251
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Mohseni M, Dragon M, Simon LV. Diagnosis of a Case of Suspected COVID-19 Using Telemedicine Technology in the Emergency Department. AMERICAN JOURNAL OF CASE REPORTS 2020; 21:e926251. [PMID: 32826846 PMCID: PMC7467631 DOI: 10.12659/ajcr.926251] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Patient: Male, 67-year-old Final Diagnosis: COVID-19 Symptoms: Fever Medication: — Clinical Procedure: — Specialty: Disaster Medicine • Infectious Diseases
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Affiliation(s)
- Michael Mohseni
- Department of Emergency Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - Marc Dragon
- Department of Emergency Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - Leslie V Simon
- Department of Emergency Medicine, Mayo Clinic, Jacksonville, FL, USA
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252
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Abstract
In late March 2020, we faced a nosocomial outbreak of novel coronavirus disease 2019 (COVID-19) at Keio University Hospital, Tokyo, Japan. Presently, COVID-19 is an unprecedented worldwide biohazard, and a nosocomial outbreak can occur in any hospital at any time. Therefore, we reviewed the literature regarding hospital preparedness, the initial management of COVID-19, and the surveillance of healthcare workers (HCWs) to find information that would be generally useful for physicians when confronted with COVID-19. In terms of hospital preparedness, each hospital should develop an incident management system and establish a designated multidisciplinary medical team. To initiate case management, COVID-19 should be suspected based on patient symptoms and/or high-risk history and then should be confirmed by viral testing, such as reverse transcription polymerase chain reaction (RT-PCR) analysis. Although some patients will become critically ill, the guidelines for respiratory failure and septic shock for non-COVID-19 cases can be followed for supportive treatment. Antiviral medications should be carefully selected because the available information is confused by the large volume of preprint literature and unreliable data. HCWs who have come into contact with patients with COVID-19 can generate new in-hospital clusters of COVID-19 cases. Quarantine following contact tracking with risk stratification is effective in preventing transmission, and the essentials of medical surveillance include monitoring different types of symptoms, delegation of supervision, and continuation of surveillance regardless of the RT-PCR results. Preparation for COVID-19 is recommended before the first COVID-19 case is encountered.
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253
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254
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Basso T, Nordbø SA, Sundqvist E, Martinsen TC, Witsø E, Wik TS. Transmission of infection from non-isolated patients with COVID-19 to healthcare workers. J Hosp Infect 2020; 106:639-642. [PMID: 32828865 PMCID: PMC7439009 DOI: 10.1016/j.jhin.2020.08.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 08/14/2020] [Indexed: 10/27/2022]
Abstract
Insufficiently protected healthcare workers (HCWs), defined as high-risk contacts of patients with coronavirus disease 2019 (COVID-19), are routinely quarantined. This study evaluated the transmission of infection from a symptomatic patient with COVID-19 to 60 HCWs exposed at ≤2 m for ≥15 min or during aerosol-generating procedures. Following ≥106 unique high-risk contacts, none of the HCWs tested positive for severe acute respiratory syndrome coronavirus-2 RNA or developed antibodies. The HCWs reported adherence to basic infection control procedures. These results are in accordance with other reports, and should reassure HCWs and further stimulate broader evaluation of the foundation for the current practice of home quarantining non-symptomatic HCWs.
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Affiliation(s)
- T Basso
- Department of Orthopaedic Surgery, St. Olavs University Hospital, Trondheim, Norway.
| | - S A Nordbø
- Department of Medical Microbiology, St. Olavs University Hospital, Trondheim, Norway; Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - E Sundqvist
- Department of Orthopaedic Surgery, St. Olavs University Hospital, Trondheim, Norway
| | - T C Martinsen
- Acting Medical Director, St. Olavs University Hospital, Trondheim, Norway; Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - E Witsø
- Department of Orthopaedic Surgery, St. Olavs University Hospital, Trondheim, Norway
| | - T S Wik
- Department of Orthopaedic Surgery, St. Olavs University Hospital, Trondheim, Norway; Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
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255
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Misra-Hebert AD, Jehi L, Ji X, Nowacki AS, Gordon S, Terpeluk P, Chung MK, Mehra R, Dell KM, Pennell N, Hamilton A, Milinovich A, Kattan MW, Young JB. Impact of the COVID-19 pandemic on healthcare workers risk of infection and outcomes in a large, integrated health system. RESEARCH SQUARE 2020:rs.3.rs-61235. [PMID: 32839766 PMCID: PMC7444292 DOI: 10.21203/rs.3.rs-61235/v1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Background: Understanding the impact of the COVID-19 pandemic on healthcare workers (HCW) is crucial. Objective: Utilizing a health system COVID-19 research registry, we assessed HCW risk for COVID-19 infection, hospitalization and intensive care unit (ICU) admission. Design: Retrospective cohort study with overlap propensity score weighting. Participants: Individuals tested for SARS-CoV-2 infection in a large academic healthcare system (N=72,909) from March 8-June 9 2020 stratified by HCW and patient-facing status. Main Measures: SARS-CoV-2 test result, hospitalization, and ICU admission for COVID-19 infection. Key Results: Of 72,909 individuals tested, 9.0% (551) of 6,145 HCW tested positive for SARS-CoV-2 compared to 6.5% (4353) of 66,764 non-HCW. The HCW were younger than non-HCW (median age 39.7 vs. 57.5, p<0.001) with more females (proportion of males 21.5 vs. 44.9%, p<0.001), higher reporting of COVID-19 exposure (72 vs. 17 %, p<0.001) and fewer comorbidities. However, the overlap propensity score weighted proportions were 8.9 vs. 7.7 for HCW vs. non-HCW having a positive test with weighted odds ratio (OR) 1.17, 95% confidence interval (CI) 0.99-1.38. Among those testing positive, weighted proportions for hospitalization were 7.4 vs.15.9 for HCW vs. non-HCW with OR of 0.42 (CI 0.26-0.66) and for ICU admission: 2.2 vs.4.5 for HCW vs. non-HCW with OR of 0.48 (CI 0.20 -1.04). Those HCW identified as patient-facing compared to not had increased odds of a positive SARS-CoV-2 test (OR 1.60, CI 1.08-2.39, proportions 8.6 vs. 5.5), but no statistically significant increase in hospitalization (OR 0.88, CI 0.20-3.66, proportions 10.2 vs. 11.4) and ICU admission (OR 0.34, CI 0.01-3.97, proportions 1.8 vs. 5.2). Conclusions: In a large healthcare system, HCW had similar odds for testing SARS-CoV-2 positive, but lower odds of hospitalization compared to non-HCW. Patient-facing HCW had higher odds of a positive test. These results are key to understanding HCW risk mitigation during the COVID-19 pandemic.
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256
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Bains J, Greenwald PW, Mulcare MR, Leyden D, Kim J, Shemesh AJ, Bodnar D, Farmer B, Steel P, Tanouye R, Kim JW, Lame M, Sharma R. Utilizing Telemedicine in a Novel Approach to COVID-19 Management and Patient Experience in the Emergency Department. Telemed J E Health 2020; 27:254-260. [PMID: 32821027 DOI: 10.1089/tmj.2020.0162] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background: The COVID-19 crisis has highlighted telemedicine as a care delivery tool uniquely suited for a disaster pandemic. Introduction: With support from emergency department (ED) leadership, our institution rapidly deployed telemedicine in a novel approach to large-scale ED infectious disease management at NewYork-Presbyterian/Weill Cornell Medical Center (NYP/WCMC) and NewYork-Presbyterian/Lower Manhattan Hospital (NYP/LMH). Materials and Methods: Nineteen telemedicine carts were placed in COVID-19 isolation rooms to conserve personal protective equipment (PPE) and mitigate infectious risk for patients and providers by decreasing in-person exposures. Results: The teleisolation carts were used for 261 COVID-19 patient interactions from March to May 2020, with 79% of overall use in March. Our urban academic site (NYP/WCMC) had 173 of these cases, and the urban community hospital (NYP/LMH) had 88. This initiative increased provider/patient communication and attention to staff safety, improved palliative care and patient support services, lowered PPE consumption, and streamlined clinical workflows. The carts also increased patient comfort and reduced the psychological toll of isolation. Discussion: Deploying customized placement strategies in these two EDs maximized cart availability for isolation patients and demonstrates the utility of telemedicine in various ED settings. Conclusions: The successful introduction of this program in both academic and urban community hospitals suggests that widespread adoption of similar initiatives could improve safe ED evaluation of potentially infectious patients. In the longer term, our experience underscores the critical role of telemedicine in disaster preparedness planning, as building these capabilities in advance allows for the agile scaling needed to manage unforeseen catastrophic scenarios.
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Affiliation(s)
- Jaskaran Bains
- NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York City, New York, USA
| | - Peter W Greenwald
- NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York City, New York, USA
| | - Mary R Mulcare
- NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York City, New York, USA
| | - David Leyden
- NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York City, New York, USA
| | - Joshua Kim
- NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York City, New York, USA
| | - Amos J Shemesh
- NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York City, New York, USA
| | - David Bodnar
- NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York City, New York, USA
| | - Brenna Farmer
- NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York City, New York, USA
| | - Peter Steel
- NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York City, New York, USA
| | - Robert Tanouye
- NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York City, New York, USA
| | - Ji Won Kim
- NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York City, New York, USA
| | - Maria Lame
- NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York City, New York, USA
| | - Rahul Sharma
- NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York City, New York, USA
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257
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Yuan L, Chen S, Xu Y. Donning and doffing of personal protective equipment protocol and key points of nursing care for patients with COVID-19 in ICU. Stroke Vasc Neurol 2020; 5:302-307. [PMID: 32817272 PMCID: PMC7548514 DOI: 10.1136/svn-2020-000456] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/18/2020] [Accepted: 08/04/2020] [Indexed: 12/29/2022] Open
Abstract
Coronavirus pandemic is the most important public health event in the world currently. Patients with coronavirus disease 2019 (COVID-19) in a critical state are at risk of progressing rapidly into many serve complications; they require a high level of care from ICU nurses. How to avoid the virus to infect health care worker is also a critical issue. Based on the summarized experience of Chinese health workers, literature review and clinical practice, this article introduced donning and doffing of personal protective equipment (PPE) protocol and some keypoints of nursing critical care in patients with coronavirus disease 2019 (COVID-19): caring of patients requiring intubation and ventilation, venous thromboembolism (VTE) prevention, caring of patients on ECMO, caring for patients requiring enteral nutrition, psychological support and nursing management of COVID-19 ICU. This article introduced a useful protocol of donning and doffing personal protective equipment to protect health care workers, and provided key points for the ICU nurses how to take care of COVID-19 patients.
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Affiliation(s)
- Li Yuan
- Department of Nursing, Huashan Hospital, Fudan University, Shanghai, China
| | - Shu Chen
- Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Yafang Xu
- Department of Nursing, Huashan Hospital, Fudan University, Shanghai, China
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258
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Affiliation(s)
- Lidia Morawska
- International Laboratory for Air Quality and Heath, World Health Organization Collaborating Centre, Queensland University of Technology, Brisbane, Australia
| | - Donald K Milton
- Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, Maryland, USA
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259
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Affiliation(s)
- Z Chagla
- McMaster University.,St. Joseph's Healthcare Hamilton
| | - S Hota
- University Health Network and University of Toronto
| | - S Khan
- McMaster University.,Hamilton Health Sciences
| | - D Mertz
- McMaster University.,Hamilton Health Sciences
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260
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Zaga CJ, Pandian V, Brodsky MB, Wallace S, Cameron TS, Chao C, Orloff LA, Atkins NE, McGrath BA, Lazarus CL, Vogel AP, Brenner MJ. Speech-Language Pathology Guidance for Tracheostomy During the COVID-19 Pandemic: An International Multidisciplinary Perspective. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 29:1320-1334. [PMID: 32525695 DOI: 10.1044/2020_ajslp-20-00089] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Purpose As the COVID-19 pandemic has unfolded, there has been growing recognition of risks to frontline health care workers. When caring for patients with tracheostomy, speech-language pathologists have significant exposure to mucosal surfaces, secretions, and aerosols that may harbor the SARS-CoV-2 virus. This tutorial provides guidance on practices for safely performing patient evaluation and procedures, thereby reducing risk of infection. Method Data were collated through review of literature, guidelines, and consensus statements relating to COVID-19 and similar high-consequent infections, with a focus on mitigating risk of transmission to health care workers. Particular emphasis was placed on speech-language pathologists, nurses, and other allied health professionals. A multinational interdisciplinary team then analyzed findings, arriving at recommendations through consensus via electronic communications and video conference. Results Reports of transmission of infection to health care workers in the current COVID-19 pandemic and previous outbreaks substantiate the need for safe practices. Many procedures routinely performed by speech-language pathologists have a significant risk of infection due to aerosol generation. COVID-19 testing can inform level of protective equipment, and meticulous hygiene can stem spread of nosocomial infection. Modifications to standard clinical practice in tracheostomy are often required. Personal protective equipment, including either powered air-purifying respirator or N95 mask, gloves, goggles, and gown, are needed when performing aerosol-generating procedures in patients with known or suspected COVID-19 infection. Conclusions Speech-language pathologists are often called on to assist in the care of patients with tracheostomy and known or suspected COVID-19 infection. Appropriate care of these patients is predicated on maintaining the health and safety of the health care team. Careful adherence to best practices can significantly reduce risk of infectious transmission.
