in order to decrease the spread of the SARS-CoV-2.
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Affiliation(s)
- Cristiano Scandurra
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Vincenzo Bochicchio
- Department of Humanistic Studies, University of Calabria, Via Ponte Bucci Cubo 18/C, 87036 Rende, Italy
| | - Pasquale Dolce
- Department of Public Health, University of Naples Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Paolo Valerio
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Benedetta Muzii
- Department of Humanistic Studies, University of Naples Federico II, Via Porta di Massa 1, 80133 Naples, Italy
| | - Nelson Mauro Maldonato
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
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268
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Català A, Muñoz-Santos C, Galván-Casas C, Roncero Riesco M, Revilla Nebreda D, Solá-Truyols A, Giavedoni P, Llamas-Velasco M, González-Cruz C, Cubiró X, Ruíz-Villaverde R, Gómez-Armayones S, Gil Mateo MP, Pesqué D, Marcantonio O, Fernández-Nieto D, Romaní J, Iglesias Pena N, Carnero Gonzalez L, Tercedor-Sanchez J, Carretero G, Masat-Ticó T, Rodríguez-Jiménez P, Gimenez-Arnau AM, Utrera-Busquets M, Vargas Laguna E, Angulo Menéndez AG, San Juan Lasser E, Iglesias-Sancho M, Alonso Naranjo L, Hiltun I, Cutillas Marco E, Polimon Olabarrieta I, Marinero Escobedo S, García-Navarro X, Calderón Gutiérrez MJ, Baeza-Hernández G, Bou Camps L, Toledo-Pastrana T, Guilabert A. Cutaneous reactions after SARS-COV-2 vaccination: A cross-sectional Spanish nationwide study of 405 cases. Br J Dermatol 2021; 186:142-152. [PMID: 34254291 PMCID: PMC8444756 DOI: 10.1111/bjd.20639] [Citation(s) in RCA: 149] [Impact Index Per Article: 49.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/05/2021] [Accepted: 07/10/2021] [Indexed: 11/30/2022]
Abstract
Background Cutaneous reactions after severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) vaccines are poorly characterized. Objective To describe and classify cutaneous reactions after SARS‐CoV‐2 vaccination. Methods A nationwide Spanish cross‐sectional study was conducted. We included patients with cutaneous reactions within 21 days of any dose of the approved vaccines at the time of the study. After a face‐to‐face visit with a dermatologist, information on cutaneous reactions was collected via an online professional survey and clinical photographs were sent by email. Investigators searched for consensus on clinical patterns and classification. Results From 16 February to 15 May 2021, we collected 405 reactions after vaccination with the BNT162b2 (Pfizer‐BioNTech; 40·2%), mRNA‐1273 (Moderna; 36·3%) and AZD1222 (AstraZeneca; 23·5%) vaccines. Mean patient age was 50·7 years and 80·2% were female. Cutaneous reactions were classified as injection site (‘COVID arm’, 32·1%), urticaria (14·6%), morbilliform (8·9%), papulovesicular (6·4%), pityriasis rosea‐like (4·9%) and purpuric (4%) reactions. Varicella zoster and herpes simplex virus reactivations accounted for 13·8% of reactions. The COVID arm was almost exclusive to women (95·4%). The most reported reactions in each vaccine group were COVID arm (mRNA‐1273, Moderna, 61·9%), varicella zoster virus reactivation (BNT162b2, Pfizer‐BioNTech, 17·2%) and urticaria (AZD1222, AstraZeneca, 21·1%). Most reactions to the mRNA‐1273 (Moderna) vaccine were described in women (90·5%). Eighty reactions (21%) were classified as severe/very severe and 81% required treatment. Conclusions Cutaneous reactions after SARS‐CoV‐2 vaccination are heterogeneous. Most are mild‐to‐moderate and self‐limiting, although severe/very severe reactions are reported. Knowledge of these reactions during mass vaccination may help healthcare professionals and reassure patients. What is already known about this topic?In clinical trials, COVID‐19 vaccines were associated with cutaneous adverse events, especially local injection site reactions. Previous descriptions of cutaneous reactions beyond the injection site were case reports or mostly reported by non‐dermatologists and lacked clinical images.
What does this study add?We describe and classify a large, representative sample of patients with unexplained skin manifestations after COVID‐19 vaccination, using consensus to define associated morphological patterns. We describe six morphological reaction patterns and herpesvirus reactivations, and their association with demographic factors and the medical record, and provide illustrations to allow for easy recognition.
Linked Comment: V. Bataille and S. Puig. Br J Dermatol 2022; 186:15. Plain language summary available online
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Affiliation(s)
- A Català
- Servicio de Dermatología. Hospital Clínic, Barcelona, Spain
| | - C Muñoz-Santos
- Servicio de Dermatología. Hospital General de Granollers, Barcelona, Spain
| | - C Galván-Casas
- Servicio de Dermatología. Hospital Universitario de Móstoles, Madrid, Spain
| | - M Roncero Riesco
- Servicio de Dermatología. Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | - D Revilla Nebreda
- Servicio de Dermatología. Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | - A Solá-Truyols
- Servicio de Dermatología. Hospital Universitario Son Llatzer, Mallorca, Spain
| | - P Giavedoni
- Servicio de Dermatología. Hospital Clínic, Barcelona, Spain
| | - M Llamas-Velasco
- Servicio de Dermatología. Hospital Universitario de La Princesa, Madrid, Spain
| | - C González-Cruz
- Servicio de Dermatología. Hospital, Universitari Vall D'Hebron, Barcelona, Spain
| | - X Cubiró
- Servicio de Dermatología. Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - R Ruíz-Villaverde
- Servicio de Dermatología. Hospital Universitario San Cecilio, Granada, Spain
| | | | - M P Gil Mateo
- Servicio de Dermatología. Hospital General de La Palma. Santa Cruz de Tenerife, Spain
| | - D Pesqué
- Servicio de Dermatología. Hospital del Mar. IMIM, Universitat Autònoma, Barcelona, Spain
| | - O Marcantonio
- Servicio de Dermatología. Hospital del Mar. IMIM, Universitat Autònoma, Barcelona, Spain
| | | | - J Romaní
- Servicio de Dermatología, Parc Taulí Hospital Universitari. Sabadell, Barcelona, Spain
| | - N Iglesias Pena
- Servicio de Dermatología. Hospital, Universitario Lucus Augusti, Lugo, Spain
| | | | | | - G Carretero
- Servicio de Dermatología.Hospital Universitario Gran Canaria Doctor Negrín, Las Palmas Gran Canaria, Spain
| | - T Masat-Ticó
- CAP Cardedeu. Institut Català de la Salut, Barcelona, Spain
| | - P Rodríguez-Jiménez
- Servicio de Dermatología. Hospital Universitario de La Princesa, Madrid, Spain
| | - A M Gimenez-Arnau
- Servicio de Dermatología. Hospital del Mar. IMIM, Universitat Autònoma, Barcelona, Spain
| | - M Utrera-Busquets
- Servicio de Dermatología. Hospital Comarcal Infanta Elena, Huelva, Spain
| | - E Vargas Laguna
- Servicio de Dermatología. Hospital, Universitario Severo Ochoa, Madrid, Spain
| | - A G Angulo Menéndez
- Servicio de Dermatología. Serveis Medics Penedés Vilanova i la Geltrú, Barcelona, Spain
| | | | - M Iglesias-Sancho
- Servicio de Dermatología. Hospital, Universitari Sagrat Cor, Barcelona, Spain
| | - L Alonso Naranjo
- Servicio de Dermatología. Hospital Universitario de Toledo, Toledo, Spain
| | - I Hiltun
- Servicio de Dermatología, Complejo Hospitalario de Navarra, Navarra, Spain
| | - E Cutillas Marco
- Servicio de Dermatología. Hospital General, Universitario Reina Sofia, Murcia, Spain
| | | | | | - X García-Navarro
- Servicio de Dermatología. Consorci Sanitari Alt Penedès-Garraf, Barcelona, Spain
| | | | - G Baeza-Hernández
- Servicio de Dermatología. Hospital Universitario de Fuenlabrada, Madrid, Spain
| | | | | | - A Guilabert
- Servicio de Dermatología. Hospital General de Granollers, Barcelona, Spain
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Batiha GES, Alqarni M, Awad DAB, Algammal AM, Nyamota R, Wahed MII, Shah MA, Amin MN, Adetuyi BO, Hetta HF, Cruz-Martins N, Koirala N, Ghosh A, Echeverría J, Pagnossa JP, Sabatier JM. Dairy-Derived and Egg White Proteins in Enhancing Immune System Against COVID-19. Front Nutr 2021; 8:629440. [PMID: 34322507 PMCID: PMC8310913 DOI: 10.3389/fnut.2021.629440] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 06/09/2021] [Indexed: 01/08/2023] Open
Abstract
Coronavirus disease (COVID-19) is a global health challenge, caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) triggers a plethora of respiratory disturbances and even multiple organs failure that can be fatal. Nutritional intervention is one of the key components toward to a proper management of COVID-19 patients, especially in those requiring medication, and should thus be considered the first-line treatment. Immuno-modulation and -stimulation are currently being explored in COVID-19 management and are gaining interest by food and pharmaceutical industries. Various dietary combinations, bioactive components, nutrients and fortified foods have been reported to modulate inflammation during disease progression. Dietary combinations of dairy-derived products and eggs are gaining an increasing attention given the huge immunomodulatory and anti-inflammatory properties attributed to some of their chemical constituents. Eggs are complex dietary components containing many essential nutrients and bioactive compounds as well as a high-quality proteins. Similarly, yogurts can replenish beneficial bacteria and contains macronutrients capable of stimulating immunity by enhancing cell immunity, reducing oxidative stress, neutralizing inflammation and regulating the intestinal barriers and gut microbiome. Thus, this review highlights the impact of nutritional intervention on COVID-19 management, focusing on the immunomodulatory and inflammatory effects of immune-enhancing nutrients.
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Affiliation(s)
- Gaber El-Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, Damanhour, Egypt
| | - Mohammed Alqarni
- Department of Pharmaceutical Chemistry, College of Pharmacy, Taif University, Taif, Saudi Arabia
| | - Dina A B Awad
- Department of Food Hygiene, Faculty of Veterinary Medicine, Benha University, Benha, Egypt
| | - Abdelazeem M Algammal
- Department of Bacteriology, Immunology, and Mycology, Faculty of Veterinary Medicine, Suez Canal University, Ismailia, Egypt
| | - Richard Nyamota
- Department of Biochemistry and Molecular Biology, Faculty of Science, Egerton University, Njoro, Kenya
| | - Mir I I Wahed
- Department of Pharmacy, University of Rajshahi, Rajshahi, Bangladesh
| | - Muhammad Ajmal Shah
- Department of Pharmacognosy, Faculty of Pharmaceutical Sciences, Government College University, Faisalabad, Pakistan
| | - Mohammad N Amin
- Department of Pharmacy, Atish Dipankar University of Science and Technology, Dhaka, Bangladesh.,Pratyasha Health Biomedical Research Center, Dhaka, Bangladesh
| | - Babatunde O Adetuyi
- Department of Natural Sciences, Faculty of Pure and Applied Sciences, Precious Cornerstone University, Ibadan, Nigeria
| | - Helal F Hetta
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Asyut, Egypt
| | - Natália Cruz-Martins
- Faculty of Medicine, University of Porto, Porto, Portugal.,Institute for Research and Innovation in Health (i3S), University of Porto, Porto, Portugal.,Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | - Niranjan Koirala
- Department of Natural Products Research, Dr. Koirala Research Institute for Biotechnology and Biodiversity, Kathmandu, Nepal.,Laboratory of Biotechnology, Faculty of Science and Technology, University of Macau, Taipa, Macau
| | - Arabinda Ghosh
- Microbiology Division, Department of Botany, Gauhati University, Guwahati, India
| | - Javier Echeverría
- Departamento de Ciencias del Ambiente, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile
| | | | - Jean-Marc Sabatier
- Université Aix-Marseille, Institut de Neuro-Physiopathologie (INP), UMR 7051, Faculté de Pharmacie, Marseille, France
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270
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Chen C, Zhou W, Fan W, Ning X, Yang S, Lei Z, Zheng C. Association of anemia and COVID-19 in hospitalized patients. Future Virol 2021. [PMID: 34290821 PMCID: PMC8270514 DOI: 10.2217/fvl-2021-0044] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 06/14/2021] [Indexed: 11/21/2022]
Abstract
Aim: COVID-19 is a major threat to public health worldwide. A large proportion of COVID-19 patients is proved to develop anemia. Herein, we investigate the association between anemia and severe pneumonia. Materials & methods: 137 of COVID-19-confirmed patients admitted to Wuhan Union Hospital (Wuhan, China) from 13 February to 17 March 2020 were included. Their clinical characteristics and laboratory data were studied, and multivariable logistic regression analyses were performed. Results: The anemic patients were less likely to develop fever in the early stage of COVID-19. Elevated IL-6 levels were found in anemic COVID-19 patients compared with those without anemia. COVID-19 patients with anemia had an 8.2 times greater possibility of developing severe pneumonia compared with their counterparts without anemia. Conclusion: This study comprehensively describes the clinical characteristics of anemic patients with ordinary, severe and critical COVID-19 and demonstrates the close relationship between the anemia and severe COVID-19.
