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Hill K, McCabe C, Brenner M. Impact of adapting paediatric intensive care units for adult care during the COVID-19 pandemic: a scoping review. BMJ Open 2023; 13:e068174. [PMID: 37640456 PMCID: PMC10462976 DOI: 10.1136/bmjopen-2022-068174] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 08/14/2023] [Indexed: 08/31/2023] Open
Abstract
OBJECTIVES The objectives were to categorise the evidence, map out the existing studies and explore what was known about the organisation of paediatric intensive care units (PICUs) during the first 18 months of the COVID-19 pandemic. Additionally, this review set out to identify any knowledge gaps in the literature and recommend areas for future research. DESIGN Scoping review. METHODS This study used Arksey and O'Malley's six-stage scoping review framework. A comprehensive search was conducted using the following databases, CINAHL Complete; MEDLINE; PsycINFO; PsycARTICLES and EMBASE and grey literature search engines. A search strategy with predefined inclusion criteria was used to uncover relevant research in this area. Screening and data collection were done in duplicate. RESULTS 47 631 articles were obtained through searching. However, only 25 articles met the inclusion criteria and were included in the analysis. Three dominant themes emerged from the literature: (1) the reorganisation of space for managing increased capacity; (2) increased staffing and support; and (3) the resulting challenges. CONCLUSION COVID-19 has strained institutional resources across the globe. To relieve the burden on intensive care units (ICUs), some PICUs adjusted their units to care for critically ill adults, with other PICUs making significant changes, including the redeployment of staff to adult ICUs to provide extra care for adults. Overall, PICUs were collectively well equipped to care for adult patients, with care enhanced by implementing elements of holistic, family-centred PICU practices. The pandemic fostered a collaborative approach among PICU teams and wider hospital communities. However, specific healthcare guidelines had to be created to safely care for adult patients.
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Affiliation(s)
- Katie Hill
- School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, Ireland
| | - Catherine McCabe
- School of Nursing & Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Maria Brenner
- School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, Ireland
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2
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Makaremi S, Asgarzadeh A, Kianfar H, Mohammadnia A, Asghariazar V, Safarzadeh E. The role of IL-1 family of cytokines and receptors in pathogenesis of COVID-19. Inflamm Res 2022; 71:923-947. [PMID: 35751653 PMCID: PMC9243884 DOI: 10.1007/s00011-022-01596-w] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 05/29/2022] [Indexed: 12/12/2022] Open
Abstract
A global pandemic has erupted as a result of the new brand coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This pandemic has been consociated with widespread mortality worldwide. The antiviral immune response is an imperative factor in confronting the recent coronavirus disease 2019 (COVID-19) infections. Meantime, cytokines recognize as crucial components in guiding the appropriate immune pathways in the restraining and eradication of the virus. Moreover, SARS-CoV-2 can induce uncontrolled inflammatory responses characterized by hyper-inflammatory cytokine production, which causes cytokine storm and acute respiratory distress syndrome (ARDS). As excessive inflammatory responses are contributed to the severe stage of the COVID-19 disease, therefore, the pro-inflammatory cytokines are regarded as the Achilles heel during COVID-19 infection. Among these cytokines, interleukin (IL-) 1 family cytokines (IL-1, IL-18, IL-33, IL-36, IL-37, and IL-38) appear to have a strong inflammatory role in severe COVID-19. Hence, understanding the underlying inflammatory mechanism of these cytokines during infection is critical for reducing the symptoms and severity of the disease. Here, the possible mechanisms and pathways involved in inflammatory immune responses are discussed.
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Affiliation(s)
- Shima Makaremi
- School of Medicine and Allied Medical Sciences, Ardabil University of Medical Sciences, Ardabil, Iran.,Department of Health Information Management, School of Medicine and Allied Medical Sciences, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Ali Asgarzadeh
- Students Research Committee, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.,Department of Health Information Management, School of Medicine and Allied Medical Sciences, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Hamed Kianfar
- Students Research Committee, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.,Department of Health Information Management, School of Medicine and Allied Medical Sciences, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Alireza Mohammadnia
- Department of Health Information Management, School of Medicine and Allied Medical Sciences, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Vahid Asghariazar
- Department of Health Information Management, School of Medicine and Allied Medical Sciences, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Elham Safarzadeh
- Department of Health Information Management, School of Medicine and Allied Medical Sciences, Ardabil University of Medical Sciences, Ardabil, Iran. .,Department of Microbiology, Parasitology and Immunology, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.
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Gasmi A, Srinath S, Dadar M, Pivina L, Menzel A, Benahmed AG, Chirumbolo S, Bjørklund G. A global survey in the developmental landscape of possible vaccination strategies for COVID-19. Clin Immunol 2022; 237:108958. [PMID: 35218966 PMCID: PMC8865932 DOI: 10.1016/j.clim.2022.108958] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 02/13/2022] [Accepted: 02/19/2022] [Indexed: 01/04/2023]
Abstract
The development of COVID-19 vaccines was promptly regulated to ensure the best possible approach. By January 2022, 75 candidates reached preclinical evaluation in various animal models, 114 vaccines were in clinical trials on humans, and 48 were in the final testing stages. Vaccine platforms range from whole virus vaccines to nucleic acid vaccines, which are the most promising in prompt availability and safety. The USA and Europe have approved vaccines developed by Pfizer-BioNTech (BNT162b2) and Moderna (mRNa1273). So far, Pfizer-BioNTech, Moderna, Johnson & Johnson, AstraZeneca-University of Oxford, Sinopharm, Sinovac Biotech Gamaleya, Bharat Biotech, and Novavax have documented effective vaccines. Even with technological advances and a fast-paced development approach, many limitations and problems need to be overcome before a large-scale production of new vaccines can start. The Key is to ensure equal and fair distribution globally through regulatory measures. Recent studies link Bacillus Calmette-Guérin (BCG) vaccination programs and lower disease severity.