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Affiliation(s)
- Charissa J Zaga
- Department of Speech Pathology, Austin Health, Melbourne, Victoria, Australia
- Centre for Neuroscience of Speech, University of Melbourne, Victoria, Australia
- Tracheostomy Review and Management Service, Austin Health, Melbourne, Victoria, Australia
| | - Vinciya Pandian
- Department of Nursing Faculty, Johns Hopkins University, Baltimore, MD
- Outcomes After Critical Illness and Surgery (OACIS) Research Group, Johns Hopkins University, Baltimore, MD
| | - Martin B Brodsky
- Outcomes After Critical Illness and Surgery (OACIS) Research Group, Johns Hopkins University, Baltimore, MD
- Department of Physical Medicine & Rehabilitation, Johns Hopkins University, Baltimore, MD
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD
| | - Sarah Wallace
- Department of Speech Voice and Swallowing, Manchester University NHS Foundation Trust, United Kingdom
| | - Tanis S Cameron
- Tracheostomy Review and Management Service, Austin Health, Melbourne, Victoria, Australia
| | - Caroline Chao
- Tracheostomy Review and Management Service, Austin Health, Melbourne, Victoria, Australia
- Department of Physiotherapy, Austin Health, Melbourne, Victoria, Australia
| | - Lisa Ann Orloff
- Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, CA
| | - Naomi E Atkins
- Department of Respiratory Medicine, Austin Health, Melbourne, Victoria, Australia
| | - Brendan A McGrath
- Anaesthetics & Intensive Care Medicine, Manchester University NHS Foundation Trust, United Kingdom
| | - Cathy L Lazarus
- Department of Otolaryngology-Head & Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Adam P Vogel
- Centre for Neuroscience of Speech, University of Melbourne, Victoria, Australia
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, Tübingen, Germany
- Redenlab, Melbourne, Victoria, Australia
| | - Michael J Brenner
- Department of Otolaryngology-Head & Neck Surgery, University of Michigan Medical School, Ann Arbor
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261
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Schünemann HJ, Khabsa J, Solo K, Khamis AM, Brignardello-Petersen R, El-Harakeh A, Darzi A, Hajizadeh A, Bognanni A, Bak A, Izcovich A, Cuello-Garcia CA, Chen C, Borowiack E, Chamseddine F, Schünemann F, Morgano GP, Muti-Schünemann GEU, Chen G, Zhao H, Neumann I, Brozek J, Schmidt J, Hneiny L, Harrison L, Reinap M, Junek M, Santesso N, El-Khoury R, Thomas R, Nieuwlaat R, Stalteri R, Yaacoub S, Lotfi T, Baldeh T, Piggott T, Zhang Y, Saad Z, Rochwerg B, Perri D, Fan E, Stehling F, Akl IB, Loeb M, Garner P, Aston S, Alhazzani W, Szczeklik W, Chu DK, Akl EA. Ventilation Techniques and Risk for Transmission of Coronavirus Disease, Including COVID-19: A Living Systematic Review of Multiple Streams of Evidence. Ann Intern Med 2020; 173:204-216. [PMID: 32442035 PMCID: PMC7281716 DOI: 10.7326/m20-2306] [Citation(s) in RCA: 94] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Mechanical ventilation is used to treat respiratory failure in coronavirus disease 2019 (COVID-19). PURPOSE To review multiple streams of evidence regarding the benefits and harms of ventilation techniques for coronavirus infections, including that causing COVID-19. DATA SOURCES 21 standard, World Health Organization-specific and COVID-19-specific databases, without language restrictions, until 1 May 2020. STUDY SELECTION Studies of any design and language comparing different oxygenation approaches in patients with coronavirus infections, including severe acute respiratory syndrome (SARS) or Middle East respiratory syndrome (MERS), or with hypoxemic respiratory failure. Animal, mechanistic, laboratory, and preclinical evidence was gathered regarding aerosol dispersion of coronavirus. Studies evaluating risk for virus transmission to health care workers from aerosol-generating procedures (AGPs) were included. DATA EXTRACTION Independent and duplicate screening, data abstraction, and risk-of-bias assessment (GRADE for certainty of evidence and AMSTAR 2 for included systematic reviews). DATA SYNTHESIS 123 studies were eligible (45 on COVID-19, 70 on SARS, 8 on MERS), but only 5 studies (1 on COVID-19, 3 on SARS, 1 on MERS) adjusted for important confounders. A study in hospitalized patients with COVID-19 reported slightly higher mortality with noninvasive ventilation (NIV) than with invasive mechanical ventilation (IMV), but 2 opposing studies, 1 in patients with MERS and 1 in patients with SARS, suggest a reduction in mortality with NIV (very-low-certainty evidence). Two studies in patients with SARS report a reduction in mortality with NIV compared with no mechanical ventilation (low-certainty evidence). Two systematic reviews suggest a large reduction in mortality with NIV compared with conventional oxygen therapy. Other included studies suggest increased odds of transmission from AGPs. LIMITATION Direct studies in COVID-19 are limited and poorly reported. CONCLUSION Indirect and low-certainty evidence suggests that use of NIV, similar to IMV, probably reduces mortality but may increase the risk for transmission of COVID-19 to health care workers. PRIMARY FUNDING SOURCE World Health Organization. (PROSPERO: CRD42020178187).
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Affiliation(s)
- Holger J Schünemann
- McMaster University, Hamilton, Ontario, Canada (H.J.S., K.S., R.B., A.D., A.H., A.B., C.A.C., F.S., G.P.M., J.B., J.S., L.H., M.J., N.S., R.N., R.S., T.L., T.B., T.P., Y.Z., B.R., D.P., M.L., W.A., D.K.C.)
| | - Joanne Khabsa
- American University of Beirut Medical Center, Beirut, Lebanon (J.K., A.E., F.C., L.H., R.E., S.Y., Z.S., I.B.A., E.A.A.)
| | - Karla Solo
- McMaster University, Hamilton, Ontario, Canada (H.J.S., K.S., R.B., A.D., A.H., A.B., C.A.C., F.S., G.P.M., J.B., J.S., L.H., M.J., N.S., R.N., R.S., T.L., T.B., T.P., Y.Z., B.R., D.P., M.L., W.A., D.K.C.)
| | | | - Romina Brignardello-Petersen
- McMaster University, Hamilton, Ontario, Canada (H.J.S., K.S., R.B., A.D., A.H., A.B., C.A.C., F.S., G.P.M., J.B., J.S., L.H., M.J., N.S., R.N., R.S., T.L., T.B., T.P., Y.Z., B.R., D.P., M.L., W.A., D.K.C.)
| | - Amena El-Harakeh
- American University of Beirut Medical Center, Beirut, Lebanon (J.K., A.E., F.C., L.H., R.E., S.Y., Z.S., I.B.A., E.A.A.)
| | - Andrea Darzi
- McMaster University, Hamilton, Ontario, Canada (H.J.S., K.S., R.B., A.D., A.H., A.B., C.A.C., F.S., G.P.M., J.B., J.S., L.H., M.J., N.S., R.N., R.S., T.L., T.B., T.P., Y.Z., B.R., D.P., M.L., W.A., D.K.C.)
| | - Anisa Hajizadeh
- McMaster University, Hamilton, Ontario, Canada (H.J.S., K.S., R.B., A.D., A.H., A.B., C.A.C., F.S., G.P.M., J.B., J.S., L.H., M.J., N.S., R.N., R.S., T.L., T.B., T.P., Y.Z., B.R., D.P., M.L., W.A., D.K.C.)
| | - Antonio Bognanni
- McMaster University, Hamilton, Ontario, Canada (H.J.S., K.S., R.B., A.D., A.H., A.B., C.A.C., F.S., G.P.M., J.B., J.S., L.H., M.J., N.S., R.N., R.S., T.L., T.B., T.P., Y.Z., B.R., D.P., M.L., W.A., D.K.C.)
| | - Anna Bak
- Evidence Prime, Krakow, Poland (A.B., E.B.)
| | - Ariel Izcovich
- German Hospital of Buenos Aires, Buenos Aires, Argentina (A.I.)
| | - Carlos A Cuello-Garcia
- McMaster University, Hamilton, Ontario, Canada (H.J.S., K.S., R.B., A.D., A.H., A.B., C.A.C., F.S., G.P.M., J.B., J.S., L.H., M.J., N.S., R.N., R.S., T.L., T.B., T.P., Y.Z., B.R., D.P., M.L., W.A., D.K.C.)
| | - Chen Chen
- Guangzhou University of Chinese Medicine, Guangzhou, China (C.C.)
| | | | - Fatimah Chamseddine
- American University of Beirut Medical Center, Beirut, Lebanon (J.K., A.E., F.C., L.H., R.E., S.Y., Z.S., I.B.A., E.A.A.)
| | - Finn Schünemann
- McMaster University, Hamilton, Ontario, Canada (H.J.S., K.S., R.B., A.D., A.H., A.B., C.A.C., F.S., G.P.M., J.B., J.S., L.H., M.J., N.S., R.N., R.S., T.L., T.B., T.P., Y.Z., B.R., D.P., M.L., W.A., D.K.C.)
| | - Gian Paolo Morgano
- McMaster University, Hamilton, Ontario, Canada (H.J.S., K.S., R.B., A.D., A.H., A.B., C.A.C., F.S., G.P.M., J.B., J.S., L.H., M.J., N.S., R.N., R.S., T.L., T.B., T.P., Y.Z., B.R., D.P., M.L., W.A., D.K.C.)
| | | | - Guang Chen
- Beijing University of Chinese Medicine, Beijing, China (G.C.)
| | - Hong Zhao
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China (H.Z.)
| | - Ignacio Neumann
- McMaster University, Hamilton, Ontario, Canada, and Pontificia Universidad Católica de Chile, Santiago, Chile (I.N.)
| | - Jan Brozek
- McMaster University, Hamilton, Ontario, Canada (H.J.S., K.S., R.B., A.D., A.H., A.B., C.A.C., F.S., G.P.M., J.B., J.S., L.H., M.J., N.S., R.N., R.S., T.L., T.B., T.P., Y.Z., B.R., D.P., M.L., W.A., D.K.C.)
| | - Joel Schmidt
- McMaster University, Hamilton, Ontario, Canada (H.J.S., K.S., R.B., A.D., A.H., A.B., C.A.C., F.S., G.P.M., J.B., J.S., L.H., M.J., N.S., R.N., R.S., T.L., T.B., T.P., Y.Z., B.R., D.P., M.L., W.A., D.K.C.)
| | - Layal Hneiny
- American University of Beirut Medical Center, Beirut, Lebanon (J.K., A.E., F.C., L.H., R.E., S.Y., Z.S., I.B.A., E.A.A.)
| | - Leila Harrison
- McMaster University, Hamilton, Ontario, Canada (H.J.S., K.S., R.B., A.D., A.H., A.B., C.A.C., F.S., G.P.M., J.B., J.S., L.H., M.J., N.S., R.N., R.S., T.L., T.B., T.P., Y.Z., B.R., D.P., M.L., W.A., D.K.C.)
| | - Marge Reinap
- London School of Hygiene and Tropical Medicine, London United Kingdom (M.R.)
| | - Mats Junek
- McMaster University, Hamilton, Ontario, Canada (H.J.S., K.S., R.B., A.D., A.H., A.B., C.A.C., F.S., G.P.M., J.B., J.S., L.H., M.J., N.S., R.N., R.S., T.L., T.B., T.P., Y.Z., B.R., D.P., M.L., W.A., D.K.C.)
| | - Nancy Santesso
- McMaster University, Hamilton, Ontario, Canada (H.J.S., K.S., R.B., A.D., A.H., A.B., C.A.C., F.S., G.P.M., J.B., J.S., L.H., M.J., N.S., R.N., R.S., T.L., T.B., T.P., Y.Z., B.R., D.P., M.L., W.A., D.K.C.)