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Affiliation(s)
- Chong Chen
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science & Technology, 1277 Jiefang Ave., Wuhan, China
| | - Wenhui Zhou
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science & Technology, 1277 Jiefang Ave., Wuhan, China
| | - Wenliang Fan
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science & Technology, 1277 Jiefang Ave., Wuhan, China
| | - Xianying Ning
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science & Technology, 1277 Jiefang Ave., Wuhan, China
| | - Shuai Yang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science & Technology, 1277 Jiefang Ave., Wuhan, China
| | - Ziqiao Lei
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science & Technology, 1277 Jiefang Ave., Wuhan, China
| | - Chuansheng Zheng
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science & Technology, 1277 Jiefang Ave., Wuhan, China
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271
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Wang Y, Li Q, Tarimo CS, Wu C, Miao Y, Wu J. Prevalence and risk factors of worry among teachers during the COVID-19 epidemic in Henan, China: a cross-sectional survey. BMJ Open 2021; 11:e045386. [PMID: 34233970 PMCID: PMC8266429 DOI: 10.1136/bmjopen-2020-045386] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE To evaluate the level of worry and its influencing factors during the COVID-19 epidemic among teachers in Henan Province in China. STUDY DESIGN A cross-sectional study was conducted. METHODS We designed a cross-sectional survey that included 88 611 teachers from three cities in Henan Province, China between 4 February 2020 and 12 February 2020. Level of worry was measured using a five-item Likert scale, with 1 being 'not worried' and 5 being 'very worried'. The OR and 95% CI of potential influencing factors for level of worry among study participants were estimated using ordinal logistic regression models. RESULTS About 59% of teachers reported being 'very worried' about the COVID-19 epidemic. The proportion of female teachers was higher than of male teachers (60.33% vs 52.89%). In all age groups considered in this study, a 'very worried' condition accounted for the highest proportion. The age group 40-49 years had the lowest proportion of participants who were very worried, 52.34% of whom were men and 58.62% were women. After controlling for potential confounding factors, age, education level, type of teacher, school location, attention level, fear level, anxiety level and behaviour status were all related to level of worry (all p<0.05). CONCLUSION During the COVID-19 epidemic, there was a high proportion of teachers who were 'very worried' about the situation in Henan Province, China. Our study may remind policymakers to consider factors including age, educational status, type of teacher, school location, source of information on COVID-19, attention level, anxiety level, fear level and behaviour status to alleviate worry.
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Affiliation(s)
- Yanqing Wang
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Quanman Li
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Clifford Silver Tarimo
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Department of Science and Laboratory Technology, Dar es Salaam Institute of Technology, Dar es Salaam, Tanzania
| | - Cuiping Wu
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Yudong Miao
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Jian Wu
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
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272
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Nobili RM, Gambazza S, Spada MS, Tutino AL, Bulfamante AM, Mariani A, Brivio A, Moioli L, Rizzato E, Sansotta N, Claut L, Faelli N, Norsa L, Colombo C. Remote support by multidisciplinary teams: A crucial means to cope with the psychological impact of the SARS-COV-2 pandemic on patients with cystic fibrosis and inflammatory bowel disease in Lombardia. Int J Clin Pract 2021; 75:e14220. [PMID: 33848388 PMCID: PMC8250111 DOI: 10.1111/ijcp.14220] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 04/08/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND During Coronavirus Disease 2019 (COVID-19) outbreak in Lombardia, people were recommended to avoid visiting emergency departments and attending routine clinic visits. In this context, it was necessary to understand the psychological reactions of patients with chronic diseases. We evaluated the psychological effects on patients with chronic respiratory conditions and inflammatory bowel disease (IBD) through the analysis of their spontaneous contacts with their referral centres. METHODS Cross-sectional study was conducted from February 23 to April 27, 2020 in patients, or their parents, who contacted their multidisciplinary teams (MDT). E-mails and phone calls directed to the MDT of the centre for cystic fibrosis (CF) in Milano and for paediatric IBD in Bergamo, were categorised according to their contents as information on routine disease management, updates on the patient's health status, COVID-19 news monitoring, empathy towards health professionals, positive feedback and concern of contagion during the emergency. RESULTS One thousand eight hundred and sixteen contacts were collected during the study period. In Milano, where the majority of patients were affected by CF, 88.7% contacted health professionals by e-mail, with paediatricians receiving the largest volume of emails and phone calls compared with other professionals (P< .001). Compared with Milano, the centre for IBD in Bergamo recorded more expression of empathy towards health professionals and thanks for their activity in the COVID-19 emergency (52.4% vs 12.7%, P< .001), as well as positive feedback (64.3% vs 2.7%, P = .003). CONCLUSION One of the most important lessons we can learn from COVID-19 is that it is not the trauma itself that can cause psychological consequences but rather the level of balance, or imbalance, between fragility and resources. To feel safe, people need to be able to count on the help of those who represent a bulwark against the threat. This is the role played, even remotely, by health professionals.
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Affiliation(s)
- Rita Maria Nobili
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoCystic Fibrosis CentreMilanoItaly
| | - Simone Gambazza
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoCystic Fibrosis CentreMilanoItaly
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoUOC Direzione Professioni SanitarieMilanoItaly
| | | | - Anna Luisa Tutino
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoCystic Fibrosis CentreMilanoItaly
| | - Anna Marta Bulfamante
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoCystic Fibrosis CentreMilanoItaly
| | - Alessandra Mariani
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoCystic Fibrosis CentreMilanoItaly
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoUOC Direzione Professioni SanitarieMilanoItaly
| | - Anna Brivio
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoCystic Fibrosis CentreMilanoItaly
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoUOC Direzione Professioni SanitarieMilanoItaly
| | - Loredana Moioli
- Clinical Psychology UnitASST Papa Giovanni XXIIIBergamoItaly
| | - Erika Rizzato
- Clinical Psychology UnitASST Papa Giovanni XXIIIBergamoItaly
| | - Naire Sansotta
- Pediatric Hepatology, Gastroenterology and TransplantationASST Papa Giovanni XXIIIBergamoItaly
| | - Laura Claut
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoCystic Fibrosis CentreMilanoItaly
| | - Nadia Faelli
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoCystic Fibrosis CentreMilanoItaly
| | - Lorenzo Norsa
- Pediatric Hepatology, Gastroenterology and TransplantationASST Papa Giovanni XXIIIBergamoItaly
| | - Carla Colombo
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoCystic Fibrosis CentreMilanoItaly
- Department of Pathophysiology and TransplantationUniversità degli Studi di MilanoMilanoItaly
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273
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Large variations in disease severity, death and ICU admission of 2993 patients infected with SARS-CoV-2: The potential impact of genetic vulnerability. J Infect Public Health 2021; 14:886-891. [PMID: 34118740 PMCID: PMC8061633 DOI: 10.1016/j.jiph.2021.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 03/23/2021] [Accepted: 04/11/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has had an immeasurable impact, affecting healthcare systems, the global economy, and society. Exploration of trends within the existing COVID-19 data may guide directions for further study and novel treatment development. As the world faces COVID-19 disease, it is essential to study its epidemiological and clinical characteristics further to better understand and aid in its detection and containment. METHODS We aimed to study the clinical characteristics of patients infected with COVID-19 in Dubai, a multi-national Society. RESULTS Our findings demonstrate that during the first wave of the COVID-19 epidemic, age, gender, and country of origin were associated with more severe cases of COVID-19, higher risk for hospitalization and death. Male individuals between 41 and 60 years of age from India had the most significant hospitalization and death predictor (p=.0001). The predictors for COVID-19 related deaths were slightly less than UAE Nationals by individuals from GCC (p=.02) that were followed closely behind by Pilipino (p=.02) and Arabs (p=.001). CONCLUSION The vulnerability of individuals to infection and in the spectrum of COVID-19 symptoms remains to be understood. There are large variations in disease severity, one component of which may be genetic variability in responding to the virus. Genomics of susceptibility to COVID-19 infection and the wide variation in clinical response to COVID-19 in patients should become active investigation areas.
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274
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Di Capua M, Conca A, Testa S, Mascolo M, Paglia S. Refractory thrombocytopenia in a severe COVID-19 patient. GERIATRIC CARE 2021. [DOI: 10.4081/gc.2021.9614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Severe acute respiratory syndromerelated coronavirus 2 (SARS-CoV-2) infection has spread worldwide. The most of patients presents fever, dyspnea and cough as a typical viral infection, others show peculiar clinical and laboratory signs, such as anosmia, ageusia and thrombocytopenia. We here describe a severe coronavirus disease 2019 patient (76-year old, male) that developed an immune thrombocytopenia and acquired pseudo-thrombocytopenia that were refractory to immunomodulators even after resolution of respiratory failure. The patient developed thrombocytopenia (platelets 88,000/mm3) that got worse the following day (14,000/mm3). We started 1 mg/kg of methylprednisolone i.v. daily. Platelet count increased up to 209,000/mm3, in sodium citrate, but remained about 14,000/mm3 in EDTA 10 days after the beginning of methylprednisolone. The patient showed great improvement in respiratory parameters and radiological finding. About one week after he developed a thrombocytopenia up to 70,000/mm3. We did not modify the steroids dosage. Platelet count slowly began to increase and in about 10 days returned to normal values.