| | - Rayane El-Khoury
- American University of Beirut Medical Center, Beirut, Lebanon (J.K., A.E., F.C., L.H., R.E., S.Y., Z.S., I.B.A., E.A.A.)
| | - Rebecca Thomas
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom (R.T., P.G.)
| | - Robby Nieuwlaat
- McMaster University, Hamilton, Ontario, Canada (H.J.S., K.S., R.B., A.D., A.H., A.B., C.A.C., F.S., G.P.M., J.B., J.S., L.H., M.J., N.S., R.N., R.S., T.L., T.B., T.P., Y.Z., B.R., D.P., M.L., W.A., D.K.C.)
| | - Rosa Stalteri
- McMaster University, Hamilton, Ontario, Canada (H.J.S., K.S., R.B., A.D., A.H., A.B., C.A.C., F.S., G.P.M., J.B., J.S., L.H., M.J., N.S., R.N., R.S., T.L., T.B., T.P., Y.Z., B.R., D.P., M.L., W.A., D.K.C.)
| | - Sally Yaacoub
- American University of Beirut Medical Center, Beirut, Lebanon (J.K., A.E., F.C., L.H., R.E., S.Y., Z.S., I.B.A., E.A.A.)
| | - Tamara Lotfi
- McMaster University, Hamilton, Ontario, Canada (H.J.S., K.S., R.B., A.D., A.H., A.B., C.A.C., F.S., G.P.M., J.B., J.S., L.H., M.J., N.S., R.N., R.S., T.L., T.B., T.P., Y.Z., B.R., D.P., M.L., W.A., D.K.C.)
| | - Tejan Baldeh
- McMaster University, Hamilton, Ontario, Canada (H.J.S., K.S., R.B., A.D., A.H., A.B., C.A.C., F.S., G.P.M., J.B., J.S., L.H., M.J., N.S., R.N., R.S., T.L., T.B., T.P., Y.Z., B.R., D.P., M.L., W.A., D.K.C.)
| | - Thomas Piggott
- McMaster University, Hamilton, Ontario, Canada (H.J.S., K.S., R.B., A.D., A.H., A.B., C.A.C., F.S., G.P.M., J.B., J.S., L.H., M.J., N.S., R.N., R.S., T.L., T.B., T.P., Y.Z., B.R., D.P., M.L., W.A., D.K.C.)
| | - Yuan Zhang
- McMaster University, Hamilton, Ontario, Canada (H.J.S., K.S., R.B., A.D., A.H., A.B., C.A.C., F.S., G.P.M., J.B., J.S., L.H., M.J., N.S., R.N., R.S., T.L., T.B., T.P., Y.Z., B.R., D.P., M.L., W.A., D.K.C.)
| | - Zahra Saad
- American University of Beirut Medical Center, Beirut, Lebanon (J.K., A.E., F.C., L.H., R.E., S.Y., Z.S., I.B.A., E.A.A.)
| | - Bram Rochwerg
- McMaster University, Hamilton, Ontario, Canada (H.J.S., K.S., R.B., A.D., A.H., A.B., C.A.C., F.S., G.P.M., J.B., J.S., L.H., M.J., N.S., R.N., R.S., T.L., T.B., T.P., Y.Z., B.R., D.P., M.L., W.A., D.K.C.)
| | - Dan Perri
- McMaster University, Hamilton, Ontario, Canada (H.J.S., K.S., R.B., A.D., A.H., A.B., C.A.C., F.S., G.P.M., J.B., J.S., L.H., M.J., N.S., R.N., R.S., T.L., T.B., T.P., Y.Z., B.R., D.P., M.L., W.A., D.K.C.)
| | - Eddy Fan
- Toronto General Hospital, Toronto, Ontario, Canada (E.F.)
| | | | - Imad Bou Akl
- American University of Beirut Medical Center, Beirut, Lebanon (J.K., A.E., F.C., L.H., R.E., S.Y., Z.S., I.B.A., E.A.A.)
| | - Mark Loeb
- McMaster University, Hamilton, Ontario, Canada (H.J.S., K.S., R.B., A.D., A.H., A.B., C.A.C., F.S., G.P.M., J.B., J.S., L.H., M.J., N.S., R.N., R.S., T.L., T.B., T.P., Y.Z., B.R., D.P., M.L., W.A., D.K.C.)
| | - Paul Garner
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom (R.T., P.G.)
| | - Stephen Aston
- Liverpool University Hospitals NHS Trust, Liverpool, United Kingdom (S.A.)
| | - Waleed Alhazzani
- McMaster University, Hamilton, Ontario, Canada (H.J.S., K.S., R.B., A.D., A.H., A.B., C.A.C., F.S., G.P.M., J.B., J.S., L.H., M.J., N.S., R.N., R.S., T.L., T.B., T.P., Y.Z., B.R., D.P., M.L., W.A., D.K.C.)
| | | | - Derek K Chu
- McMaster University, Hamilton, Ontario, Canada (H.J.S., K.S., R.B., A.D., A.H., A.B., C.A.C., F.S., G.P.M., J.B., J.S., L.H., M.J., N.S., R.N., R.S., T.L., T.B., T.P., Y.Z., B.R., D.P., M.L., W.A., D.K.C.)
| | - Elie A Akl
- American University of Beirut Medical Center, Beirut, Lebanon (J.K., A.E., F.C., L.H., R.E., S.Y., Z.S., I.B.A., E.A.A.)
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Klompas M, Baker MA, Rhee C. Airborne Transmission of SARS-CoV-2: Theoretical Considerations and Available Evidence. JAMA 2020; 324:441-442. [PMID: 32749495 DOI: 10.1001/jama.2020.12458] [Citation(s) in RCA: 260] [Impact Index Per Article: 65.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- Michael Klompas
- Harvard Medical School and Harvard Pilgrim Health Care Institute, Department of Population Medicine, Boston, Massachusetts
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Meghan A Baker
- Harvard Medical School and Harvard Pilgrim Health Care Institute, Department of Population Medicine, Boston, Massachusetts
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Chanu Rhee
- Harvard Medical School and Harvard Pilgrim Health Care Institute, Department of Population Medicine, Boston, Massachusetts
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
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264
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Tsui BCH, Pan S. Distanced-based dynamic behaviour of aerosol particles during aerosol-generating medical procedures. Br J Anaesth 2020; 125:e426-e428. [PMID: 32828494 PMCID: PMC7836680 DOI: 10.1016/j.bja.2020.07.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 07/27/2020] [Accepted: 07/27/2020] [Indexed: 11/16/2022] Open
Affiliation(s)
- Ban C H Tsui
- Department of Anesthesiology, Perioperative, and Pain Medicine, Lucile Packard Children's Hospital at Stanford, Stanford, CA, USA.
| | - Stephanie Pan
- Department of Anesthesiology, Perioperative, and Pain Medicine, Lucile Packard Children's Hospital at Stanford, Stanford, CA, USA
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265
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Rowe TA, Patel M, O'Conor R, McMackin S, Hoak V, Lindquist LA. COVID-19 exposures and infection control among home care agencies. Arch Gerontol Geriatr 2020; 91:104214. [PMID: 32768800 PMCID: PMC7390796 DOI: 10.1016/j.archger.2020.104214] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 07/23/2020] [Accepted: 07/27/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND OBJECTIVES Home care agencies (HCAs) provide caregivers, who perform an important role in maintaining the health and well-being of older adults. However, during the COVID-19 pandemic, paid caregivers had the potential to inadvertently spread COVID-19. We sought to characterize the effects of COVID-19 on HCAs and examine HCAs' infection prevention and control (IPC) policies. RESEARCH DESIGN AND METHODS This was a qualitative analysis of data collected from a national survey of HCAs. Surveys were e-mailed to members of a national HCA association on March 18, 2020. Questions included queries on demographics, COVID-19 exposures, effects of COVID-19, and IPC protocols. RESULTS 1204 HCAs responded with an average census of 96.2 (5-2800) patients daily. Across 36 states, 238 HCAs reported COVID-19 cases or exposures among caregivers. HCAs experienced challenges related to changing patient needs (e.g. decreased caregiver requests), staffing shortages (e.g., fear of COVID-19, inability to train caregivers), and management issues (e.g., inability to obtain supplies). ICP protocols varied in how HCAs followed recommended guidelines, responded to COVID-19 exposures, performed infection surveillance, and implemented precautions. Additionally, HCAs had varying policies for caregiver PTO. CONCLUSIONS HCAs experienced COVID-19 exposures and/or cases early in the pandemic. HCAs identified staffing and PPE shortages, and lack of IPC guidance as challenges. Although caregivers are providing essential care for millions of older adults, they have been largely absent from federal, state, and health system strategies for mitigating the spread of COVID-19. Future policies must include HCAs and their caregivers to optimize care for older adults.
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Affiliation(s)
- Theresa A Rowe
- Division of General Internal Medicine and Geriatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.
| | - Mallika Patel
- Division of General Internal Medicine and Geriatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Rachel O'Conor
- Division of General Internal Medicine and Geriatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | | | - Vicki Hoak
- Home Care Association of America, Washington, DC, United States
| | - Lee A Lindquist
- Division of General Internal Medicine and Geriatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
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266
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Maltezou HC, Theodoridou K, Poland G. Influenza immunization and COVID-19. Vaccine 2020; 38:6078-6079. [PMID: 32773245 PMCID: PMC7388780 DOI: 10.1016/j.vaccine.2020.07.058] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 07/24/2020] [Accepted: 07/27/2020] [Indexed: 12/25/2022]
Affiliation(s)
- Helena C Maltezou
- Directorate of Epidemiological Surveillance and Interventions for Infectious Diseases, National Public Health Organization, Athens, Greece.
| | - Kalliopi Theodoridou
- Department of Microbiology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Gregory Poland
- Mayo Vaccine Research Group, Mayo Clinic and Foundation, 200 First Street, SW Rochester, MN 55905, United States
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267
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Healthcare worker acute respiratory illness cluster in 2020: Could it be from COVID-19? Infect Control Hosp Epidemiol 2020; 42:904-905. [PMID: 32698934 PMCID: PMC7411436 DOI: 10.1017/ice.2020.364] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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268
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Zhang GQ, Pan HQ, Hu XX, He SJ, Chen YF, Wei CJ, Ni L, Zhang LP, Cheng ZS, Yang J. The role of isolation rooms, facemasks and intensified hand hygiene in the prevention of nosocomial COVID-19 transmission in a pulmonary clinical setting. Infect Dis Poverty 2020; 9:104. [PMID: 32703281 PMCID: PMC7376530 DOI: 10.1186/s40249-020-00725-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 07/14/2020] [Indexed: 01/08/2023] Open
Abstract
From December 25, 2019 to January 31, 2020, 33 cases of the coronavirus disease 2019 (COVID-19) were identified in the Department of Respiratory and Critical Care Medicine of Zhongnan Hospital of Wuhan University, China, yet none of the affiliated HCWs was infected. Here we analyzed the infection control measures used in three different departments in the Zhongnan Hospital of Wuhan University and correlated the measures with the corresponding infection data of HCWs affiliated with these departments. We found that three infection control measures, namely the isolation of the presumed positive patients, the use of facemasks and intensified hand hygiene play important roles in preventing nosocomial transmission of COVID-19.
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Affiliation(s)
- Gu-Qin Zhang
- Department of Respiratory and Critical Care Medicine, Zhongnan Hospital of Wuhan University, 169 Eastlake Road, Wuhan, 430071, China
| | - Hua-Qin Pan
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Xing-Xing Hu
- Department of Respiratory and Critical Care Medicine, Zhongnan Hospital of Wuhan University, 169 Eastlake Road, Wuhan, 430071, China
| | - Shao-Jun He
- Department of Respiratory and Critical Care Medicine, Zhongnan Hospital of Wuhan University, 169 Eastlake Road, Wuhan, 430071, China
| | - Yi-Fei Chen
- Department of Respiratory and Critical Care Medicine, Zhongnan Hospital of Wuhan University, 169 Eastlake Road, Wuhan, 430071, China
| | - Chao-Jie Wei
- Department of Respiratory and Critical Care Medicine, Zhongnan Hospital of Wuhan University, 169 Eastlake Road, Wuhan, 430071, China
| | - Lan Ni
- Department of Respiratory and Critical Care Medicine, Zhongnan Hospital of Wuhan University, 169 Eastlake Road, Wuhan, 430071, China
| | - Li-Ping Zhang
- Department of Social Medical Development, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Zhen-Shun Cheng
- Department of Respiratory and Critical Care Medicine, Zhongnan Hospital of Wuhan University, 169 Eastlake Road, Wuhan, 430071, China.
| | - Jiong Yang
- Department of Respiratory and Critical Care Medicine, Zhongnan Hospital of Wuhan University, 169 Eastlake Road, Wuhan, 430071, China.