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275
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DURMAZPINAR PM, SEZGİN G. Characteristics and Coronavirus Anxiety Levels of Endodontic Patients During the Covid-19 Pandemic. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2021. [DOI: 10.33808/clinexphealthsci.938847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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276
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Marinaci T, Venuleo C, Savarese G. The COVID-19 Pandemic from the Health Workers’ Perspective: Between Health Emergency and Personal Crisis. HUMAN ARENAS 2021. [PMCID: PMC8220108 DOI: 10.1007/s42087-021-00232-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/29/2022]
Abstract
AbstractDifferent scholars have emphasised the psychological distress experienced by health workers during the COVID-19 pandemic; however, there are almost no qualitative studies and we know very little about the everyday experience of this group. The present study’s goal was to explore how health workers interpreted the meaning of the pandemic crisis in their life. An online survey was available during the Italian lockdown. Respondents were asked to write a passage about the meaning of living in the time of COVID-19. A total number of 130 questionnaires (M = 42.35; DS = 10.52; women: 56.2%) were collected. The Automated Method for Content Analysis (ACASM) procedure was applied to the collected texts to detect the factorial dimensions underpinning (dis)similarities in the respondents’ narratives. Such factors were interpreted as the markers of latent dimensions of meanings (DS). The two main DS that emerged were characterised by the pertinentisation of two extremely basic issues: what the pandemic represents (health emergency versus personal crisis) and its impact (powerlessness versus discovery of new meanings). On the whole, health workers’ narratives help to highlight the risk of normalising the feelings of fear and impotence experienced when facing the health emergency and the need to recognise that such feelings are strictly intertwined with the limited resources received to “face the battle”; the need to recognize the human vulnerability of the women and men “inside the lab coat” and the human effort to maintain or reconstruct a sense of self and purpose in the face of troubled circumstances.
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277
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Aquino-Jarquin G. Recent progress on rapid SARS-CoV-2/COVID-19 detection by CRISPR-Cas13-based platforms. Drug Discov Today 2021; 26:2025-2035. [PMID: 34147688 PMCID: PMC8216859 DOI: 10.1016/j.drudis.2021.06.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 03/10/2021] [Accepted: 06/11/2021] [Indexed: 12/11/2022]
Abstract
The limitations of conventional diagnostic procedures, such as real-time PCR-based methods and serological tests, have led the scientific community to innovate alternative nucleic acid detection approaches for SARS-CoV-2 RNA, thereby addressing the dire need for increased testing. Such approaches aim to provide rapid, accurate, cost-effective, sensitive, and high-throughput detection of SARS-CoV-2 RNA, on multiple specimen types, and without specialized equipment and expertise. The CRISPR-Cas13 system functions as a sequence-specific RNA-sensing tool that has recently been harnessed to develop simplified and flexible testing formats. This review recapitulates technical advances in the most recent CRISPR-Cas13-based methods for SARS-CoV-2/COVID-19 diagnosis. The challenges and opportunities for implementing mass testing using these novel CRISPR-Cas13 platforms are critically analyzed.
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Affiliation(s)
- Guillermo Aquino-Jarquin
- Laboratorio de Investigación en Genómica, Genética y Bioinformática, Hospital Infantil de México, Federico Gómez, Ciudad de México, Mexico; Departamento de Ciencias Naturales, Unidad Cuajimalpa, Universidad Autónoma Metropolitana, Ciudad de México, Mexico.
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Predictive Value of Comorbid Conditions for COVID-19 Mortality. J Clin Med 2021; 10:jcm10122652. [PMID: 34208640 PMCID: PMC8233968 DOI: 10.3390/jcm10122652] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 06/12/2021] [Accepted: 06/14/2021] [Indexed: 12/12/2022] Open
Abstract
In this paper, we aim at understanding the broad spectrum of factors influencing the survival of infected patients and the correlations between these factors to create a predictive probabilistic score for surviving the COVID-19 disease. Initially, 510 hospital admissions were counted in the study, out of which 310 patients did not survive. A prediction model was developed based on this data by using a Bayesian approach. Following the data collection process for the development study, the second cohort of patients totaling 541 was built to validate the risk matrix previously created. The final model has an area under the curve of 0.773 and predicts the mortality risk of SARS-CoV-2 infection based on nine disease groups while considering the gender and age of the patient as distinct risk groups. To ease medical workers’ assessment of patients, we created a visual risk matrix based on a probabilistic model, ranging from a score of 1 (very low mortality risk) to 5 (very high mortality risk). Each score comprises a correlation between existing comorbid conditions, the number of comorbid conditions, gender, and age group category. This clinical model can be generalized in a hospital context and can be used to identify patients at high risk for whom immediate intervention might be required.
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279
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Habeebullah TM, Abd El-Rahim IHA, Morsy EA. Impact of outdoor and indoor meteorological conditions on the COVID-19 transmission in the western region of Saudi Arabia. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2021; 288:112392. [PMID: 33765578 PMCID: PMC7980220 DOI: 10.1016/j.jenvman.2021.112392] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 03/07/2021] [Accepted: 03/07/2021] [Indexed: 05/24/2023]
Abstract
Meteorological conditions may influence the incidence of many infectious diseases. Coronavirus disease-2019 (COVID-19) is a highly contagious, air-borne, emerging, viral disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). In 2020, the COVID-19 global pandemic affected more than 210 countries and territories worldwide including Saudi Arabia. There are contradictory research papers about the correlation between meteorological parameters and incidence of COVID-19 in some countries worldwide. The current study investigates the impact of outdoor and indoor meteorological conditions on the daily recorded COVID-19 cases in western region (Makkah and Madinah cities) of Saudi Arabia over a period of 8 months from March to October 2020. Reports of the daily confirmed COVID-19 cases from the webpage of Saudi Ministry of Health (MOH) were used. Considering, the incubation period of COVID-19 which ranged from 2 to 14 days, the relationships between daily COVID-19 cases and outdoor meteorological factors (temperature, relative humidity, and wind speed) using a lag time of 10 days are investigated. The results showed that the highest daily COVID-19 cases in Makkah and Madinah were reported during the hottest months of the year (April-July 2020) when outdoor temperature ranged from 26.51 to 40.71 °C in Makkah and of 23.89-41.20 °C in Madinah, respectively. Partial negative correlation was detected between outdoor relative humidity and daily recorded COVID-19 cases. No obvious correlation could be demonstrated between wind speed and daily COVID-19 cases. This indicated that most of SARS-CoV-2 infection occurred in the cool, air-conditioned, dry, and bad-ventilated indoor environment in the investigated cities. These results will help the epidemiologists to understand the correlation between both outdoor and indoor meteorological conditions and SARS-CoV-2 transmissibility. These findings would be also a useful supplement to assist the local healthcare policymakers to implement and apply a specific preventive measures and education programs for controlling of COVID-19 transmission.
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Affiliation(s)
- Turki M Habeebullah
- Department of Environmental and Health Research, Umm Al-Qura University, P.O. Box 6287, 21955, Makkah Al-Mukaramah, Saudi Arabia
| | - Ibrahim H A Abd El-Rahim
- Department of Environmental and Health Research, Umm Al-Qura University, P.O. Box 6287, 21955, Makkah Al-Mukaramah, Saudi Arabia; Infectious Diseases, Department of Animal Medicine, Faculty of Veterinary Medicine, Assiut University, 71526, Assiut, Egypt.
| | - Essam A Morsy
- Department of Environmental and Health Research, Umm Al-Qura University, P.O. Box 6287, 21955, Makkah Al-Mukaramah, Saudi Arabia; Geophysics Department, Faculty of Science, Cairo University, Egypt
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280
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Ghazanfari M, Arastehfar A, Davoodi L, Yazdani Charati J, Moazeni M, Abastabar M, Haghani I, Mirzakhani R, Mayahi S, Fang W, Liao W, Nguyen MH, Perlin DS, Hoenigl M, Pan W, Hedayati MT. Pervasive but Neglected: A Perspective on COVID-19-Associated Pulmonary Mold Infections Among Mechanically Ventilated COVID-19 Patients. Front Med (Lausanne) 2021; 8:649675. [PMID: 34195207 PMCID: PMC8236642 DOI: 10.3389/fmed.2021.649675] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 05/03/2021] [Indexed: 12/12/2022] Open
Abstract
Background: Recent studies from multiple countries have shown a high prevalence of coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) among severely ill patients. Despite providing valuable insight into the clinical management of CAPA, large-scale prospective studies are limited. Here, we report on one of the largest multicenter epidemiological studies to explore the clinical features and prevalence of COVID-19-associated pulmonary mold infections (CAPMIs) among mechanically ventilated patients. Methods: Bronchoalveolar lavage (BAL) and serum samples were collected for culture, galactomannan (GM), and β-D-glucan (BDG) testing. Patients were classified as probable CAPMI based on the presence of host factors, radiological findings, and mycological criteria. Results: During the study period, 302 COVID-19 patients were admitted to intensive care units (ICUs), among whom 105 were mechanically ventilated for ≥4 days. Probable CAPMI was observed among 38% of patients (40/105), among whom BAL culture of 29 patients turned positive for molds, while galactomannan testing on BAL (GM index ≥1) and serum (GM index >0.5) samples were positive for 60% (24/40) and 37.5% (15/39) of patients, respectively. Aspergillus (22/29; 75.8%) and Fusarium (6/29; 20.6%) constituted 96.5% of the molds isolated. Diaporthe foeniculina was isolated from a COVID-19 patient. None of the patients who presented with CAPMI were treated with antifungal drugs. Conclusion: Despite being prevalent, the absence of appropriate antifungal treatment highlights that CAPMI is a neglected complication among mechanically ventilated COVID-19 patients admitted to ICUs. CAPMI can be caused by species other than Aspergillus.
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Affiliation(s)
- Mona Ghazanfari
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Amir Arastehfar
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ, United States
| | - Lotfollah Davoodi
- Antimicrobial Resistance Research Center/Department of Infectious Diseases, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Jamshid Yazdani Charati
- Department of Biostatistics, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Maryam Moazeni
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahdi Abastabar
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Iman Haghani
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Roghayeh Mirzakhani
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Sabah Mayahi
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Wenjie Fang
- Medical Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Wanqing Liao
- Medical Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - M Hong Nguyen
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - David S Perlin
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ, United States
| | - Martin Hoenigl
- Clinical and Translational Fungal-Working Group, University of California, San Diego, La Jolla, CA, United States.,Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria.,Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, San Diego, CA, United States
| | - Weihua Pan
- Medical Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Mohammad T Hedayati
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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281
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Ghazanfari M, Arastehfar A, Davoodi L, Yazdani Charati J, Moazeni M, Abastabar M, Haghani I, Mirzakhani R, Mayahi S, Fang W, Liao W, Nguyen MH, Perlin DS, Hoenigl M, Pan W, Hedayati MT. Pervasive but Neglected: A Perspective on COVID-19-Associated Pulmonary Mold Infections Among Mechanically Ventilated COVID-19 Patients. Front Med (Lausanne) 2021; 8:649675. [PMID: 34195207 PMCID: PMC8236642 DOI: 10.3389/fmed.2021.649675; doi: 10.3389/fmed.2021.649675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 05/03/2021] [Indexed: 09/17/2023] Open
Abstract
Background: Recent studies from multiple countries have shown a high prevalence of coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) among severely ill patients. Despite providing valuable insight into the clinical management of CAPA, large-scale prospective studies are limited. Here, we report on one of the largest multicenter epidemiological studies to explore the clinical features and prevalence of COVID-19-associated pulmonary mold infections (CAPMIs) among mechanically ventilated patients. Methods: Bronchoalveolar lavage (BAL) and serum samples were collected for culture, galactomannan (GM), and β-D-glucan (BDG) testing. Patients were classified as probable CAPMI based on the presence of host factors, radiological findings, and mycological criteria. Results: During the study period, 302 COVID-19 patients were admitted to intensive care units (ICUs), among whom 105 were mechanically ventilated for ≥4 days. Probable CAPMI was observed among 38% of patients (40/105), among whom BAL culture of 29 patients turned positive for molds, while galactomannan testing on BAL (GM index ≥1) and serum (GM index >0.5) samples were positive for 60% (24/40) and 37.5% (15/39) of patients, respectively. Aspergillus (22/29; 75.8%) and Fusarium (6/29; 20.6%) constituted 96.5% of the molds isolated. Diaporthe foeniculina was isolated from a COVID-19 patient. None of the patients who presented with CAPMI were treated with antifungal drugs. Conclusion: Despite being prevalent, the absence of appropriate antifungal treatment highlights that CAPMI is a neglected complication among mechanically ventilated COVID-19 patients admitted to ICUs. CAPMI can be caused by species other than Aspergillus.
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Affiliation(s)
- Mona Ghazanfari
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Amir Arastehfar
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ, United States
| | - Lotfollah Davoodi
- Antimicrobial Resistance Research Center/Department of Infectious Diseases, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Jamshid Yazdani Charati
- Department of Biostatistics, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Maryam Moazeni
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahdi Abastabar
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Iman Haghani
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Roghayeh Mirzakhani
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Sabah Mayahi
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Wenjie Fang
- Medical Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Wanqing Liao
- Medical Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - M. Hong Nguyen
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - David S. Perlin
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ, United States
| | - Martin Hoenigl
- Clinical and Translational Fungal-Working Group, University of California, San Diego, La Jolla, CA, United States
- Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, San Diego, CA, United States
| | - Weihua Pan
- Medical Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Mohammad T. Hedayati
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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282
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Lee DS, Jeong JB, Kim JW, Lee KL, Kim BG, Kim SH, Kang HW. Investigation of droplets released during digestive endoscopy using a high-speed camera (with video): a pilot study. Surg Endosc 2021; 35:5392-5396. [PMID: 34115216 PMCID: PMC8194380 DOI: 10.1007/s00464-021-08581-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 06/02/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND A large release of droplets is often expected around the periphery of the digestive endoscope insertion site. Therefore, a sense of alarm over infection because of droplets that may be released during digestive endoscopy examination is increasing. This study aimed to investigate the droplets released during digestive endoscopy using a high-speed camera. METHODS We utilized a high-speed camera (FASTCAM SA-3, Photron Limited) capable of recording small, transparent droplets with a black background and high-brightness lighting. The obtained video files were analyzed using post-processing software. We divided the 20 models into the control (a spray bottle model and a cough model) and experimental groups (digestive endoscopy models). The sedative, proficiency of digestive endoscopy and the amount of gas injected were modulated to change the level of released droplets. RESULTS For the control groups, droplets were clearly observed using a high-speed camera. However, no droplet larger than 10 µm in size was observed in the experimental groups. Furthermore, the changes in the sedative, proficiency of digestive endoscopy, and amount of gas injected did not affect droplet formation. CONCLUSIONS Based on high-speed camera photography, the risk of droplet generation during digestive endoscopy was not higher than that during violent expiratory events, such as coughing and sneezing.
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Affiliation(s)
- Dong Seok Lee
- Department of Gastroenterology, Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Ji Bong Jeong
- Department of Gastroenterology, Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Ji Won Kim
- Department of Gastroenterology, Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.
| | - Kook Lae Lee
- Department of Gastroenterology, Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Byeong Gwan Kim
- Department of Gastroenterology, Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Su Hwan Kim
- Department of Gastroenterology, Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Hyoun Woo Kang
- Department of Gastroenterology, Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
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283
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Gwak DW, Hwang JM. Step-by-step inpatient rehabilitation for critical illness after coronavirus disease 2019: A CARE-compliant case report. Medicine (Baltimore) 2021; 100:e26317. [PMID: 34115043 PMCID: PMC8202574 DOI: 10.1097/md.0000000000026317] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 05/17/2021] [Accepted: 05/25/2021] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Since the coronavirus disease (COVID-19) outbreak in Wuhan, China, in December 2019, COVID-19 has become a worldwide pandemic. Muscle weakness and deconditioning caused by COVID-19-induced critical illness requires rehabilitation. PATIENT CONCERNS A 74-year-old male patient complained of general weakness after COVID-19, requiring ventilator treatment. DIAGNOSIS He was confirmed as having COVID-19 using a polymerase chain reaction test. INTERVENTIONS During admission in the intensive care unit, medical staff wearing level D protective equipment performed the bedside manual range of motion exercise. After a negative COVID-19 test, the patient was transferred to a general ward, where sitting balance training and pulmonary rehabilitation were additionally performed by rehabilitation therapists wearing protective gear. When the patient was able to stand up with support, standing balance training and sit-to-stand training were performed. OUTCOMES After a month of rehabilitation, the patient could sit alone, but he needed help with standing balance. The Berg Balance Scale score improved from 0 to 4, and the Modified Barthel Index score improved from 8 to 18. He was able to breathe in room air without an oxygen supply. LESSONS This case report shows an example of how safe and effective rehabilitation can be provided to COVID-19 patients.
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Affiliation(s)
- Dae-Won Gwak
- Department of Rehabilitation Medicine, Kyungpook National University Hospital
| | - Jong-Moon Hwang
- Department of Rehabilitation Medicine, Kyungpook National University Hospital
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
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284
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Lévy Y, Wiedemann A, Hejblum BP, Durand M, Lefebvre C, Surénaud M, Lacabaratz C, Perreau M, Foucat E, Déchenaud M, Tisserand P, Blengio F, Hivert B, Gauthier M, Cervantes-Gonzalez M, Bachelet D, Laouénan C, Bouadma L, Timsit JF, Yazdanpanah Y, Pantaleo G, Hocini H, Thiébaut R. CD177, a specific marker of neutrophil activation, is associated with coronavirus disease 2019 severity and death. iScience 2021; 24:102711. [PMID: 34127958 PMCID: PMC8189740 DOI: 10.1016/j.isci.2021.102711] [Citation(s) in RCA: 73] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/26/2021] [Accepted: 06/08/2021] [Indexed: 01/03/2023] Open
Abstract
The identification of patients with coronavirus disease 2019 and high risk of severe disease is a challenge in routine care. We performed cell phenotypic, serum, and RNA sequencing gene expression analyses in severe hospitalized patients (n = 61). Relative to healthy donors, results showed abnormalities of 27 cell populations and an elevation of 42 cytokines, neutrophil chemo-attractants, and inflammatory components in patients. Supervised and unsupervised analyses revealed a high abundance of CD177, a specific neutrophil activation marker, contributing to the clustering of severe patients. Gene abundance correlated with high serum levels of CD177 in severe patients. Higher levels were confirmed in a second cohort and in intensive care unit (ICU) than non-ICU patients (P < 0.001). Longitudinal measurements discriminated between patients with the worst prognosis, leading to death, and those who recovered (P = 0.01). These results highlight neutrophil activation as a hallmark of severe disease and CD177 assessment as a reliable prognostic marker for routine care.
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Affiliation(s)
- Yves Lévy
- Vaccine Research Institute, Université Paris-Est Créteil, Faculté de Médecine, INSERM U955, Team 16, Hopital Henri Mondor, 51 Av Marechal de Lattre de Tassigny, 94010 Créteil, France,Assistance Publique-Hôpitaux de Paris, Groupe Henri-Mondor Albert-Chenevier, Service Immunologie Clinique, Créteil, France,Corresponding author
| | - Aurélie Wiedemann
- Vaccine Research Institute, Université Paris-Est Créteil, Faculté de Médecine, INSERM U955, Team 16, Hopital Henri Mondor, 51 Av Marechal de Lattre de Tassigny, 94010 Créteil, France
| | - Boris P. Hejblum
- Vaccine Research Institute, Université Paris-Est Créteil, Faculté de Médecine, INSERM U955, Team 16, Hopital Henri Mondor, 51 Av Marechal de Lattre de Tassigny, 94010 Créteil, France,Univ. Bordeaux, Department of Public Health, INSERM U1219 Bordeaux Population Health Research Centre, Inria SISTM, UMR 1219, 146 Rue Leo Saignat, 33076 Bordeaux, France
| | - Mélany Durand
- Vaccine Research Institute, Université Paris-Est Créteil, Faculté de Médecine, INSERM U955, Team 16, Hopital Henri Mondor, 51 Av Marechal de Lattre de Tassigny, 94010 Créteil, France,Univ. Bordeaux, Department of Public Health, INSERM U1219 Bordeaux Population Health Research Centre, Inria SISTM, UMR 1219, 146 Rue Leo Saignat, 33076 Bordeaux, France
| | - Cécile Lefebvre
- Vaccine Research Institute, Université Paris-Est Créteil, Faculté de Médecine, INSERM U955, Team 16, Hopital Henri Mondor, 51 Av Marechal de Lattre de Tassigny, 94010 Créteil, France
| | - Mathieu Surénaud
- Vaccine Research Institute, Université Paris-Est Créteil, Faculté de Médecine, INSERM U955, Team 16, Hopital Henri Mondor, 51 Av Marechal de Lattre de Tassigny, 94010 Créteil, France
| | - Christine Lacabaratz
- Vaccine Research Institute, Université Paris-Est Créteil, Faculté de Médecine, INSERM U955, Team 16, Hopital Henri Mondor, 51 Av Marechal de Lattre de Tassigny, 94010 Créteil, France
| | - Matthieu Perreau
- Swiss Vaccine Research Institute, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Emile Foucat
- Vaccine Research Institute, Université Paris-Est Créteil, Faculté de Médecine, INSERM U955, Team 16, Hopital Henri Mondor, 51 Av Marechal de Lattre de Tassigny, 94010 Créteil, France
| | - Marie Déchenaud
- Vaccine Research Institute, Université Paris-Est Créteil, Faculté de Médecine, INSERM U955, Team 16, Hopital Henri Mondor, 51 Av Marechal de Lattre de Tassigny, 94010 Créteil, France
| | - Pascaline Tisserand
- Vaccine Research Institute, Université Paris-Est Créteil, Faculté de Médecine, INSERM U955, Team 16, Hopital Henri Mondor, 51 Av Marechal de Lattre de Tassigny, 94010 Créteil, France
| | - Fabiola Blengio
- Vaccine Research Institute, Université Paris-Est Créteil, Faculté de Médecine, INSERM U955, Team 16, Hopital Henri Mondor, 51 Av Marechal de Lattre de Tassigny, 94010 Créteil, France
| | - Benjamin Hivert
- Univ. Bordeaux, Department of Public Health, INSERM U1219 Bordeaux Population Health Research Centre, Inria SISTM, UMR 1219, 146 Rue Leo Saignat, 33076 Bordeaux, France
| | - Marine Gauthier
- Univ. Bordeaux, Department of Public Health, INSERM U1219 Bordeaux Population Health Research Centre, Inria SISTM, UMR 1219, 146 Rue Leo Saignat, 33076 Bordeaux, France
| | - Minerva Cervantes-Gonzalez
- AP-HP, Hôpital Bichat, Département Épidémiologie Biostatistiques et Recherche Clinique, INSERM, Centre d’Investigation clinique-Epidémiologie Clinique 1425, F-75018 Paris, France,AP-HP, Hôpital Bichat, Service de Maladies Infectieuses et Tropicales, F-75018 Paris, France,Université de Paris, INSERM, IAME UMR 1137, F-75018 Paris, France
| | - Delphine Bachelet
- AP-HP, Hôpital Bichat, Département Épidémiologie Biostatistiques et Recherche Clinique, INSERM, Centre d’Investigation clinique-Epidémiologie Clinique 1425, F-75018 Paris, France,Université de Paris, INSERM, IAME UMR 1137, F-75018 Paris, France
| | - Cédric Laouénan
- AP-HP, Hôpital Bichat, Département Épidémiologie Biostatistiques et Recherche Clinique, INSERM, Centre d’Investigation clinique-Epidémiologie Clinique 1425, F-75018 Paris, France,Université de Paris, INSERM, IAME UMR 1137, F-75018 Paris, France
| | - Lila Bouadma
- APHP- Hôpital Bichat – Médecine Intensive et Réanimation des Maladies Infectieuses, Paris, France
| | - Jean-François Timsit
- APHP- Hôpital Bichat – Médecine Intensive et Réanimation des Maladies Infectieuses, Paris, France
| | - Yazdan Yazdanpanah
- AP-HP, Hôpital Bichat, Service de Maladies Infectieuses et Tropicales, F-75018 Paris, France,Université de Paris, INSERM, IAME UMR 1137, F-75018 Paris, France
| | - Giuseppe Pantaleo
- Vaccine Research Institute, Université Paris-Est Créteil, Faculté de Médecine, INSERM U955, Team 16, Hopital Henri Mondor, 51 Av Marechal de Lattre de Tassigny, 94010 Créteil, France,Swiss Vaccine Research Institute, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland,Immunology and Allergy Service, Department of Medicine, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Hakim Hocini
- Vaccine Research Institute, Université Paris-Est Créteil, Faculté de Médecine, INSERM U955, Team 16, Hopital Henri Mondor, 51 Av Marechal de Lattre de Tassigny, 94010 Créteil, France
| | - Rodolphe Thiébaut
- Vaccine Research Institute, Université Paris-Est Créteil, Faculté de Médecine, INSERM U955, Team 16, Hopital Henri Mondor, 51 Av Marechal de Lattre de Tassigny, 94010 Créteil, France,Univ. Bordeaux, Department of Public Health, INSERM U1219 Bordeaux Population Health Research Centre, Inria SISTM, UMR 1219, 146 Rue Leo Saignat, 33076 Bordeaux, France,CHU de Bordeaux, Pôle de Santé Publique, Service d’Information Médicale, Bordeaux, France,Corresponding author
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Clinical and radiological findings for the new multisystem inflammatory syndrome in children associated with COVID-19. RADIOLOGIA 2021; 63:334-344. [PMID: 34246424 PMCID: PMC8179117 DOI: 10.1016/j.rxeng.2021.03.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 03/01/2021] [Indexed: 12/14/2022]
Abstract
The World Health Organization defines the multisystem inflammatory syndrome in children (MIS-C) as a new syndrome reported in patients aged <19 years old who have a history of exposure to SARS-CoV-2. The onset of this syndrome is characterized by persistent fever that is associated with lethargy, abdominal pain, vomiting and/or diarrhea, and, less frequently, rash and conjunctivitis. The course and severity of the signs and symptoms vary; in some children, MIS-C worsens rapidly and can lead to hypotension, cariogenic shock, or even damage to multiple organs. The characteristic laboratory findings are elevated markers of inflammation and heart dysfunction. The most common radiological findings are cardiomegaly, pleural effusion, signs of heart failure, ascites, and inflammatory changes in the right iliac fossa. In the context of the current COVID-19 pandemic, radiologists need to know the clinical, laboratory, and radiological characteristics of this syndrome to ensure the correct diagnosis.