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269
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Chou R, Dana T, Buckley DI, Selph S, Fu R, Totten AM. Update Alert: Epidemiology of and Risk Factors for Coronavirus Infection in Health Care Workers. Ann Intern Med 2020; 173:W46-W47. [PMID: 32515983 PMCID: PMC7304657 DOI: 10.7326/l20-0768] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Affiliation(s)
- Roger Chou
- Pacific Northwest Evidence-based Practice Center and Oregon Health & Science University, Portland, Oregon (R.C., T.D., S.S., A.M.T.)
| | - Tracy Dana
- Pacific Northwest Evidence-based Practice Center and Oregon Health & Science University, Portland, Oregon (R.C., T.D., S.S., A.M.T.)
| | - David I Buckley
- Pacific Northwest Evidence-based Practice Center and School of Public Health, Oregon Health & Science University-Portland State University, Portland, Oregon (D.I.B., R.F.)
| | - Shelley Selph
- Pacific Northwest Evidence-based Practice Center and Oregon Health & Science University, Portland, Oregon (R.C., T.D., S.S., A.M.T.)
| | - Rongwei Fu
- Pacific Northwest Evidence-based Practice Center and School of Public Health, Oregon Health & Science University-Portland State University, Portland, Oregon (D.I.B., R.F.)
| | - Annette M Totten
- Pacific Northwest Evidence-based Practice Center and Oregon Health & Science University, Portland, Oregon (R.C., T.D., S.S., A.M.T.)
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270
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Kaur S, Bherwani H, Gulia S, Vijay R, Kumar R. Understanding COVID-19 transmission, health impacts and mitigation: timely social distancing is the key. ENVIRONMENT, DEVELOPMENT AND SUSTAINABILITY 2020; 23:6681-6697. [PMID: 32837280 PMCID: PMC7368631 DOI: 10.1007/s10668-020-00884-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 07/11/2020] [Indexed: 05/16/2023]
Abstract
COVID-19 is a highly infectious disease caused by SARS-CoV-2, first identified in China and spread globally, resulting into pandemic. Transmission of virus takes place either directly through close contact with infected individual (symptomatic/asymptomatic) or indirectly by touching contaminated surfaces. Virus survives on the surfaces from few hours to days. It enters the human body through nose, eyes or mouth. Other sources of contamination are faeces, blood, food, water, semen etc. Parameters such as temperature/relative humidity also play an important role in transmission. As the disease is evolving, so are the number of cases. Proper planning and restriction are helping in influencing the trajectory of the transmission. Various measures are undertaken to prevent infection such as maintaining hygiene, using facemasks, isolation/quarantine, social/physical distancing, in extreme cases lockdown (restricted movement except essential services) in hot spot areas or throughout the country. Countries that introduced various mitigation measures had experienced control in transmission of COVID-19. Python programming is conducted for change point analysis (CPA) using Bayesian probability approach for understanding the impact of restrictions and mitigation methods in terms of either increase or stagnation in number of COVID-19 cases for eight countries. From analysis it is concluded that countries which acted late in bringing in the social distancing measures are suffering in terms of high number of cases with USA, leading among eight countries analysed. The CPA week in comparison with date of lockdown and first reported case strongly correlates (Pearson's r = - 0.86 to - 0.97) to cases, cases per unit area and cases per unit population, indicating earlier the mitigation strategy, lesser the number of cases. The overall paper will help the decision makers in understanding the possible steps for mitigation, more so in developing countries where the fight against COVID-19 seems to have just begun.
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Affiliation(s)
- Satinder Kaur
- CSIR-National Environmental Engineering Research Institute, Mumbai, Maharashtra 400018 India
| | - Hemant Bherwani
- CSIR-National Environmental Engineering Research Institute, Nagpur, Maharashtra 440020 India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, Uttar Pradesh 201002 India
| | - Sunil Gulia
- CSIR-National Environmental Engineering Research Institute, Delhi, 110028 India
| | - Ritesh Vijay
- CSIR-National Environmental Engineering Research Institute, Nagpur, Maharashtra 440020 India
| | - Rakesh Kumar
- CSIR-National Environmental Engineering Research Institute, Nagpur, Maharashtra 440020 India
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Trentzsch H, Flake F, Häske D, Hossfeld B, Knapp J, Gotthardt P. [Recommendations for therapy in pandemic times: Acting (and treating) correctly under pressure to act]. Notf Rett Med 2020; 23:382-384. [PMID: 32837304 PMCID: PMC7359438 DOI: 10.1007/s10049-020-00739-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- H. Trentzsch
- Institut für Notfallmedizin und Medizinmanagement (INM), Klinikum der Universität München, LMU München, Schillerstr. 53, 80336 München, Deutschland
| | - F. Flake
- Notfallvorsorge Oldenburg Nord, Malteser Hilfsdienst e. V., Oldenburg, Deutschland
| | - D. Häske
- Zentrum für öffentliches Gesundheitswesen und Versorgungsforschung Tübingen, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - B. Hossfeld
- Notfallmedizinisches Zentrum, Klinik für Anästhesiologie, Intensivmedizin, Notfallmedizin u. Schmerztherapie, Bundeswehrkrankenhaus Ulm, Ulm, Deutschland
| | - J. Knapp
- Universitätsklinik für Anästhesiologie und Schmerztherapie, Universitätsspital Bern, Bern, Schweiz
| | - P. Gotthardt
- Klinikum Nürnberg – Klinik für Kardiologie – Zentrale Notaufnahme Süd, Breslauer Str. 201, 90471 Nürnberg, Deutschland
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272
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Nasir A, Shaukat K, Hameed IA, Luo S, Alam TM, Iqbal F. A Bibliometric Analysis of Corona Pandemic in Social Sciences: A Review of Influential Aspects and Conceptual Structure. IEEE ACCESS : PRACTICAL INNOVATIONS, OPEN SOLUTIONS 2020; 8:133377-133402. [PMID: 34812340 PMCID: PMC8545329 DOI: 10.1109/access.2020.3008733] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 07/06/2020] [Indexed: 05/07/2023]
Abstract
Corona pandemic has affected the whole world, and it is a highly researched area in biological sciences. As the current pandemic has affected countries socially and economically, the purpose of this bibliometric analysis is to provide a holistic review of the corona pandemic in the field of social sciences. This study aims to highlight significant, influential aspects, research streams, and themes. We have reviewed 395 journal articles related to coronavirus in the field of social sciences from 2003 to 2020. We have deployed 'biblioshiny' a web-interface of the 'bibliometrix 3.0' package of R-studio to conduct bibliometric analysis and visualization. In the field of social sciences, we have reported influential aspects of coronavirus literature. We have found that the 'Morbidity and Mortality Weekly Report' is the top journal. The core article of coronavirus literature is 'Guidelines for preventing health-care-associated pneumonia'. The most commonly used word, in titles, abstracts, author's keywords, and keywords plus, is 'SARS'. Top affiliation is 'The University of Hong Kong'. Hong Kong is a leading country based on citations, and the USA is on top based on total publications. We have used a conceptual framework to identify potential research streams and themes in coronavirus literature. Four research streams are found by deploying a co-occurrence network. These research streams are 'Social and economic effects of epidemic disease', 'Infectious disease calamities and control', 'Outbreak of COVID 19,' and 'Infectious diseases and the role of international organizations'. Finally, a thematic map is used to provide a holistic understanding by dividing significant themes into basic or transversal, emerging or declining, motor, highly developed, but isolated themes. These themes and subthemes have proposed future directions and critical areas of research.
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Affiliation(s)
- Adeel Nasir
- Department of Management SciencesLahore College for Women UniversityLahore54000Pakistan
| | - Kamran Shaukat
- School of Electrical Engineering and ComputingThe University of NewcastleCallaghanNSW2308Australia
- Punjab University College of Information Technology, University of the PunjabLahore54590Pakistan
| | - Ibrahim A. Hameed
- Department of ICT and Natural SciencesNorwegian University of Science and Technology7491TrondheimNorway
| | - Suhuai Luo
- School of Electrical Engineering and ComputingThe University of NewcastleCallaghanNSW2308Australia
| | - Talha Mahboob Alam
- Department of Computer ScienceUniversity of Engineering and TechnologyLahore54890Pakistan
| | - Farhat Iqbal
- Punjab University College of Information Technology, University of the PunjabLahore54590Pakistan
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273
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Ng-Kamstra J, Stelfox HT, Fiest K, Conly J, Leigh JP. Perspectives on personal protective equipment in acute care facilities during the COVID-19 pandemic. CMAJ 2020; 192:E805-E809. [PMID: 32586837 PMCID: PMC7828870 DOI: 10.1503/cmaj.200575] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Affiliation(s)
- Josh Ng-Kamstra
- Department of Critical Care Medicine (Ng-Kamstra, Stelfox, Fiest), Cumming School of Medicine, University of Calgary and Alberta Health Services; Departments of Community Health Sciences and O'Brien Institute for Public Health (Stelfox, Fiest), Psychiatry and Hotchkiss Brain Institute (Fiest), Medicine (Conly), Pathology and Laboratory Medicine (Conly) and Microbiology, Immunology, and Infectious Diseases, and Snyder Institute for Chronic Diseases (Conly), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Faculty of Health ( Parsons Leigh), School of Health Administration, and Department of Critical Care Medicine, Faculty of Medicine (Parsons Leigh), Dalhousie University, Halifax, NS
| | - Henry T Stelfox
- Department of Critical Care Medicine (Ng-Kamstra, Stelfox, Fiest), Cumming School of Medicine, University of Calgary and Alberta Health Services; Departments of Community Health Sciences and O'Brien Institute for Public Health (Stelfox, Fiest), Psychiatry and Hotchkiss Brain Institute (Fiest), Medicine (Conly), Pathology and Laboratory Medicine (Conly) and Microbiology, Immunology, and Infectious Diseases, and Snyder Institute for Chronic Diseases (Conly), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Faculty of Health ( Parsons Leigh), School of Health Administration, and Department of Critical Care Medicine, Faculty of Medicine (Parsons Leigh), Dalhousie University, Halifax, NS
| | - Kirsten Fiest
- Department of Critical Care Medicine (Ng-Kamstra, Stelfox, Fiest), Cumming School of Medicine, University of Calgary and Alberta Health Services; Departments of Community Health Sciences and O'Brien Institute for Public Health (Stelfox, Fiest), Psychiatry and Hotchkiss Brain Institute (Fiest), Medicine (Conly), Pathology and Laboratory Medicine (Conly) and Microbiology, Immunology, and Infectious Diseases, and Snyder Institute for Chronic Diseases (Conly), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Faculty of Health ( Parsons Leigh), School of Health Administration, and Department of Critical Care Medicine, Faculty of Medicine (Parsons Leigh), Dalhousie University, Halifax, NS
| | - John Conly
- Department of Critical Care Medicine (Ng-Kamstra, Stelfox, Fiest), Cumming School of Medicine, University of Calgary and Alberta Health Services; Departments of Community Health Sciences and O'Brien Institute for Public Health (Stelfox, Fiest), Psychiatry and Hotchkiss Brain Institute (Fiest), Medicine (Conly), Pathology and Laboratory Medicine (Conly) and Microbiology, Immunology, and Infectious Diseases, and Snyder Institute for Chronic Diseases (Conly), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Faculty of Health ( Parsons Leigh), School of Health Administration, and Department of Critical Care Medicine, Faculty of Medicine (Parsons Leigh), Dalhousie University, Halifax, NS
| | - Jeanna Parsons Leigh
- Department of Critical Care Medicine (Ng-Kamstra, Stelfox, Fiest), Cumming School of Medicine, University of Calgary and Alberta Health Services; Departments of Community Health Sciences and O'Brien Institute for Public Health (Stelfox, Fiest), Psychiatry and Hotchkiss Brain Institute (Fiest), Medicine (Conly), Pathology and Laboratory Medicine (Conly) and Microbiology, Immunology, and Infectious Diseases, and Snyder Institute for Chronic Diseases (Conly), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Faculty of Health ( Parsons Leigh), School of Health Administration, and Department of Critical Care Medicine, Faculty of Medicine (Parsons Leigh), Dalhousie University, Halifax, NS
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274
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Miles A, Connor NP, Desai RV, Jadcherla S, Allen J, Brodsky M, Garand KL, Malandraki GA, McCulloch TM, Moss M, Murray J, Pulia M, Riquelme LF, Langmore SE. Dysphagia Care Across the Continuum: A Multidisciplinary Dysphagia Research Society Taskforce Report of Service-Delivery During the COVID-19 Global Pandemic. Dysphagia 2020; 36:170-182. [PMID: 32654059 PMCID: PMC7353832 DOI: 10.1007/s00455-020-10153-8] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 07/03/2020] [Indexed: 12/11/2022]
Abstract
At the time of writing this paper, there are over 11 million reported cases of COVID-19 worldwide. Health professionals involved in dysphagia care are impacted by the COVID-19 pandemic in their day-to-day practices. Otolaryngologists, gastroenterologists, rehabilitation specialists, and speech-language pathologists are subject to virus exposure due to their proximity to the aerodigestive tract and reliance on aerosol-generating procedures in swallow assessments and interventions. Across the globe, professional societies and specialty associations are issuing recommendations about which procedures to use, when to use them, and how to reduce the risk of COVID-19 transmission during their use. Balancing safety for self, patients, and the public while maintaining adequate evidence-based dysphagia practices has become a significant challenge. This paper provides current evidence on COVID-19 transmission during commonly used dysphagia practices and provides recommendations for protection while conducting these procedures. The paper summarizes current understanding of dysphagia in patients with COVID-19 and draws on evidence for dysphagia interventions that can be provided without in-person consults and close proximity procedures including dysphagia screening and telehealth.