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286
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Assar S, Pournazari M, Soufivand P, Mohamadzadeh D, Sanaee S. Microscopic polyangiitis associated with coronavirus disease-2019 (COVID-19) infection in an elderly male. THE EGYPTIAN RHEUMATOLOGIST 2021; 43:225-228. [PMID: 38620809 PMCID: PMC7942159 DOI: 10.1016/j.ejr.2021.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 03/02/2021] [Indexed: 01/14/2023]
Abstract
Background Microscopic polyangiitis (MPA) is an antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) that affects predominantly small- sized vessels. A causal relationship between viral infections and vasculitis has been postulated.Aim of the workTo present the concomitant association of coronavirus disease 2019 (COVID-19) infection with MPA in an elderly Iranian male. Case presentation A 67 year old Iranian man with the history of COVID-19 infection and a positive polymerized chain reaction (PCR) test four weeks before admission to the neurology department with acute onset pain, numbness and progressive weakness in both hands grip, sudden left foot drop and paresthesia. Erythrocyte sedimentation rate (ESR) was 95 mm/hr, ferritin 912 ng/ml and C-reactive protein (CRP) positive, proteinuria 1.1 g/24 h and markedly elevated perinuclear (P-ANCA): 526 IU/ml. Diagnosis of MPA was held presenting with mononeuritis multiplex, glomerulonephritis followed by diffuse alveolar hemorrhage and infiltration of lymphocytes in muscle fibers and vessels wall in sural nerve biopsy. He was successfully treated by methylprednisolone (1 g/day for 3 days) followed by 1 mg/kg with gradual tapering along with cyclophosphamide (CYC) (2 mg/kg). Intravenous immunoglobulin (IVIG, 2 g/kg in four divided doses) started for the management of inflammatory mononeuritis multiplex with gradual improvement. During hospitalization, plasmapheresis was performed due to alveolar hemorrhage for 5 day. The patient returned home on day 32 and followed-up in the rheumatology clinic with improvement of muscle power and handgrip strength. Conclusion Vasculitis is potentially one of COVID-19's presenting symptoms and prompt diagnosis and treatment is crucial in improving outcome of patients.
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Affiliation(s)
- Shirin Assar
- Rheumatology Department, Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mehran Pournazari
- Rheumatology Department, Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Parviz Soufivand
- Rheumatology Department, Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Dena Mohamadzadeh
- Rheumatology Department, Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Simindokht Sanaee
- Rheumatology Department, Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
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287
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Pieren DKJ, Smits NAM, Hoeboer J, Kandiah V, Postel RJ, Mariman R, Beek J, Baarle D, Wit J, Guichelaar T. Regulatory KIR + RA + T cells accumulate with age and are highly activated during viral respiratory disease. Aging Cell 2021; 20:e13372. [PMID: 34043881 PMCID: PMC8208794 DOI: 10.1111/acel.13372] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 03/18/2021] [Accepted: 04/06/2021] [Indexed: 12/14/2022] Open
Abstract
Severe respiratory viral infectious diseases such as influenza and COVID‐19 especially affect the older population. This is partly ascribed to diminished CD8+ T‐cell responses a result of aging. The phenotypical diversity of the CD8+ T‐cell population has made it difficult to identify the impact of aging on CD8+ T‐cell subsets associated with diminished CD8+ T‐cell responses. Here we identify a novel human CD8+ T‐cell subset characterized by expression of Killer‐cell Immunoglobulin‐like Receptors (KIR+) and CD45RA (RA+). These KIR+RA+ T cells accumulated with age in the blood of healthy individuals (20–82 years of age, n = 50), expressed high levels of aging‐related markers of T‐cell regulation, and were functionally capable of suppressing proliferation of other CD8+ T cells. Moreover, KIR+RA+ T cells were a major T‐cell subset becoming activated in older adults suffering from an acute respiratory viral infection (n = 36), including coronavirus and influenza virus infection. In addition, older adults with influenza A infection showed that higher activation status of their KIR+RA+ T cells associated with longer duration of respiratory symptoms. Together, our data indicate that KIR+RA+ T cells are a unique human T‐cell subset with regulatory properties that may explain susceptibility to viral respiratory disease at old age.
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Affiliation(s)
- Daan K. J. Pieren
- Centre for Infectious Disease Control National Institute for Public Health and the Environment Bilthoven The Netherlands
| | - Noortje A. M. Smits
- Centre for Infectious Disease Control National Institute for Public Health and the Environment Bilthoven The Netherlands
| | - Jeroen Hoeboer
- Centre for Infectious Disease Control National Institute for Public Health and the Environment Bilthoven The Netherlands
| | - Vinitha Kandiah
- Centre for Infectious Disease Control National Institute for Public Health and the Environment Bilthoven The Netherlands
| | - Rimke J. Postel
- Centre for Infectious Disease Control National Institute for Public Health and the Environment Bilthoven The Netherlands
| | - Rob Mariman
- Centre for Infectious Disease Control National Institute for Public Health and the Environment Bilthoven The Netherlands
| | - Josine Beek
- Centre for Infectious Disease Control National Institute for Public Health and the Environment Bilthoven The Netherlands
| | - Debbie Baarle
- Centre for Infectious Disease Control National Institute for Public Health and the Environment Bilthoven The Netherlands
- Center for Translational Immunology University Medical Center Utrecht Utrecht University Utrecht The Netherlands
| | - Jelle Wit
- Centre for Infectious Disease Control National Institute for Public Health and the Environment Bilthoven The Netherlands
| | - Teun Guichelaar
- Centre for Infectious Disease Control National Institute for Public Health and the Environment Bilthoven The Netherlands
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288
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Willschke H, Wochele-Thoma T, Atanasov AG, Klager E, Haslinger C, Kletecka-Pulker M, Laxar D, Ay C, Öhlinger T, Kimberger O, Steinrigl A, Holzer B, Heger F, Indra A. Can We Protect Those We Care for in A Pandemic? - Prevalence of Neutralizing Antibodies against SARS-CoV-2 in Nursing Homes. Aging Dis 2021; 12:710-717. [PMID: 34094636 PMCID: PMC8139192 DOI: 10.14336/ad.2021.0217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 02/17/2021] [Indexed: 01/08/2023] Open
Abstract
In December 2019, the People's Republic of China and the World Health Organization first reported on a cluster of pneumonia with an unknown cause. Nine months later more than 1.4 million people have died from COVID 19. In this work, the effects of the COVID 19 pandemic on five nursing homes in Austria, which cared for 889 residents in the first half of 2020, were examined. The research question was whether the measures taken were appropriate to prevent an outbreak within the individual facilities. To detect previously unrecognized infections, the present study evaluated the prevalence of neutralizing antibodies against the SARS-CoV-2 virus in residents and employees of the nursing homes. Following the analysis of blood samples, the prospectively collected data was connected to data from screening examinations and data from contact tracing. The present study demonstrated an overall prevalence of neutralizing antibodies against the SARS-CoV-2 virus in nursing homes of 3.7%. Whereas the prevalence in those facilities that have never been hit by an outbreak is 0%, the prevalence in those facilities with an outbreak is up to 4.9%. Neutralizing antibodies against SARS-CoV-2 were detected in 35 persons. A retrospective analysis of all 5 included nursing homes demonstrated that upon regular clinical screening in combination with PCRs an infection with SARS-COV-2 was detected in 66 residents and 24 employees from different professional groups. In only 25 of the 35 persons with neutralizing antibodies against SARS-CoV-2 an infection was proven in advance. This study suggests that specific measures can prevent transmission within a health care facility. Nevertheless, the results also show that a risk reduction to 0% cannot be achieved. In preparation for further pandemic waves there is still the need to reduce the probability of a transmission in nursing homes with specific test strategies.
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Affiliation(s)
- Harald Willschke
- 1Ludwig Boltzmann Institute of Digital Health and Patient Safety, Vienna, Austria.,2Department of Anaesthesia and General Intensive Care, Medical University Vienna, Austria
| | - Thomas Wochele-Thoma
- 1Ludwig Boltzmann Institute of Digital Health and Patient Safety, Vienna, Austria.,3Caritas Erzdiözese Wien, Vienna, Austria
| | - Atanas G Atanasov
- 1Ludwig Boltzmann Institute of Digital Health and Patient Safety, Vienna, Austria.,4Institute of Genetics and Animal Biotechnology of the Polish Academy of Sciences, Jastrzebiec, Magdalenka, Poland.,5Institute of Neurobiology, Bulgarian Academy of Sciences, Sofia, Bulgaria.,6Department of Pharmacognosy, University of Vienna, Vienna, Austria
| | - Elisabeth Klager
- 1Ludwig Boltzmann Institute of Digital Health and Patient Safety, Vienna, Austria
| | | | | | - Daniel Laxar
- 1Ludwig Boltzmann Institute of Digital Health and Patient Safety, Vienna, Austria.,2Department of Anaesthesia and General Intensive Care, Medical University Vienna, Austria
| | - Care Ay
- 2Department of Anaesthesia and General Intensive Care, Medical University Vienna, Austria
| | - Thomas Öhlinger
- 2Department of Anaesthesia and General Intensive Care, Medical University Vienna, Austria
| | - Oliver Kimberger
- 1Ludwig Boltzmann Institute of Digital Health and Patient Safety, Vienna, Austria.,2Department of Anaesthesia and General Intensive Care, Medical University Vienna, Austria
| | - Adi Steinrigl
- 8AGES - Österreichische Agentur für Gesundheit und Ernährungssicherheit GmbH, Institute for Veterinary Disease Control, Mödling, Austria
| | - Barbara Holzer
- 8AGES - Österreichische Agentur für Gesundheit und Ernährungssicherheit GmbH, Institute for Veterinary Disease Control, Mödling, Austria
| | - Florian Heger
- 9AGES - Österreichische Agentur für Gesundheit und Ernährungssicherheit GmbH, Institute for medical Microbiology and Hygiene Vienna, Vienna, Austria
| | - Alexander Indra
- 10Paracelsus Medical University of Salzburg, Salzburg, Austria
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289
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Khanna S, Tande A, Rubin DT, Khoruts A, Kahn SA, Pardi DS. Fecal Microbiota Transplantation for Recurrent C difficile Infection During the COVID-19 Pandemic: Experience and Recommendations. Mayo Clin Proc 2021; 96:1418-1425. [PMID: 34088413 PMCID: PMC8169126 DOI: 10.1016/j.mayocp.2021.04.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 02/23/2021] [Accepted: 04/12/2021] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To report experience with fecal microbiota transplantation (FMT) for recurrent Clostridioides difficile infection (rCDI) and provide recommendations for management of rCDI and donor testing during the COVID-19 pandemic. METHODS A retrospective study of patients with rCDI who underwent FMT from May 26, 2020, to September 30, 2020, with stool from well-screened donors with health and infectious screening and a newly implemented strategy for COVID-19 screening with every 2-week bookend testing with stool quarantine. Patients were followed up for development of rCDI and COVID-19. RESULTS Of the 57 patients who underwent FMT for rCDI, 29 were tested for COVID-19 via nasopharyngeal polymerase chain reaction (PCR) and 22 via serology. All results were negative, except for 1 positive serology. Donor testing every 2 weeks for COVID-19 via serology and nasopharyngeal swab PCR was negative, except for 2 donors at 1 center who were excluded. Three patients had rCDI after FMT, and 1 underwent repeat FMT. One patient developed respiratory symptoms suggestive of COVID-19 and tested negative via nasopharyngeal PCR. Eleven patients who underwent COVID-19 testing for elective procedures or hospitalizations tested negative. No SARS-CoV-2 transmission was noted. CONCLUSIONS With appropriate donor screening, FMT can be performed safely for rCDI during the COVID-19 pandemic. Development of a validated stool assay for SARS-CoV-2 will simplify this process further.
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Affiliation(s)
- Sahil Khanna
- Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN.
| | - Aaron Tande
- Infectious Diseases, Mayo Clinic, Rochester, MN
| | - David T Rubin
- Section of Gastroenterology, Hepatology and Nutrition, University of Chicago Medicine, Chicago, IL
| | - Alexander Khoruts
- Gastroenterology, Hepatology and Nutrition, University of Minnesota, Minneapolis, MN
| | - Stacy A Kahn
- Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, MA
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290
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Signorini L, Moioli G, Calza S, Van Hauwermeiren E, Lorenzotti S, Del Fabro G, Renisi G, Lanza P, Saccani B, Zambolin G, Latronico N, Castelli F, Cattaneo S, Marshall JC, Matteelli A, Piva S. Epidemiological and Clinical Characterization of Superinfections in Critically Ill Coronavirus Disease 2019 Patients. Crit Care Explor 2021; 3:e0430. [PMID: 34136819 PMCID: PMC8202543 DOI: 10.1097/cce.0000000000000430] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
To describe the epidemiology of superinfections (occurring > 48 hr after hospital admission) and their impact on the ICU and 28-day mortality in patients with coronavirus disease 2019 with acute respiratory distress syndrome, requiring mechanical ventilation. DESIGN Retrospective analysis of prospectively collected observational data. SETTING University-affiliated adult ICU. PATIENTS Ninety-two coronavirus disease 2019 patients admitted to the ICU from February 21, 2020, to May 6, 2020. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS The prevalence of superinfection at ICU admission was 21.7%, and 53 patients (57.6%) had at least one superinfection during ICU stay, with a total of 75 (82%) ventilator-associated pneumonia and 57 (62%) systemic infections. The most common pathogens responsible for ventilator-associated pneumonia were Pseudomonas aeruginosa (n = 26, 34.7%) and Stenotrophomonas maltophilia (n = 14, 18.7%). Bloodstream infection occurred in 16 cases, including methicillin-resistant Staphylococcus epidermidis (n = 8, 14.0%), Enterococcus species (n = 6, 10.5%), and Streptococcus species (n = 2, 3.5%). Fungal infections occurred in 41 cases, including 36 probable (30 by Candida albicans, six by C. nonalbicans) and five proven invasive candidiasis (three C. albicans, two C. nonalbicans). Presence of bacterial infections (odds ratio, 10.53; 95% CI, 2.31-63.42; p = 0.005), age (odds ratio, 1.17; 95% CI, 1.07-1.31; p = 0.001), and the highest Sequential Organ Failure Assessment score (odds ratio, 1.27; 95% CI, 1.06-1.63; p = 0.032) were independently associated with ICU or 28-day mortality. CONCLUSIONS Prevalence of superinfections in coronavirus disease 2019 patients requiring mechanical ventilation was high in this series, and bacterial superinfections were independently associated with ICU or 28-day mortality (whichever comes first).
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Affiliation(s)
- Liana Signorini
- Division of Infectious and Tropical Diseases, Spedali Civili University Hospital, Brescia, Italy
| | - Giovanni Moioli
- Division of Infectious and Tropical Diseases, Spedali Civili University Hospital, Brescia, Italy
| | | | - Evelyn Van Hauwermeiren
- Division of Infectious and Tropical Diseases, Spedali Civili University Hospital, Brescia, Italy
| | - Silvia Lorenzotti
- Division of Infectious and Tropical Diseases, Spedali Civili University Hospital, Brescia, Italy
| | - Giovanni Del Fabro
- Division of Infectious and Tropical Diseases, Spedali Civili University Hospital, Brescia, Italy
| | - Giulia Renisi
- Division of Infectious and Tropical Diseases, Spedali Civili University Hospital, Brescia, Italy
| | - Paola Lanza
- Division of Infectious and Tropical Diseases, Spedali Civili University Hospital, Brescia, Italy
| | - Barbara Saccani
- Division of Infectious and Tropical Diseases, Spedali Civili University Hospital, Brescia, Italy
| | - Giulia Zambolin
- Division of Infectious and Tropical Diseases, Spedali Civili University Hospital, Brescia, Italy
| | - Nicola Latronico
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
- Department of Anesthesia, Critical Care and Emergency, Spedali Civili University Hospital, Brescia, Italy
| | - Francesco Castelli
- Division of Infectious and Tropical Diseases, Spedali Civili University Hospital, Brescia, Italy
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Sergio Cattaneo
- Division of Cardio-Thoracic Intensive Care, ASST Spedali Civili, Brescia, Italy
| | - John C Marshall
- Li Ka Shing Knowledge Institute, Unity Health Toronto, University of Toronto, Toronto, ON, Canada
| | - Alberto Matteelli
- Division of Infectious and Tropical Diseases, Spedali Civili University Hospital, Brescia, Italy
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Simone Piva
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
- Department of Anesthesia, Critical Care and Emergency, Spedali Civili University Hospital, Brescia, Italy
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291
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Gunadi, Wibawa H, Hakim MS, Marcellus, Trisnawati I, Khair RE, Triasih R, Irene, Afiahayati, Iskandar K, Siswanto, Anggorowati N, Daniwijaya EW, Supriyati E, Nugrahaningsih DAA, Budiono E, Retnowulan H, Puspadewi Y, Puspitawati I, Sianipar O, Afandy D, Simanjaya S, Widitjiarso W, Puspitarani DA, Fahri F, Riawan U, Fauzi AR, Kalim AS, Ananda NR, Setyati A, Setyowireni D, Laksanawati IS, Arguni E, Nuryastuti T, Wibawa T. Molecular epidemiology of SARS-CoV-2 isolated from COVID-19 family clusters. BMC Med Genomics 2021; 14:144. [PMID: 34074255 PMCID: PMC8169432 DOI: 10.1186/s12920-021-00990-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 05/18/2021] [Indexed: 02/06/2023] Open
Abstract
Background Transmission within families and multiple spike protein mutations have been associated with the rapid transmission of SARS-CoV-2.
We aimed to: (1) describe full genome characterization of SARS-CoV-2 and correlate the sequences with epidemiological data within family clusters, and (2) conduct phylogenetic analysis of all samples from Yogyakarta and Central Java, Indonesia and other countries. Methods The study involved 17 patients with COVID-19, including two family clusters. We determined the full-genome sequences of SARS-CoV-2 using the Illumina MiSeq next-generation sequencer. Phylogenetic analysis was performed using a dataset of 142 full-genomes of SARS-CoV-2 from different regions. Results Ninety-four SNPs were detected throughout the open reading frame (ORF) of SARS-CoV-2 samples with 58% (54/94) of the nucleic acid changes resulting in amino acid mutations. About 94% (16/17) of the virus samples showed D614G on spike protein and 56% of these (9/16) showed other various amino acid mutations on this protein, including L5F, V83L, V213A, W258R, Q677H, and N811I. The virus samples from family cluster-1 (n = 3) belong to the same clade GH, in which two were collected from deceased patients, and the other from the survived patient. All samples from this family cluster revealed a combination of spike protein mutations of D614G and V213A. Virus samples from family cluster-2 (n = 3) also belonged to the clade GH and showed other spike protein mutations of L5F alongside the D614G mutation. Conclusions Our study is the first comprehensive report associating the full-genome sequences of SARS-CoV-2 with the epidemiological data within family clusters. Phylogenetic analysis revealed that the three viruses from family cluster-1 formed a monophyletic group, whereas viruses from family cluster-2 formed a polyphyletic group indicating there is the possibility of different sources of infection. This study highlights how the same spike protein mutations among members of the same family might show different disease outcomes. Supplementary Information The online version contains supplementary material available at 10.1186/s12920-021-00990-3.