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Affiliation(s)
- Anna Miles
- The University of Auckland, Auckland, New Zealand. .,Speech Science, School of Psychology, The University of Auckland, Grafton Campus, Private Bag 92019, Auckland, New Zealand.
| | - Nadine P Connor
- Communication Sciences & Disorders; Otolaryngology, Head and Neck Surgery, University of Wisconsin-Madison, Madison, USA
| | - Rinki Varindani Desai
- Department of Otolaryngology - Head and Neck Surgery, University of Mississippi Medical Center, Jackson, MS, USA
| | - Sudarshan Jadcherla
- Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, OH, USA
| | - Jacqui Allen
- The University of Auckland, Auckland, New Zealand
| | - Martin Brodsky
- Outcomes After Critical Illness and Surgery (OACIS) Research Group, Division of Pulmonary and Critical Care Medicine, Department of Physical Medicine & Rehabilitation, Johns Hopkins University, Baltimore, MD, USA
| | - Kendrea L Garand
- Department of Speech Pathology and Audiology, University of South Alabama, Mobile, AL, USA
| | - Georgia A Malandraki
- Speech, Language, and Hearing Sciences, and Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
| | - Timothy M McCulloch
- Otolaryngology, Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, USA
| | - Marc Moss
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Joseph Murray
- Audiology Speech Pathology Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
| | - Michael Pulia
- Emergency Care for Infectious Diseases (ECID) Research Program, BerbeeWalsh Department of Emergency Medicine, University of Wisconsin School of Medicine and Public Health, Madison, USA
| | - Luis F Riquelme
- New York Medical College, Valhalla, NY, USA.,Barrique Speech-Language Pathology, PC, Brooklyn, NY, USA
| | - Susan E Langmore
- Otolaryngology Head/Neck Surgery, Boston University School of Medicine, Boston, USA
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275
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Groenewold MR, Burrer SL, Ahmed F, Uzicanin A, Free H, Luckhaupt SE. Increases in Health-Related Workplace Absenteeism Among Workers in Essential Critical Infrastructure Occupations During the COVID-19 Pandemic - United States, March-April 2020. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2020; 69:853-858. [PMID: 32644979 PMCID: PMC7727595 DOI: 10.15585/mmwr.mm6927a1] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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276
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Cummings DAT, Radonovich LJ, Gorse GJ, Gaydos CA, Bessesen MT, Brown AC, Gibert CL, Hitchings MDT, Lessler J, Nyquist AC, Rattigan SM, Rodriguez-Barradas MC, Price CS, Reich NG, Simberkoff MS, Perl TM. Risk Factors for Healthcare Personnel Infection with Endemic Coronaviruses (HKU1, OC43, NL63, 229E): Results from the Respiratory Protection Effectiveness Clinical Trial (ResPECT). Clin Infect Dis 2020; 73:e4428-e4432. [PMID: 32645144 PMCID: PMC7454439 DOI: 10.1093/cid/ciaa900] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 07/07/2020] [Indexed: 11/13/2022] Open
Abstract
Background SARS-CoV-2 presents a large risk to healthcare personnel. Quantifying the risk of coronavirus infection associated with workplace activities is an urgent need. Methods We assessed the association of worker characteristics, occupational roles and behaviors, and participation in procedures with the risk of endemic coronavirus infection among healthcare personnel who participated in the Respiratory Protection Effectiveness Trial (ResPECT), a cluster randomized trial to assess personal protective equipment to prevent respiratory infections and illness conducted from 2011 to 2016. Results Among 4,689 HCP-seasons, we detected coronavirus infection in 387 (8%). HCP who participated in an aerosol generation procedure (AGP) at least once during the viral respiratory season were 105% (95% CI 21%, 240%) more likely to be diagnosed with a laboratory-confirmed coronavirus infection. Younger individuals, those who saw pediatric patients and those with household members under the age of five were at increased risk of coronavirus infection. Conclusions Our analysis suggests the risk of HCP becoming infected with an endemic coronavirus increases approximately two-fold with exposures to AGP. Our findings may be relevant to the Coronavirus Disease 2019 (COVID-19) pandemic; however, SARS-COV-2, the virus that causes COVID-19, may differ from endemic coronaviruses in important ways.
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Affiliation(s)
| | - Lewis J Radonovich
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Geoffrey J Gorse
- Veterans Affairs St. Louis Health Care System, St. Louis, MO, USA.,Saint Louis University School of Medicine, St. Louis, MO, USA
| | | | - Mary T Bessesen
- Veterans Affairs Eastern Colorado Healthcare System, Denver, CO, USA.,University of Colorado School of Medicine, Aurora, CO, USA
| | | | - Cynthia L Gibert
- Veterans Affairs Medical Center, Washington, DC, USA.,George Washington University School of Medical and Health Sciences, Washington, DC, USA
| | | | - Justin Lessler
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ann-Christine Nyquist
- University of Colorado School of Medicine, Aurora, CO, USA.,Children's Hospital Colorado, Aurora, CO, USA
| | | | - Maria C Rodriguez-Barradas
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA.,Baylor College of Medicine, Houston, Texas, USA
| | - Connie Savor Price
- University of Colorado School of Medicine, Aurora, CO, USA.,Denver Health Medical Center, Denver, CO, USA
| | | | - Michael S Simberkoff
- Veterans Affairs New York Harbor Healthcare System, New York, NY, USA.,NYU School of Medicine, New York, NY, USA
| | - Trish M Perl
- Johns Hopkins School of Medicine, Baltimore, MD, USA.,University of Texas Southwestern Medical Center, Dallas, TX, USA
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277
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Covid-19 Airborne Transmission and Its Prevention: Waiting for Evidence or Applying the Precautionary Principle? ATMOSPHERE 2020. [DOI: 10.3390/atmos11070710] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Besides the predominant ways of transmission of SARS-CoV-2 (namely, contacts and large droplets) the airborne one is increasingly taken into consideration as a result of latest research findings. Nevertheless, this possibility has been already suggested by previous studies on other coronaviruses including SARS-CoV and MERS-CoV. To describe the state of the art of coronaviruses and airborne transmission, a systematic review was carried out using the PRISMA methodology. Overall, 64 papers were selected and classified into three main groups: laboratory experiments (12 papers), air monitoring (22) and epidemiological and airflow model studies (30). The airborne transmission of SARS-CoV-2 is suggested by the studies of the three groups, but none has yet obtained complete evidence. The sampling and detection methods have not been validated, therefore monitoring results are affected by a possible underestimation. Then, epidemiological investigations only hypothesize the airborne transmission as a possible explanation for some illness cases, but without estimating its attributable risk. Nevertheless, while waiting for more evidence, it is urgent to base advice on preventive measures, such as the use of masks, safe distancing and air ventilation, on the precautionary principle.
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278
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Bekeschus S, Kramer A, Suffredini E, von Woedtke T, Colombo V. Gas Plasma Technology-An Asset to Healthcare During Viral Pandemics Such as the COVID-19 Crisis? IEEE TRANSACTIONS ON RADIATION AND PLASMA MEDICAL SCIENCES 2020; 4:391-399. [PMID: 34192214 PMCID: PMC8043491 DOI: 10.1109/trpms.2020.3002658] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 06/12/2020] [Indexed: 12/21/2022]
Abstract
The COVID-19 crisis profoundly disguised the vulnerability of human societies and healthcare systems in the situation of a pandemic. In many instances, it became evident that the quick and safe reduction of viral load and spread is the foremost principle in the successful management of such a pandemic. However, it became also clear that many of the established routines in healthcare are not always sufficient to cope with the increased demand for decontamination procedures of items, healthcare products, and even infected tissues. For the last 25 years, the use of gas plasma technology has sparked a tremendous amount of literature on its decontaminating properties, especially for heat-labile targets, such as polymers and tissues, where chemical decontamination often is not appropriate. However, while the majority of earlier work focused on bacteria, only relatively few reports are available on the inactivation of viruses. We here aim to provide a perspective for the general audience of the chances and opportunities of gas plasma technology for supporting healthcare during viral pandemics such as the COVID-19 crisis. This includes possible real-world plasma applications, appropriate laboratory viral test systems, and critical points on the technical and safety requirements of gas plasmas for virus inactivation.
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Affiliation(s)
- Sander Bekeschus
- ZIK plasmatis, Leibniz Institute for Plasma Science and Technology (INP)17489GreifswaldGermany
- Leibniz Networks on Health Technologies and Immune-mediated Diseases
| | - Axel Kramer
- Institute for Hygiene and Environmental Medicine, Greifswald University Medical Center17489GreifswaldGermany
| | - Elisabetta Suffredini
- Department of Food Safety, Nutrition and Veterinary Public HealthIstituto Superiore di Sanità00161RomeItaly
| | - Thomas von Woedtke
- ZIK plasmatis, Leibniz Institute for Plasma Science and Technology (INP)17489GreifswaldGermany
- Leibniz Network on Health Technologies
| | - Vittorio Colombo
- Department of Industrial Engineering, Interdepartmental Center for Agri-food Industrial Research, Interdepartmental Center for Industrial Research on Advanced Applications in Mechanical Engineering and Materials TechnologyAlma Mater Studiorum-Università di Bologna40136BolognaItaly
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279
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Anwar SL, Harahap WA, Aryandono T. Perspectives on how to navigate cancer surgery in the breast, head and neck, skin, and soft tissue tumor in limited-resource countries during COVID-19 pandemic. Int J Surg 2020; 79:206-212. [PMID: 32497751 PMCID: PMC7832808 DOI: 10.1016/j.ijsu.2020.05.072] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 05/23/2020] [Accepted: 05/27/2020] [Indexed: 01/01/2023]
Abstract
The rapidly spreading coronavirus infection (COVID-19) worldwide has contracted all aspects of health systems. Developing countries that mostly have a weaker healthcare system and insufficient resources are likely to be the most hardly affected by the pandemic. Cancers are frequently diagnosed in late stages with higher case-fatality rates compared to those in high-income countries. Delayed diagnosis, lack of cancer awareness, low adherence to treatment, and unequal or limited access to treatment are among the challenging factors of cancer management in developing countries. Elective cancer surgeries are often considered to be postponed during COVID-19 pandemic to preserve valuable hospital resources such as personal protection equipment, hospital bed, intensive care unit capacity, and manpower to screen and treat the affected individuals. However, specific considerations to defer cancer surgery in developing countries might need to be carefully adjusted to counterbalance between preventing COVID-19 transmission and preserving patients 'long-term life expectancy and quality of life.
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Affiliation(s)
- Sumadi Lukman Anwar
- Division of Surgical Oncology - Department of Surgery, Dr Sardjito Hospital / Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia.
| | - Wirsma Arif Harahap
- Division of Surgical Oncology - Department of Surgery, Dr M. Djamil Hospital / Faculty of Medicine, Universitas Andalas, Padang, 25217, Indonesia
| | - Teguh Aryandono
- Division of Surgical Oncology - Department of Surgery, Dr Sardjito Hospital / Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia
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280
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Schulz-Stübner S, Kunitz O. [Infection Prevention in Anesthesiology during the SARS-CoV 2-pandemic]. Anasthesiol Intensivmed Notfallmed Schmerzther 2020; 55:494-502. [PMID: 32736389 PMCID: PMC7416219 DOI: 10.1055/a-1174-7359] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
It is necessary to discuss the sometimes competing goals of sufficient critical care capacity, maintenance of regular patient care, protection of medical staff, interruption of infectious chains within the general public and individual aspects of patient care in anesthesia and the operating room in times of the SARS CoV-2 pandemic, given the uncertainty of many data on which decisions need to be based. Basic hygiene remains the cornerstone of infection prevention especially when resources are sparse and SARS-CoV-2 specific additional measures need to be taken according to a risk analysis taking the dynamic of the pandemic as well as local factors into account.