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Affiliation(s)
- Gunadi
- Pediatric Surgery Division, Department of Surgery/Genetics Working Group, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr, Sardjito Hospital, Jl. Kesehatan No. 1, Yogyakarta, 55281, Indonesia.
| | - Hendra Wibawa
- Disease Investigation Center Wates, Directorate General of Livestock and Animal Health Services, Ministry of Agriculture, Yogyakarta, Indonesia
| | - Mohamad Saifudin Hakim
- Department of Microbiology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Marcellus
- Genetics Working Group, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Ika Trisnawati
- Pulmonology Division, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr, Sardjito Hospital, Yogyakarta, Indonesia
| | - Riat El Khair
- Department of Clinical Pathology and Laboratory Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr, Sardjito Hospital, Yogyakarta, 55281, Indonesia
| | - Rina Triasih
- Department of Child Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr, Sardjito Hospital, Yogyakarta, Indonesia
| | - Irene
- Balai Besar Teknik Kesehatan Lingkungan Dan Pengendalian Penyakit, Yogyakarta, Yogyakarta, Indonesia
| | - Afiahayati
- Department of Computer Science and Electronics Faculty of Mathematics and Natural Sciences, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Kristy Iskandar
- Department of Child Health/Genetics Working Group, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/UGM Academic Hospital, Yogyakarta, Indonesia
| | - Siswanto
- Department of Physiology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/UGM Academic Hospital, Yogyakarta, Indonesia
| | - Nungki Anggorowati
- Department of Anatomical Pathology/Genetics Working Group, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Edwin Widyanto Daniwijaya
- Department of Microbiology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, UGM Academic Hospital, Yogyakarta, Indonesia
| | - Endah Supriyati
- Centre of Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Dwi Aris Agung Nugrahaningsih
- Department of Pharmacology and Therapy/Genetics Working Group, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Eko Budiono
- Pulmonology Division, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr, Sardjito Hospital, Yogyakarta, Indonesia
| | - Heni Retnowulan
- Pulmonology Division, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr, Sardjito Hospital, Yogyakarta, Indonesia
| | - Yunika Puspadewi
- Department of Clinical Pathology and Laboratory Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr, Sardjito Hospital, Yogyakarta, 55281, Indonesia
| | - Ira Puspitawati
- Department of Clinical Pathology and Laboratory Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr, Sardjito Hospital, Yogyakarta, 55281, Indonesia
| | - Osman Sianipar
- Department of Clinical Pathology and Laboratory Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr, Sardjito Hospital, Yogyakarta, 55281, Indonesia
| | - Dwiki Afandy
- Genetics Working Group, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Susan Simanjaya
- Genetics Working Group, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - William Widitjiarso
- Genetics Working Group, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Dyah Ayu Puspitarani
- Genetics Working Group, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Fadil Fahri
- Genetics Working Group, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Untung Riawan
- Genetics Working Group, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Aditya Rifqi Fauzi
- Genetics Working Group, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Alvin Santoso Kalim
- Genetics Working Group, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Nur Rahmi Ananda
- Pulmonology Division, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr, Sardjito Hospital, Yogyakarta, Indonesia
| | - Amalia Setyati
- Department of Child Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr, Sardjito Hospital, Yogyakarta, Indonesia
| | - Dwikisworo Setyowireni
- Department of Child Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr, Sardjito Hospital, Yogyakarta, Indonesia
| | - Ida Safitri Laksanawati
- Department of Child Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr, Sardjito Hospital, Yogyakarta, Indonesia
| | - Eggi Arguni
- Department of Child Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr, Sardjito Hospital, Yogyakarta, Indonesia
| | - Titik Nuryastuti
- Department of Microbiology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Tri Wibawa
- Department of Microbiology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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Alwazzan RA, Baseer MA, ALMugeiren OM, Ingle NA. Dental Professional's Knowledge, Preventive Awareness and Attitude Towards COVID-19 in Saudi Arabia: A Cross-Sectional Survey. Risk Manag Healthc Policy 2021; 14:2277-2288. [PMID: 34104018 PMCID: PMC8179811 DOI: 10.2147/rmhp.s303858] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 05/09/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Given the COVID-19 pandemic, it is necessary to assess the dentist's knowledge, preventive awareness, and attitude towards COVID-19 in Saudi Arabia. This study aimed to assess dental professionals' knowledge, preventive awareness, and attitude towards dental care during the COVID-19 pandemic in Saudi Arabia. STUDY SUBJECTS AND METHODS The study participants consisted of dental professionals working in government, private and academic sectors in Saudi Arabia. An online questionnaire (Whatsapp and Twitter) was sent to dental professionals in July 2020. The questionnaire consisted of questions on dental professional's demographic variables, their knowledge of the incubation period, the symptoms, mode of transmission, preventive awareness of COVID-19, and their attitude toward treating patients with COVID-19. Mann-Whitney U and Kruskal-Wallis tests were applied to compare mean ranks and a p<0.05 is considered statistically significant. RESULTS This study included a total of 356 dental professionals (dentists and dental students) aged 22-60 years (mean±SD, 32.14±7.48 years). Majority of the participants were graduates/general practitioners (GP) 145 (40.7%), followed by post graduate (PG) student 108 (30.3%), undergraduate students 23 (6.5%) and specialist 80 (22.5%). Dental professionals showed a high level (>90% correct responses) of knowledge of COVID-19 except for the infection among comorbid patients 283 (79.5%) and incubation period of COVID-19, 164 (46.1%). An overall high knowledge of COVID-19 (87.26%), preventive awareness (88.64%) and a positive attitude (65.26%) towards dental care were observed among the study participants. The mean knowledge ranks differed significantly in different genders (p=0.029) and marital status (p=0.023), whereas preventive awareness differed significantly across various qualifications (p=0.004). The mean attitude rank was significantly higher among Saudi (182.29) compared to non-Saudi (141.36) study participants (p=0.025). CONCLUSION The dental professionals participated in this study demonstrated adequate knowledge of symptoms, preventive awareness, and a positive attitude towards dental care of the COVID-19 infected patients.
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Affiliation(s)
- Rayyan Abdallah Alwazzan
- Department of Preventive Dentistry, College of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia
| | - Mohammad A Baseer
- Department of Preventive Dentistry, College of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia
| | | | - Navin Anand Ingle
- Department of Preventive Dentistry, College of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia
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293
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Corona G, Pizzocaro A, Vena W, Rastrelli G, Semeraro F, Isidori AM, Pivonello R, Salonia A, Sforza A, Maggi M. Diabetes is most important cause for mortality in COVID-19 hospitalized patients: Systematic review and meta-analysis. Rev Endocr Metab Disord 2021; 22:275-296. [PMID: 33616801 PMCID: PMC7899074 DOI: 10.1007/s11154-021-09630-8] [Citation(s) in RCA: 119] [Impact Index Per Article: 39.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/20/2021] [Indexed: 12/16/2022]
Abstract
The presence of SARS-CoV-2 was officially documented in Europe at the end of February 2020. Despite many observations, the real impact of COVID-19 in the European Union (EU), its underlying factors and their contribution to mortality and morbidity outcomes were never systematically investigated. The aim of the present work is to provide an overview and a meta-analysis of main predictors and of country differences of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection-associated mortality rate (MR) in hospitalized patients. Out of 3714 retrieved articles, 87 studies were considered, including 35,486 patients (mean age 60.9 ± 8.2 years) and 5867 deaths. After adjustment for confounders, diabetes mellitus was the best predictors of MR in an age- and sex-dependent manner, followed by chronic pulmonary obstructive diseases and malignancies. In both the US and Europe, MR was higher than that reported in Asia (25[20;29] % and 20[17;23] % vs. 13[10;17]%; both p < 0.02). Among clinical parameters, dyspnea, fatigue and myalgia, along with respiratory rate, emerged as the best predictors of MR. Finally, reduced lymphocyte and platelet count, along with increased D-dimer levels, all significantly contributed to increased mortality. The optimization of glucose profile along with an adequate thrombotic complications preventive strategy must become routine practice in diseased SARS-CoV-2 infected patients.
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Affiliation(s)
- Giovanni Corona
- Endocrinology Unit, Medical Department, Azienda Usl Bologna Maggiore-Bellaria Hospital, Largo Nigrisoli, 2 - 40133, Bologna, Italy.
| | - Alessandro Pizzocaro
- Unit of Endocrinology, Diabetology and Medical Andrology, IRCSS, Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Walter Vena
- Unit of Endocrinology, Diabetology and Medical Andrology, IRCSS, Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Giulia Rastrelli
- Female Endocrinology and Gender Incongruence Unit, Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Florence, Italy
| | - Federico Semeraro
- Department of Anaesthesia, Intensive Care and EMS, Maggiore Hospital Bologna, Bologna, Italy
| | - Andrea M Isidori
- Department of Experimental Medicine, Sapienza University of Rome - Policlinico Umberto I Hospital, Rome, Italy
| | - Rosario Pivonello
- Dipartimento Di Medicina Clinica E Chirurgia, Sezione Di Endocrinologia, Unità Di Andrologia E Medicina Della Riproduzione E Della SessualitàMaschile E Femminile, Università Federico II Di Napoli, Naples, Italy
- Staff of UNESCO, Chair for Health Education and Sustainable Development, Federico II University, Naples, Italy
| | - Andrea Salonia
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Alessandra Sforza
- Endocrinology Unit, Medical Department, Azienda Usl Bologna Maggiore-Bellaria Hospital, Largo Nigrisoli, 2 - 40133, Bologna, Italy
| | - Mario Maggi
- Endocrinology Unit, Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Florence, Italy
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294
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Jefsen OH, Rohde C, Nørremark B, Østergaard SD. Editorial Perspective: COVID-19 pandemic-related psychopathology in children and adolescents with mental illness. J Child Psychol Psychiatry 2021; 62:798-800. [PMID: 32779748 PMCID: PMC7361472 DOI: 10.1111/jcpp.13292] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 06/05/2020] [Indexed: 01/19/2023]
Abstract
The coronavirus disease (COVID-19) pandemic is likely to have negative health consequences way beyond those caused by the virus per se - including significant psychological distress. Children and adolescents who already live with a mental illness may be particularly vulnerable to the distress associated with the pandemic - due to, for example, fear of the virus as well as the significant societal changes launched to minimize spread of the virus (social distancing and quarantine). In this editorial perspective, we (a) provide data on COVID-19 pandemic-related psychopathology in children and adolescents from a large psychiatric treatment setting in Denmark, (b) give advice on how the likely harmful effects of the COVID-19 pandemic on the mental health of children and adolescents may be minimized, and (c) propose six lines of research into pandemic-related psychopathology with emphasis on children and adolescents. Finally, we underline the necessity of politicians, health authorities, and funding bodies supporting these research initiatives here and now.
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Affiliation(s)
- Oskar Hougaard Jefsen
- Department of Affective DisordersAarhus University Hospital – PsychiatryAarhusDenmark,Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | - Christopher Rohde
- Department of Affective DisordersAarhus University Hospital – PsychiatryAarhusDenmark,Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | - Bettina Nørremark
- Department of Affective DisordersAarhus University Hospital – PsychiatryAarhusDenmark
| | - Søren Dinesen Østergaard
- Department of Affective DisordersAarhus University Hospital – PsychiatryAarhusDenmark,Department of Clinical MedicineAarhus UniversityAarhusDenmark
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295
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Nayahangan LJ, Konge L, Russell L, Andersen S. Training and education of healthcare workers during viral epidemics: a systematic review. BMJ Open 2021; 11:e044111. [PMID: 34049907 PMCID: PMC8166630 DOI: 10.1136/bmjopen-2020-044111] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 05/11/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND It is necessary to train a large number of healthcare workers (HCW) within a limited time to ensure adequate human resources during an epidemic. There remains an urgent need for best practices on development and implementation of training programmes. OBJECTIVE To explore published literature in relation to training and education for viral epidemics as well as the effect of these interventions to inform training of HCW. DATA SOURCES Systematic searches in five databases performed between 1 January 2000 and 24 April 2020 for studies reporting on educational interventions in response to major viral epidemics. STUDY ELIGIBILITY CRITERIA All studies on educational interventions developed, implemented and evaluated in response to major global viral outbreaks from 2000 to 2020. PARTICIPANTS Healthcare workers. INTERVENTIONS Educational or training interventions. STUDY APPRAISAL AND SYNTHESIS METHODS Descriptive information were extracted and synthesised according to content, competency category, educational methodology, educational effects and level of educational outcome. Quality appraisal was performed using a criterion-based checklist. RESULTS A total of 15 676 records were identified and 46 studies were included. Most studies were motivated by the Ebola virus outbreak with doctors and nurses as primary learners. Traditional didactic methods were commonly used to teach theoretical knowledge. Simulation-based training was used mainly for training of technical skills, such as donning and doffing of personal protective equipment. Evaluation of the interventions consisted mostly of surveys on learner satisfaction and confidence or tests of knowledge and skills. Only three studies investigated transfer to the clinical setting or effect on patient outcomes. CONCLUSIONS AND IMPLICATIONS OF FINDINGS The included studies describe important educational experiences from past epidemics with a variety of educational content, design and modes of delivery. High-level educational evidence is limited. Evidence-based and standardised training programmes that are easily adapted locally are recommended in preparation for future outbreaks.
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Affiliation(s)
- Leizl Joy Nayahangan
- Copenhagen Academy for Medical Education and Simulation (CAMES), Centre for Human Resouces and Education, The Capital Region of Denmark, Copenhagen, Denmark
| | - Lars Konge
- Copenhagen Academy for Medical Education and Simulation (CAMES), Centre for Human Resouces and Education, The Capital Region of Denmark, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Lene Russell
- Copenhagen Academy for Medical Education and Simulation (CAMES), Centre for Human Resouces and Education, The Capital Region of Denmark, Copenhagen, Denmark
- Department of Intensive Care, Rigshospitalet, Copenhagen, Denmark
| | - Steven Andersen
- Copenhagen Academy for Medical Education and Simulation (CAMES), Centre for Human Resouces and Education, The Capital Region of Denmark, Copenhagen, Denmark
- Department of Otorhinolaryngology-Head & Neck Surgery, Rigshospitalet, Copenhagen, Denmark
- Department of Otolaryngology, Ohio State University, Columbus, Ohio, USA
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296
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de Carvalho LS, da Silva Júnior RT, Oliveira BVS, de Miranda YS, Rebouças NLF, Loureiro MS, Pinheiro SLR, da Silva RS, Correia PVSLM, Silva MJS, Ribeiro SN, da Silva FAF, de Brito BB, Santos MLC, Leal RAOS, Oliveira MV, de Melo FF. Highlighting COVID-19: What the imaging exams show about the disease. World J Radiol 2021; 13:122-136. [PMID: 34141092 PMCID: PMC8188839 DOI: 10.4329/wjr.v13.i5.122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 03/16/2021] [Accepted: 05/07/2021] [Indexed: 02/06/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19), a global emergency, is caused by severe acute respiratory syndrome coronavirus 2. The gold standard for its diagnosis is the reverse transcription polymerase chain reaction, but considering the high number of infected people, the low availability of this diagnostic tool in some contexts, and the limitations of the test, other tools that aid in the identification of the disease are necessary. In this scenario, imaging exams such as chest X-ray (CXR) and computed tomography (CT) have played important roles. CXR is useful for assessing disease progression because it allows the detection of extensive consolidations, besides being a fast and cheap method. On the other hand, CT is more sensitive for detecting lung changes in the early stages of the disease and is also useful for assessing disease progression. Of note, ground-glass opacities are the main COVID-19-related CT findings. Positron emission tomography combined with CT can be used to evaluate chronic and substantial damage to the lungs and other organs; however, it is an expensive test. Lung ultrasound (LUS) has been shown to be a promising technique in that context as well, being useful in the screening and monitoring of patients, disease classification, and management related to mechanical ventilation. Moreover, LUS is an inexpensive alternative available at the bedside. Finally, magnetic resonance imaging, although not usually requested, allows the detection of pulmonary, cardiovascular, and neurological abnormalities associated with COVID-19. Furthermore, it is important to consider the challenges faced in the radiology field in the adoption of control measures to prevent infection and in the follow-up of post-COVID-19 patients.
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Affiliation(s)
- Lorena Sousa de Carvalho
- Department of Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | | | - Bruna Vieira Silva Oliveira
- Department of Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Yasmin Silva de Miranda
- Department of Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Nara Lúcia Fonseca Rebouças
- Department of Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Matheus Sande Loureiro
- Department of Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Samuel Luca Rocha Pinheiro
- Department of Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Regiane Santos da Silva
- Department of Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | | | - Maria José Souza Silva
- Department of Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Sabrina Neves Ribeiro
- Department of Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Filipe Antônio França da Silva
- Department of Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Breno Bittencourt de Brito
- Department of Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Maria Luísa Cordeiro Santos
- Department of Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | | | - Márcio Vasconcelos Oliveira
- Department of Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Fabrício Freire de Melo
- Department of Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
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297
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Zhou Z, Li Y, Ma Y, Zhang H, Deng Y, Zhu Z. Multi-biomarker is an early-stage predictor for progression of Coronavirus disease 2019 (COVID-19) infection. Int J Med Sci 2021; 18:2789-2798. [PMID: 34220307 PMCID: PMC8241766 DOI: 10.7150/ijms.58742] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 04/27/2021] [Indexed: 12/12/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) has spread widely in the communities in many countries. Although most of the mild patients could be cured by their body's ability to self-heal, many patients quickly progressed to severe disease and had to undergo treatment in the intensive care unit (ICU). Thus, it is very important to effectively predict which patients with mild disease are more likely to progress to severe disease. A total of 72 patients hospitalized with COVID-19 in Shandong Provincial Public Health Clinical Center and 1141 patients included in the published papers were enrolled in this study. We determined that the combination of interleukin-6 (IL-6), Neutrophil (NEUT), and Natural Killer (NK) cells had the highest prediction accuracy (with 75% sensitivity and 95% specificity) for progression of COVID-19 infection. A binomial regression equation that accounted for a multiple risk score for the combination of IL-6, NEUT, and NK was also established. The multiple risk score is a good indicator for early stratification of mild patients into risk categories, which is very important for adjusting the treatment plan and preventing death.
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Affiliation(s)
- Zheng Zhou
- Katharine Hsu International Research Institute of Infectious Disease, Shandong Provincial Public Health Clinical Center, Shandong University, Jinan 250013, China
| | - Ying Li
- Medical Technology School of Xuzhou Medical University, Xuzhou 221004, China
| | - Yuanhui Ma
- Department of Pathology, Shandong Provincial Public Health Clinical Center, Shandong University, Jinan 250013, China
| | - Heng Zhang
- Department of Labor, Jining Psychiatric Hospital, Jining 272051, China
| | - Yunfeng Deng
- Katharine Hsu International Research Institute of Infectious Disease, Shandong Provincial Public Health Clinical Center, Shandong University, Jinan 250013, China
| | - Zuobin Zhu
- Department of Genetics, Xuzhou Medical University, Xuzhou 221004, China
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298
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Abstract
The immune system is capable of adequately controlling SARS-CoV-2 infection in 81% of patients, whose disease is asymptomatic or who experience moderate symptoms. However, 19% of infected patients develop severe disease which can become critical or fatal. This review article intends to provide an overview of the epidemiological antecedents of β-coronaviruses, describe the mechanisms of SARS-CoV-2 infection, and summarize the rational immunological underpinnings known at present which allow for a better understanding of the immunopathology of COVID-19. The SARS-CoV-2 virus is capable of profoundly altering the behavior of molecular and cellular components of the immune system. The initial decisions of the innate immune system are responsible for a proper or improper response of the adaptive immune system and, along with comorbidities, are directly associated with disease progression.
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299
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Aziz A, Asif M, Ashraf G, Yang Q, Wang S. COVID-19 Impacts, Diagnosis and Possible Therapeutic Techniques: A Comprehensive Review. Curr Pharm Des 2021; 27:1170-1184. [PMID: 33280586 DOI: 10.2174/1874467213666201204154239] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 10/19/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND The spread of COVID-19 has become a growing cause of mortalities over the globe since its major outbreak in December 2019. The scientific and medical communities are rallying to study different strains and probable mutations to develop more rapid and reliable molecular diagnostic tests and possible therapeutic approaches for SARS-CoV-2. INTRODUCTION In the first section, following the introductory part, we shed light on structural and pathogenic features of SARS-CoV-2 and risk factors related to age, gender, neonatal and comorbidities. The next section summarizes the current diagnostic tests for COVID-19, such as nucleic acid and computed tomography (CT) techniques, with further emphasis on emerging diagnostic approaches for COVID-19. METHODS Further, we also review the ongoing therapeutic practices which can block virus-host interaction, cease viral proliferation or inhibit hyperbolic host immune response with subsections on drug therapy, cell therapy, immunotherapy and herbal medicines that are being used for the possible treatment of patients. RESULTS AND CONCLUSION Among the different promising drugs, remdesivir, by inhibiting the RNA-dependent RNA-Polymerase activity, gives much better results, including declined viral load and quick lung tissue recovery. The long-lasting repercussions of COVID-19 have also been discussed at the end. In this review, we have also critically discussed the progress in several vaccines that are under development.
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Affiliation(s)
- Ayesha Aziz
- School of Biomedical Engineering, Huazhong University of Science and Technology (HUST), Wuhan, 430074, China
| | - Muhammad Asif
- School of Chemistry and Chemical Engineering, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - Ghazala Ashraf
- Britton Chance Center for Biomedical Photonics at Wuhan National Laboratory for Optoelectronics-Hubei Bioinformatics & Molecular Imaging Key Laboratory, Collaborative Innovation Center for Biomedical Engineering, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - Qiaoli Yang
- School of Biomedical Engineering, Huazhong University of Science and Technology (HUST), Wuhan, 430074, China
| | - Shenqi Wang
- School of Biomedical Engineering, Huazhong University of Science and Technology (HUST), Wuhan, 430074, China
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300
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Zhao J, Guo D, Fan M, Liu Y. Efficacy and safety of Xuanfei Baidu granules for treating COVID-19: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e25653. [PMID: 34011026 PMCID: PMC8136981 DOI: 10.1097/md.0000000000025653] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 04/05/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Corona Virus Disease 2019 (COVID-19) is currently prevalent in most countries around the world. It has become a common threat to global human health because there is no specific cure and no targeted treatment for this disease at this stage. Xuanfei Baidu granule (XFBD) included the traditional Chinese medicine prescription in COVID-19 diagnosis and treatment Plan (trial eighth Edition) released in August 2020, which has played a great role in the diagnosis and treatment of COVID-19 in Wuhan, China. This paper intends to evaluate the efficacy and safety of Xuanfei Baidu granule in the treatment of COVID-19. METHODS The search strategies of different websites were searched on Cochrane Central controlled Trials Registry, PubMed, excerpt database, Web of science, China National knowledge Infrastructure, Chinese Science and Technology Journal Database, WanFang and other websites. All qualified studies were confirmed to include randomized controlled trials. The search time range was from January 1, 2019 to February 28, 2021. In the meanwhile, the list of references and related reviews was checked. Two evaluators were responsible for the extraction and management of the data independently. The literature quality was evaluated according to Cochrane manual 4.2.2. Heterogeneity test and Meta analysis were carried out by Review Manager V.5.3 software. The bias risk included in the study was evaluated by Cochrane "bias risk" tool, and the relevant statistical data were evaluated by GRADE3.6 evidence quality grading system. RESULTS This study intends to evaluate the efficacy and safety of XFBD in the treatment of COVID-19 from 4 aspects, including nucleic acid negative conversion time, average hospital stay, clinical symptom improvement rate and lung computed tomography improvement rate. CONCLUSION The conclusion of this scheme intends to provide evidence for judging whether the intervention of XFBD on COVID-19 patients is effective or not. PROSPERO REGISTRATION NUMBER CRD42021245640.
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Affiliation(s)
- Jisen Zhao
- The First Clinical Medical College of Shandong University of Traditional Chinese Medicine
| | - Dong Guo
- Teacher Development Center of Shandong University of Traditional Chinese Medicine
| | - Maoxia Fan
- The First Clinical Medical College of Shandong University of Traditional Chinese Medicine
| | - Yongcheng Liu
- The First Clinical Medical College of Shandong University of Traditional Chinese Medicine
- Shandong Provincial Hospital of Traditional Chinese Medicine, Jinan, Shandong Province, China
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