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Affiliation(s)
- Sebastian Schulz-Stübner
- Korrespondenzadresse PD Dr. med. Sebastian Schulz-Stübner BZH GmbH – Deutsches Beratungszentrum für HygieneSchnewlinstraße 479098 Freiburg im BreisgauDeutschland
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281
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Chu DK, Akl EA, Duda S, Solo K, Yaacoub S, Schünemann HJ. Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis. Lancet 2020; 395:1973-1987. [PMID: 32497510 PMCID: PMC7263814 DOI: 10.1016/s0140-6736(20)31142-9] [Citation(s) in RCA: 2286] [Impact Index Per Article: 571.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 05/07/2020] [Accepted: 05/07/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19 and is spread person-to-person through close contact. We aimed to investigate the effects of physical distance, face masks, and eye protection on virus transmission in health-care and non-health-care (eg, community) settings. METHODS We did a systematic review and meta-analysis to investigate the optimum distance for avoiding person-to-person virus transmission and to assess the use of face masks and eye protection to prevent transmission of viruses. We obtained data for SARS-CoV-2 and the betacoronaviruses that cause severe acute respiratory syndrome, and Middle East respiratory syndrome from 21 standard WHO-specific and COVID-19-specific sources. We searched these data sources from database inception to May 3, 2020, with no restriction by language, for comparative studies and for contextual factors of acceptability, feasibility, resource use, and equity. We screened records, extracted data, and assessed risk of bias in duplicate. We did frequentist and Bayesian meta-analyses and random-effects meta-regressions. We rated the certainty of evidence according to Cochrane methods and the GRADE approach. This study is registered with PROSPERO, CRD42020177047. FINDINGS Our search identified 172 observational studies across 16 countries and six continents, with no randomised controlled trials and 44 relevant comparative studies in health-care and non-health-care settings (n=25 697 patients). Transmission of viruses was lower with physical distancing of 1 m or more, compared with a distance of less than 1 m (n=10 736, pooled adjusted odds ratio [aOR] 0·18, 95% CI 0·09 to 0·38; risk difference [RD] -10·2%, 95% CI -11·5 to -7·5; moderate certainty); protection was increased as distance was lengthened (change in relative risk [RR] 2·02 per m; pinteraction=0·041; moderate certainty). Face mask use could result in a large reduction in risk of infection (n=2647; aOR 0·15, 95% CI 0·07 to 0·34, RD -14·3%, -15·9 to -10·7; low certainty), with stronger associations with N95 or similar respirators compared with disposable surgical masks or similar (eg, reusable 12-16-layer cotton masks; pinteraction=0·090; posterior probability >95%, low certainty). Eye protection also was associated with less infection (n=3713; aOR 0·22, 95% CI 0·12 to 0·39, RD -10·6%, 95% CI -12·5 to -7·7; low certainty). Unadjusted studies and subgroup and sensitivity analyses showed similar findings. INTERPRETATION The findings of this systematic review and meta-analysis support physical distancing of 1 m or more and provide quantitative estimates for models and contact tracing to inform policy. Optimum use of face masks, respirators, and eye protection in public and health-care settings should be informed by these findings and contextual factors. Robust randomised trials are needed to better inform the evidence for these interventions, but this systematic appraisal of currently best available evidence might inform interim guidance. FUNDING World Health Organization.
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Affiliation(s)
- Derek K Chu
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada; Department of Medicine, McMaster University, Hamilton, ON, Canada; The Research Institute of St Joe's Hamilton, Hamilton, ON, Canada
| | - Elie A Akl
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada; Department of Internal Medicine, American University of Beirut, Beirut, Lebanon; Clinical Research Institute, American University of Beirut, Beirut, Lebanon
| | - Stephanie Duda
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Karla Solo
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Sally Yaacoub
- Clinical Research Institute, American University of Beirut, Beirut, Lebanon
| | - Holger J Schünemann
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada; Department of Medicine, McMaster University, Hamilton, ON, Canada; Michael G DeGroote Cochrane Canada and GRADE Centres, Hamilton, ON, Canada.
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282
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Chu DK, Akl EA, Duda S, Solo K, Yaacoub S, Schünemann HJ. Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis. Lancet 2020. [PMID: 32497510 DOI: 10.1016/s0140-6736(20)31142-31149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19 and is spread person-to-person through close contact. We aimed to investigate the effects of physical distance, face masks, and eye protection on virus transmission in health-care and non-health-care (eg, community) settings. METHODS We did a systematic review and meta-analysis to investigate the optimum distance for avoiding person-to-person virus transmission and to assess the use of face masks and eye protection to prevent transmission of viruses. We obtained data for SARS-CoV-2 and the betacoronaviruses that cause severe acute respiratory syndrome, and Middle East respiratory syndrome from 21 standard WHO-specific and COVID-19-specific sources. We searched these data sources from database inception to May 3, 2020, with no restriction by language, for comparative studies and for contextual factors of acceptability, feasibility, resource use, and equity. We screened records, extracted data, and assessed risk of bias in duplicate. We did frequentist and Bayesian meta-analyses and random-effects meta-regressions. We rated the certainty of evidence according to Cochrane methods and the GRADE approach. This study is registered with PROSPERO, CRD42020177047. FINDINGS Our search identified 172 observational studies across 16 countries and six continents, with no randomised controlled trials and 44 relevant comparative studies in health-care and non-health-care settings (n=25 697 patients). Transmission of viruses was lower with physical distancing of 1 m or more, compared with a distance of less than 1 m (n=10 736, pooled adjusted odds ratio [aOR] 0·18, 95% CI 0·09 to 0·38; risk difference [RD] -10·2%, 95% CI -11·5 to -7·5; moderate certainty); protection was increased as distance was lengthened (change in relative risk [RR] 2·02 per m; pinteraction=0·041; moderate certainty). Face mask use could result in a large reduction in risk of infection (n=2647; aOR 0·15, 95% CI 0·07 to 0·34, RD -14·3%, -15·9 to -10·7; low certainty), with stronger associations with N95 or similar respirators compared with disposable surgical masks or similar (eg, reusable 12-16-layer cotton masks; pinteraction=0·090; posterior probability >95%, low certainty). Eye protection also was associated with less infection (n=3713; aOR 0·22, 95% CI 0·12 to 0·39, RD -10·6%, 95% CI -12·5 to -7·7; low certainty). Unadjusted studies and subgroup and sensitivity analyses showed similar findings. INTERPRETATION The findings of this systematic review and meta-analysis support physical distancing of 1 m or more and provide quantitative estimates for models and contact tracing to inform policy. Optimum use of face masks, respirators, and eye protection in public and health-care settings should be informed by these findings and contextual factors. Robust randomised trials are needed to better inform the evidence for these interventions, but this systematic appraisal of currently best available evidence might inform interim guidance. FUNDING World Health Organization.
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Affiliation(s)
- Derek K Chu
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada; Department of Medicine, McMaster University, Hamilton, ON, Canada; The Research Institute of St Joe's Hamilton, Hamilton, ON, Canada
| | - Elie A Akl
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada; Department of Internal Medicine, American University of Beirut, Beirut, Lebanon; Clinical Research Institute, American University of Beirut, Beirut, Lebanon
| | - Stephanie Duda
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Karla Solo
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Sally Yaacoub
- Clinical Research Institute, American University of Beirut, Beirut, Lebanon
| | - Holger J Schünemann
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada; Department of Medicine, McMaster University, Hamilton, ON, Canada; Michael G DeGroote Cochrane Canada and GRADE Centres, Hamilton, ON, Canada.
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283
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Maranhao B, Scott AW, Scott AR, Maeng J, Song Z, Baddigam R, King CR, McCormick M, Kangrga I, Guffey R. Probability of fit failure with reuse of N95 mask respirators. Br J Anaesth 2020; 125:e322-e324. [PMID: 32682553 PMCID: PMC7318975 DOI: 10.1016/j.bja.2020.06.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 06/15/2020] [Accepted: 06/16/2020] [Indexed: 11/10/2022] Open
Affiliation(s)
- Bruno Maranhao
- Department of Anaesthesiology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Alex W Scott
- Department of Anaesthesiology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Alex R Scott
- School of Medicine, Washington University School of Medicine, Saint Louis, MO, USA
| | - Jooyoung Maeng
- Department of Anaesthesiology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Ziyan Song
- Department of Anaesthesiology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Ramya Baddigam
- Department of Anaesthesiology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Christopher R King
- Department of Anaesthesiology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Molly McCormick
- Department of Anaesthesiology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Ivan Kangrga
- Department of Anaesthesiology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Ryan Guffey
- Department of Anaesthesiology, Washington University School of Medicine, Saint Louis, MO, USA.
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284
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Qureshi AI, French BR, Siddiq F, Arora NA, Nattanmai P, Gomez CR. COVID-19 Screening with Chest CT in Acute Stroke Imaging: A Clinical Decision Model. J Neuroimaging 2020; 30:617-624. [PMID: 32589348 PMCID: PMC7361470 DOI: 10.1111/jon.12746] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 06/08/2020] [Accepted: 06/09/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND AND PURPOSE Acute stroke patients may have undiagnosed coronavirus disease 2019 (COVID‐19) infection, transmissible to medical professionals involved in their care. Our aim was to determine the value of incorporating a chest computed tomography (CT) scan during acute stroke imaging, and the factors that influence this decision. METHODS We constructed a probabilistic decision tree of the value of acquiring a chest CT scan or not, expressed in quality‐adjusted life months (QALM) of patients and medical professionals. The model was based on the chance of detecting infection by chest CT scan, the case fatality rates of COVID‐19 infection, the risk of COVID‐19 infection after exposure, the expected proportion of medical professionals exposed, and the exposure reduction derived from early disease detection. RESULTS The decision to incorporate the chest CT scan was superior to not doing so (12.00 QALM vs 11.99 QALM, respectively), when the probability of patients having undetected COVID‐19 infection is 3.5%, potentially exposing 100% of medical professionals, and if early detection reduces exposure by 50%. The risk of developing symptomatic COVID‐19 infection following exposure casts uncertainty on the results, but this is offset by the potential for reducing exposure. CONCLUSIONS We identified a measurable benefit of incorporating a chest CT into the urgent imaging protocol of acute stroke patients in reducing exposure of medical professionals without appropriate precautions. The clinical impact of this benefit, however, may not be materially significant.
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Affiliation(s)
- Adnan I Qureshi
- Department of Neurology, University of Missouri, School of Medicine, Columbia, MO.,Zeenat Qureshi Stroke Institute, St. Cloud, MN
| | - Brandi R French
- Department of Neurology, University of Missouri, School of Medicine, Columbia, MO
| | - Farhan Siddiq
- Division of Neurosurgery, University of Missouri, School of Medicine, Columbia, MO
| | - Niraj A Arora
- Department of Neurology, University of Missouri, School of Medicine, Columbia, MO
| | - Premkumar Nattanmai
- Department of Neurology, University of Missouri, School of Medicine, Columbia, MO
| | - Camilo R Gomez
- Department of Neurology, University of Missouri, School of Medicine, Columbia, MO
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285
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Ren YR, Golding A, Sorbello A, Ji P, Chen J, Saluja B, Witzmann K, Arya V, Reynolds KS, Choi SY, Nikolov NP, Sahajwalla C. A Comprehensive Updated Review on SARS-CoV-2 and COVID-19. J Clin Pharmacol 2020; 60:954-975. [PMID: 32469437 PMCID: PMC7283834 DOI: 10.1002/jcph.1673] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 05/20/2020] [Indexed: 01/08/2023]
Abstract
This literature review aims to provide a comprehensive current summary of the pathogenesis, clinical features, disease course, host immune responses, and current investigational antiviral and immunomodulatory pharmacotherapies to facilitate the development of future therapies and measures for prevention and control.
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Affiliation(s)
- Yunzhao R Ren
- Division of Inflammation and Immune Pharmacology, Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, FDA, Silver Spring, Maryland, USA
| | - Amit Golding
- Division of Rheumatology and Transplant Medicine, Office of Immunology and Inflammation, Office of New Drugs, Center for Drug Evaluation and Research, FDA, Silver Spring, Maryland, USA
| | - Alfred Sorbello
- Office of Translational Sciences, Center for Drug Evaluation and Research, FDA, Silver Spring, Maryland, USA
| | - Ping Ji
- Division of Inflammation and Immune Pharmacology, Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, FDA, Silver Spring, Maryland, USA
| | - Jianmeng Chen
- Division of Inflammation and Immune Pharmacology, Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, FDA, Silver Spring, Maryland, USA
| | - Bhawana Saluja
- Division of Inflammation and Immune Pharmacology, Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, FDA, Silver Spring, Maryland, USA
| | - Kimberly Witzmann
- Office of Bioequivalence, Office of Generic Drugs, Center for Drug Evaluation and Research, FDA, Silver Spring, Maryland, USA
| | - Vikram Arya
- Division of Infectious Disease Pharmacology, Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, FDA, Silver Spring, Maryland, USA
| | - Kellie S Reynolds
- Division of Infectious Disease Pharmacology, Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, FDA, Silver Spring, Maryland, USA
| | - Su-Young Choi
- Division of Infectious Disease Pharmacology, Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, FDA, Silver Spring, Maryland, USA
| | - Nikolay P Nikolov
- Division of Rheumatology and Transplant Medicine, Office of Immunology and Inflammation, Office of New Drugs, Center for Drug Evaluation and Research, FDA, Silver Spring, Maryland, USA
| | - Chandrahas Sahajwalla
- Division of Inflammation and Immune Pharmacology, Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, FDA, Silver Spring, Maryland, USA
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de Leeuw RA, Burger NB, Ceccaroni M, Zhang J, Tuynman J, Mabrouk M, Barri Soldevila P, Bonjer HJ, Ankum P, Huirne J. COVID-19 and Laparoscopic Surgery: Scoping Review of Current Literature and Local Expertise. JMIR Public Health Surveill 2020; 6:e18928. [PMID: 32406853 PMCID: PMC7313384 DOI: 10.2196/18928] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 05/07/2020] [Accepted: 05/13/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The current coronavirus disease (COVID-19) pandemic is holding the world in its grip. Epidemiologists have shown that the mortality risks are higher when the health care system is subjected to pressure from COVID-19. It is therefore of great importance to maintain the health of health care providers and prevent contamination. An important group who will be required to treat patients with COVID-19 are health care providers during semiacute surgery. There are concerns that laparoscopic surgery increases the risk of contamination more than open surgery; therefore, balancing the safety of health care providers with the benefit of laparoscopic surgery for the patient is vital. OBJECTIVE We aimed to provide an overview of potential contamination routes and possible risks for health care providers; we also aimed to propose research questions based on current literature and expert opinions about performing laparoscopic surgery on patients with COVID-19. METHODS We performed a scoping review, adding five additional questions concerning possible contaminating routes. A systematic search was performed on the PubMed, CINAHL, and Embase databases, adding results from gray literature as well. The search not only included COVID-19 but was extended to virus contamination in general. We excluded society and professional association statements about COVID-19 if they did not add new insights to the available literature. RESULTS The initial search provided 2007 records, after which 267 full-text papers were considered. Finally, we used 84 papers, of which 14 discussed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Eight papers discussed the added value of performing intubation in a low-pressure operating room, mainly based on the SARS outbreak experience in 2003. Thirteen papers elaborated on the risks of intubation for health care providers and SARS-CoV-2, and 19 papers discussed this situation with other viruses. They conclude that there is significant evidence that intubation and extubation is a high-risk aerosol-producing procedure. No papers were found on the risk of SARS-CoV-2 and surgical smoke, although 25 papers did provide conflicting evidence on the infection risk of human papillomavirus, hepatitis B, polio, and rabies. No papers were found discussing tissue extraction or the deflation risk of the pneumoperitoneum after laparoscopic surgery. CONCLUSIONS There seems to be consensus in the literature that intubation and extubation are high-risk procedures for health care providers and that maximum protective equipment is needed. On the other hand, minimal evidence is available of the actual risk of contamination of health care providers during laparoscopy itself, nor of operating room pressure, surgical smoke, tissue extraction, or CO2 deflation. However, new studies are being published daily from current experiences, and society statements are continuously updated. There seems to be no reason to abandon laparoscopic surgery in favor of open surgery. However, the risks should not be underestimated, surgery should be performed on patients with COVID-19 only when necessary, and health care providers should use logic and common sense to protect themselves and others by performing surgery in a safe and protected environment.
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Affiliation(s)
| | - Nicole Birgit Burger
- Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Marcello Ceccaroni
- Department of Obstetrics and Gynecology, Gynecologic Oncology and Minimally-Invasive Pelvic Surgery, International School of Surgical Anatomy, Istituto Di Ricovero e Cura a Carabettere Scientifico Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Jian Zhang
- Department of Obstetrics and Gynecology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Jurriaan Tuynman
- Department of Surgery, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Mohamed Mabrouk
- Cambridge Endometriosis and Endoscopic Surgery Unit, Cambridge University Hospitals NHS Foundation Trust, Addenbrook, United Kingdom
| | | | - Hendrik Jaap Bonjer
- Department of Surgery, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Pim Ankum
- Department of Gynecology and Obstetrics, Research Institute Reproduction and Development, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Judith Huirne
- Department of Gynecology and Obstetrics, Research Institute Reproduction and Development, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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Badawi A. Hypercytokinemia and Pathogen-Host Interaction in COVID-19. J Inflamm Res 2020; 13:255-261. [PMID: 32606886 PMCID: PMC7320995 DOI: 10.2147/jir.s259096] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 06/10/2020] [Indexed: 12/13/2022] Open
Abstract
Severe acute respiratory syndrome (SARS) coronavirus (CoV)-2 (SARS-CoV-2) is a novel coronavirus identified as the cause of coronavirus disease-2019 (COVID-19) that began in Wuhan, China in late 2019 and spread now in 210 countries and territories around the world. Many people are asymptomatic or with mild symptoms. However, in some cases (usually the elderly and those with comorbidities) the disease may progress to pneumonia, acute respiratory distress syndrome and multi-organ dysfunction that can lead to death. Such wide interindividual differences in response to SARS-CoV-2 infection may relate to several pathogen- and host-related factors. These include the different levels of the ubiquitously present human angiotensin I converting enzyme 2 (ACE2) receptors gene expression and its variant alleles, the different binding affinities of ACE2 to the virus spike (S) protein given its L- and S-subtypes and the subsequent extent of innate immunity-related hypercytokinemia. The extensive synthesis of cytokines and chemokines in coronavirus diseases was suggested as a major factor in exacerbating lung damage and other fatal complications. The polymorphisms in genes coding for pro-inflammatory cytokines and chemokines have been associated with mediating the response and susceptibility to a wide range of infections and their severe outcomes. Understanding the nature of pathogen-host interaction in COVID-19 symptomatology together with the role of hypercytokinemia in disease severity may permit developing new avenues of approach for prevention and treatment and can delineate public health measures to control the spread of the disease.
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Affiliation(s)
- Alaa Badawi
- Public Health Risk Sciences Division, Public Health Agency of Canada, Toronto, ON, Canada
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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288
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Policies and practices of SHEA Research Network hospitals during the COVID-19 pandemic. Infect Control Hosp Epidemiol 2020; 41:1127-1135. [PMID: 32571447 PMCID: PMC7360941 DOI: 10.1017/ice.2020.303] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
To understand hospital policies and practices as the COVID-19 pandemic accelerated, the Society for Healthcare Epidemiology of America (SHEA) conducted a survey through the SHEA Research Network (SRN). The survey assessed policies and practices around the optimization of personal protection equipment (PPE), testing, healthcare personnel policies, visitors of COVID-19 patients in relation to procedures, and types of patients. Overall, 69 individual healthcare facilities responded in the United States and internationally, for a 73% response rate.
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289
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Arora G, Arora S, Talathi A, Kandhari R, Joshi V, Langar S, Nagpal S, Shetty VH, Nair RV, Sharma D, Sharma R, Sondhi P. Safer Practice of Aesthetic Dermatology during the COVID-19 Pandemic: Recommendations by SIG Aesthetics (IADVL Academy). Indian Dermatol Online J 2020; 11:534-539. [PMID: 32832438 PMCID: PMC7413460 DOI: 10.4103/idoj.idoj_328_20] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 05/12/2020] [Accepted: 05/19/2020] [Indexed: 01/20/2023] Open
Abstract
The COVID-19 pandemic caused by the SARS-CoV-2 virus, has changed the homeostasis of the medical world. In this critical phase, in addition to the general recommendations issued by World Health Organization (WHO) for medical practitioners and health care givers, certain other precautions and safe care practices need to be emphasized which are unique to each branch of medicine. Aesthetic dermatology is no exception. With aesthetic treatments on the rise, it is pertinent to formulate safe practices for aesthetic dermatology to protect the doctor, health staff and the patients from getting exposed during this phase and in the aftermath of the pandemic. Recommendations for surgical and dental procedures advice to defer such procedures. This can be extrapolated to aesthetic dermatology also, but once health care services start, there should be some safety recommendations to be followed until we have definitive management or a vaccine for it.
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Affiliation(s)
- Gulhima Arora
- Consultant Dermatologist, ehektagul Dermaclinic, New Delhi, India
| | - Sandeep Arora
- Professor and Head, Department of Dermatology, Command Hospital Air Force, Bangalore, India
| | - Abhay Talathi
- Consultant Dermatologist, SkinSpace Clinic, Mumbai, India
| | - Rajat Kandhari
- Consultant Dermatologist, Dr. Kandhari's Skin and Dental Clinic, New Delhi, India
| | - Vineeta Joshi
- Consultant Dermatologist, Dr. Vineeta Joshi's Skin n Hair Clinic, Pune, India
| | - Sonali Langar
- Consultant Dermatologist, Skin Remedies Clinic and Laser Centre, Noida, India
| | - Smita Nagpal
- Consultant Dermatologist, Anya Skin Clinic, Ahmedabad, India
| | - Vinma H Shetty
- Associate Professor, Department of Dermatology, AJ Institute of Medical Sciences, Mangalore, India
| | - Rakhee V Nair
- Associate Professor, Department of Dermatology, Azeezia Medical College, Kollam, India
| | - Divya Sharma
- Consultant Dermatologist, Dr Divya's Skin and Hair Solutions, Bengaluru, India
| | - Rashmi Sharma
- Consultant Dermatologist, Fortis Hospital, New Delhi, India
| | - Prateek Sondhi
- Consultant Dermatologist, Derma Circles Clinic, New Delhi, India
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290
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Personal Protective Equipment (PPE) Guidelines, adaptations and lessons during the COVID-19 pandemic. ACTA ACUST UNITED AC 2020; 14:100546. [PMID: 32835061 PMCID: PMC7298470 DOI: 10.1016/j.jemep.2020.100546] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 06/11/2020] [Indexed: 01/25/2023]
Abstract
The COVID-19 pandemic has placed unprecedented strain on the American healthcare system. Personal protective equipment (PPE) remains critical in keeping healthcare providers healthy and safe. The sudden increase in demand as well as the limited availability places increased risk on providers which may inhibit their ability to effectively manage patients. The purpose of this brief article is to review the recommended guidelines for PPE usage and compare them to how medical societies have adapted and responded to decreased supply, as well as public response.
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291
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Kapoor KM, Chatrath V, Boxley SG, Nurlin I, Snozzi P, Demosthenous N, Belo V, Chan WM, Kanaris N, Kapoor P. COVID-19 Pandemic: Consensus guidelines for preferred practices in an aesthetic clinic. Dermatol Ther 2020; 33:e13597. [PMID: 32415753 PMCID: PMC7267045 DOI: 10.1111/dth.13597] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 05/09/2020] [Accepted: 05/12/2020] [Indexed: 12/14/2022]
Abstract
Strict infection control measures in response to the current COVID‐19 pandemic are expected to remain for an extended period. In aesthetic clinics, most procedures are provided on one to one basis by the physician or therapist. In such a scenario, guidelines detailing the infection control measures for aesthetic clinics are of particular importance. An online meeting of an international group of experts in the field of aesthetic medicine, with experience in administration of an aesthetic clinic, was convened. The meeting aimed to provide a set of consensus guidelines to protect clinic staff and patients from SARS‐CoV‐2 infection. Consensus guidelines for “preferred practices” were provided for scheduling of patients, patient evaluation and triaging, and for safety precautions about the different procedures. Procedures were categorized into low‐risk, moderate risk, and high‐risk based on the likelihood of transmission of SARS‐CoV‐2 virus from the patient to the treating physician or therapist. While not intended to be complete or exhaustive, these guidelines provide sound infection control measures for aesthetic practices. Since guidelines regarding safety measures and use of PPEs may vary from country to country, the local guidelines should also be followed to prevent COVID‐19 infection in aesthetic clinics.
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Affiliation(s)
- Krishan M Kapoor
- Department of Plastic Surgery, Fortis Hospital, Mohali, India.,Anticlock Clinic, Chandigarh, India
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292
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Bani Hani D, Altal O, Aleshawi A, Alhowary AA, Obeidat B. Expanding access for COVID-19 patients by transforming a burn unit into a closed-circuit unit for surgical patients: experience from an academic medical center in Jordan. Patient Saf Surg 2020; 14:25. [PMID: 32514313 PMCID: PMC7274061 DOI: 10.1186/s13037-020-00251-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 05/28/2020] [Indexed: 02/01/2023] Open
Affiliation(s)
- Diab Bani Hani
- Faculty of Medicine, Jordan University of Science and Technology, P. O. Box: 3030, Irbid, 22110 Jordan
| | - Omar Altal
- Faculty of Medicine, Jordan University of Science and Technology, P. O. Box: 3030, Irbid, 22110 Jordan
| | | | - Ala A Alhowary
- Faculty of Medicine, Jordan University of Science and Technology, P. O. Box: 3030, Irbid, 22110 Jordan
| | - Basil Obeidat
- Faculty of Medicine, Jordan University of Science and Technology, P. O. Box: 3030, Irbid, 22110 Jordan
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293
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Jorden MA, Rudman SL, Villarino E, Hoferka S, Patel MT, Bemis K, Simmons CR, Jespersen M, Iberg Johnson J, Mytty E, Arends KD, Henderson JJ, Mathes RW, Weng CX, Duchin J, Lenahan J, Close N, Bedford T, Boeckh M, Chu HY, Englund JA, Famulare M, Nickerson DA, Rieder MJ, Shendure J, Starita LM. Evidence for Limited Early Spread of COVID-19 Within the United States, January-February 2020. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2020; 69:680-684. [PMID: 32497028 PMCID: PMC7315848 DOI: 10.15585/mmwr.mm6922e1] [Citation(s) in RCA: 107] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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294
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MMWR summary: COVID-19 reports. Am J Transplant 2020; 20:1748. [PMID: 32472642 PMCID: PMC7300540 DOI: 10.1111/ajt.15991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
This month’s MMWR selections summarize several recent observations related to COVID-19 infection.
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295
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Romão VC, Cordeiro I, Macieira C, Oliveira-Ramos F, Romeu JC, Rosa CM, Saavedra MJ, Saraiva F, Vieira-Sousa E, Fonseca JE. Rheumatology practice amidst the COVID-19 pandemic: a pragmatic view. RMD Open 2020; 6:e001314. [PMID: 32584782 PMCID: PMC7425193 DOI: 10.1136/rmdopen-2020-001314] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 06/07/2020] [Accepted: 06/08/2020] [Indexed: 12/15/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has come with many challenges for healthcare providers and patients alike. In addition to the direct burden it has placed on societies and health systems, it had a significant impact in the care of patients with chronic diseases, as healthcare resources were deployed to fight the crisis, and major travel and social restrictions were adopted. In the field of rheumatology, this has required notable efforts from departments and clinicians to adapt to the novel status quo and assure the follow-up of patients with rheumatic and musculoskeletal diseases. In the present viewpoint, we provide a practical approach to tackle this reality. Key measures include setting up preventive team management strategies, optimising communication with patients and reorganising patient care in all its dimensions. We then anticipate the nuances of rheumatology practice as restrictive measures are progressively lifted, while an effective vaccine is still pending. This includes the need to reimpose the same strategy as further waves unfold. Finally, we look ahead and address the lessons we can incorporate into post-COVID-19 rheumatology.
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Affiliation(s)
- Vasco C Romão
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon Academic Medical Centre, Lisbon, Portugal
- Rheumatology Research Unit, Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Inês Cordeiro
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon Academic Medical Centre, Lisbon, Portugal
- Rheumatology Research Unit, Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Carla Macieira
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon Academic Medical Centre, Lisbon, Portugal
| | - Filipa Oliveira-Ramos
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon Academic Medical Centre, Lisbon, Portugal
- Rheumatology Research Unit, Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - José Carlos Romeu
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon Academic Medical Centre, Lisbon, Portugal
| | - Carlos Miranda Rosa
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon Academic Medical Centre, Lisbon, Portugal
| | - Maria João Saavedra
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon Academic Medical Centre, Lisbon, Portugal
- Rheumatology Research Unit, Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Fernando Saraiva
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon Academic Medical Centre, Lisbon, Portugal
- Rheumatology Research Unit, Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Elsa Vieira-Sousa
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon Academic Medical Centre, Lisbon, Portugal
- Rheumatology Research Unit, Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - João Eurico Fonseca
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon Academic Medical Centre, Lisbon, Portugal
- Rheumatology Research Unit, Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
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296
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Çolakoğlu MK, Mehmet Özgün Y, Pişkin E, Birol Bostancı E, Özmen MM. The attitude of Turkish general surgeons during the COVID-19 pandemic: Results of "general surgery COVID-19 pandemic attitude survey". Turk J Surg 2020; 36:137-146. [PMID: 33015559 PMCID: PMC7515648 DOI: 10.5578/turkjsurg.4809] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 04/21/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The whole world is dealing with the COVID-19 pandemic, and healthcare professionals are the most affected group. The aim of this study was to evaluate the knowledge of general surgeons about COVID-19 and understand the attitude and current situation of our colleagues. MATERIAL AND METHODS This descriptive study comprised general surgeons working in different parts of Turkey. A survey with 23 questions was prepared to determine the demographic characteristics of the participants, workplace characteristics, change in daily work practices and their attitudes in the pandemic process. RESULTS A total of 332 forms were evaluated. Survey results show that the majority of surgeons have changed their daily surgical practices. Many surgeons take part in the treatment of COVID-19. While most benign cases are delayed, the managemet of malignant cases differs. There are also differences in the evaluation of patients preoperatively and the type of operation. Personal protective measures are followed. While the rate of infected surgeons is low, the majority of surgeons have concerns about infection. CONCLUSION Turkish surgeons have managed to get a quick reaction from the start of the pandemic. However, there are still differences in preoperative patient evaluation and operation selection and precautions during the operation. Surgeons also should be informed about the management of malignant patients.
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Affiliation(s)
- Muhammet Kadri Çolakoğlu
- Department of Gastrointestinal Surgery, Health Sciences University, Ankara City Hospital, Ankara, Turkey
| | - Yiğit Mehmet Özgün
- Department of Gastrointestinal Surgery, Health Sciences University, Ankara City Hospital, Ankara, Turkey
| | - Erol Pişkin
- Department of Gastrointestinal Surgery, Health Sciences University, Ankara City Hospital, Ankara, Turkey
| | - Erdal Birol Bostancı
- Department of Gastrointestinal Surgery, Health Sciences University, Ankara City Hospital, Ankara, Turkey
| | - Mehmet Mahir Özmen
- Department of Surgery, Istinye University School of Medicine, Istanbul / Liv Hospital Ankara, Turkey
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297
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Basseal JM, Westerway SC, McAuley T. COVID-19: Infection prevention and control guidance for all ultrasound practitioners. Australas J Ultrasound Med 2020; 23:90-95. [PMID: 32514319 PMCID: PMC7267166 DOI: 10.1002/ajum.12210] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The severe acute respiratory syndrome coronavirus (SARS‐CoV‐2), an enveloped virus, is the causative agent of the disease known as COVID‐19 (coronavirus disease‐2019). Proper infection prevention and control measures and good hygiene practices are essential to prevent spread of COVID‐19 and protect both patients and the healthcare worker. These guidelines are relevant to all ultrasound practitioners and provides guidance on cleaning and disinfection of ultrasound equipment, the environment and PPE (protective personal equipment) during the COVID‐19 outbreak in the Australasian region.
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Affiliation(s)
- Jocelyne M Basseal
- Discipline of Infectious Diseases & Immunology Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia.,Australasian Society for Ultrasound in Medicine Sydney New South Wales Australia
| | | | - Terry McAuley
- Director STEAM Consulting Pty Ltd Victoria 3059 Australia
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298
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Archie SR, Cucullo L. Cerebrovascular and Neurological Dysfunction under the Threat of COVID-19: Is There a Comorbid Role for Smoking and Vaping? Int J Mol Sci 2020; 21:E3916. [PMID: 32486196 PMCID: PMC7312781 DOI: 10.3390/ijms21113916] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 05/28/2020] [Accepted: 05/29/2020] [Indexed: 01/08/2023] Open
Abstract
The recently discovered novel coronavirus, SARS-CoV-2 (COVID-19 virus), has brought the whole world to standstill with critical challenges, affecting both health and economic sectors worldwide. Although initially, this pandemic was associated with causing severe pulmonary and respiratory disorders, recent case studies reported the association of cerebrovascular-neurological dysfunction in COVID-19 patients, which is also life-threatening. Several SARS-CoV-2 positive case studies have been reported where there are mild or no symptoms of this virus. However, a selection of patients are suffering from large artery ischemic strokes. Although the pathophysiology of the SARS-CoV-2 virus affecting the cerebrovascular system has not been elucidated yet, researchers have identified several pathogenic mechanisms, including a role for the ACE2 receptor. Therefore, it is extremely crucial to identify the risk factors related to the progression and adverse outcome of cerebrovascular-neurological dysfunction in COVID-19 patients. Since many articles have reported the effect of smoking (tobacco and cannabis) and vaping in cerebrovascular and neurological systems, and considering that smokers are more prone to viral and bacterial infection compared to non-smokers, it is high time to explore the probable correlation of smoking in COVID-19 patients. Herein, we have reviewed the possible role of smoking and vaping on cerebrovascular and neurological dysfunction in COVID-19 patients, along with potential pathogenic mechanisms associated with it.
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Affiliation(s)
- Sabrina Rahman Archie
- Department of Pharmaceutical Sciences, Texas Tech University Health Sciences Center, Amarillo, TX 79106, USA;
| | - Luca Cucullo
- Department of Pharmaceutical Sciences, Texas Tech University Health Sciences Center, Amarillo, TX 79106, USA;
- Center for Blood-Brain Barrier Research, Texas Tech University Health Sciences Center, Amarillo, TX 79106, USA
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299
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COVID-19 infections among HCWs exposed to a patient with a delayed diagnosis of COVID-19. Infect Control Hosp Epidemiol 2020; 41:1075-1076. [PMID: 32456720 PMCID: PMC7276498 DOI: 10.1017/ice.2020.256] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
We report on COVID-19 risk among HCWs exposed to a patient diagnosed with COVID-19 on day 13 of hospitalization. There were 44 HCWs exposed to the patient before contact and droplet precautions were implemented: of these, 2 of 44 (5%) developed COVID-19 potentially attributable to the exposure.
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Singleton MN, Soffin EM. Daring discourse: are we ready to recommend neuraxial anesthesia and peripheral nerve blocks during the COVID-19 pandemic? A pro-con. Reg Anesth Pain Med 2020; 45:831-834. [PMID: 32447292 PMCID: PMC7513257 DOI: 10.1136/rapm-2020-101653] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 05/17/2020] [Accepted: 05/19/2020] [Indexed: 01/01/2023]
Abstract
The recent joint statement from the American Society of Regional Anesthesia and Pain Medicine (ASRA) and the European Society of Regional Anesthesia and Pain Therapy (ESRA) recommends neuraxial and peripheral nerve blocks for patients with coronavirus disease 2019 (COVID-2019) illness. The benefits of regional anesthetic and analgesic techniques on patient outcomes and healthcare systems are evident. Regional techniques are now additionally promoted as a mechanism to reduce aerosolizing procedures. However, caring for patients with COVID-19 illness requires rapid redefinition of risks and benefits—both for patients and practitioners. These should be fully considered within the context of available evidence and expert opinion. In this Daring Discourse, we present two opposing perspectives on adopting the ASRA/ESRA recommendation. Areas of controversy in the literature and opportunities for research to address knowledge gaps are highlighted. We hope this will stimulate dialogue and research into the optimal techniques to improve patient outcomes and ensure practitioner safety during the pandemic.
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Affiliation(s)
- Michael N Singleton
- Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, New York, USA
| | - Ellen M Soffin
- Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, New York, USA
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