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Affiliation(s)
- Amin Gasmi
- Société Francophone de Nutrithérapie et de Nutrigénétique Appliquée, Villeurbanne, France
| | - Shvetha Srinath
- Société Francophone de Nutrithérapie et de Nutrigénétique Appliquée, Villeurbanne, France
| | - Maryam Dadar
- Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization (AREEO), Karaj, Iran
| | - Lyudmila Pivina
- Semey Medical University, Semey, Kazakhstan; CONEM Kazakhstan Environmental Health and Safety Research Group, Semey Medical University, Semey, Kazakhstan
| | | | - Asma Gasmi Benahmed
- Université Claude Bernard, Villeurbanne, France; Académie Internationale de Médecine Dentaire Intégrative, Paris, France
| | - Salvatore Chirumbolo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy; CONEM Scientific Secretary, Verona, Italy
| | - Geir Bjørklund
- Council for Nutritional and Environmental Medicine (CONEM), Mo i Rana, Norway.
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4
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Leung KKY, Hon KLE. The role of media messaging in COVID-19 vaccine hesitancy amongst the student population: Friend or foe. Pediatr Pulmonol 2021; 56:4066-4068. [PMID: 34597474 PMCID: PMC8661598 DOI: 10.1002/ppul.25686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 08/31/2021] [Accepted: 09/04/2021] [Indexed: 12/24/2022]
Affiliation(s)
- Karen Ka Yan Leung
- Department of Paediatrics and Adolescent MedicineThe Hong Kong Children's HospitalHong KongChina
| | - Kam Lun Ellis Hon
- Department of Paediatrics and Adolescent MedicineThe Hong Kong Children's HospitalHong KongChina
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5
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Calcaterra V, Verduci E, Vandoni M, Rossi V, Di Profio E, Carnevale Pellino V, Tranfaglia V, Pascuzzi MC, Borsani B, Bosetti A, Zuccotti G. Telehealth: A Useful Tool for the Management of Nutrition and Exercise Programs in Pediatric Obesity in the COVID-19 Era. Nutrients 2021; 13:3689. [PMID: 34835945 PMCID: PMC8618189 DOI: 10.3390/nu13113689] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 10/17/2021] [Accepted: 10/19/2021] [Indexed: 12/18/2022] Open
Abstract
The COVID-19 pandemic has led to the implementation of policies that mandate various restrictions on daily life, including social distancing, the closure of public services and schools, and movement limitations. Even though these restrictive measures decreased the COVID-19 spread, they may have detrimental effects on various lifestyle components such as physical inactivity, sedentary behavior, and dietary habits, influencing the maintenance of weight and contributing to obesity among children and adolescents. The coexistence of childhood obesity and COVID-19 and changes in the bioecological environment have put children and adolescents at increased risk for developing obesity and exacerbating the severity of this disorder. The use of telehealth technology is a modern approach useful for the delivery of health care services by health care professionals, where distance is a critical factor. Telehealth is effective in promoting increased self-monitoring and behavioral change, and provides the opportunity to perform online nutritional support and exercise training programs to promote a healthy lifestyle and reduce sedentary behaviors in children and adolescents. Telehealth, including tele-exercise and tele-nutrition, has the potential to address many of the key challenges in providing health services, including in patients with obesity during the COVID-19 outbreak. This narrative review aims to describe the role of telehealth as an opportunity in the management of pediatric obesity in the COVID-19 era, and to deliver nutrition and exercise programs for the maintenance of health.
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Affiliation(s)
- Valeria Calcaterra
- Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
| | - Elvira Verduci
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
- Department of Health Sciences, University of Milan, 20142 Milan, Italy
| | - Matteo Vandoni
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (M.V.); (V.C.P.)
| | - Virginia Rossi
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
| | - Elisabetta Di Profio
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
| | - Vittoria Carnevale Pellino
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (M.V.); (V.C.P.)
| | - Valeria Tranfaglia
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
| | - Martina Chiara Pascuzzi
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
| | - Barbara Borsani
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
| | - Alessandra Bosetti
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
| | - Gianvincenzo Zuccotti
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
- Pediatric Clinical Research Center Romeo ed Enrica Invernizzi, Department of Biomedical and Clinical Science “L. Sacco”, University of Milan, 20157 Milan, Italy
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Nogueira-de-Almeida CA, Ciampo LAD, Ferraz IS, Ciampo IRLD, Contini AA, Ued FDV. Pediatric multisystem inflammatory syndrome associated with COVID-19: urgent attention required. Rev Assoc Med Bras (1992) 2021; 67Suppl 1:115-120. [PMID: 34406301 DOI: 10.1590/1806-9282.67.suppl1.20200691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 10/21/2020] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To identify epidemiological and clinical characteristics of multisystemic inflammatory syndrome associated with coronavirus infection as one of the severe forms of COVID-19 involvement in children and adolescents. METHODS review was based on articles published in 2020 in the PubMed, Medline, Scopus, SciELO and Cochrane databases. SUMMARY Multisystemic inflammatory syndrome is a serious clinical disorder that affects children and adolescents and is associated with the detection of previous exposure to SARS-CoV-2. It is characterized by the installation of a shock picture, with a significant increase in inflammatory markers such as presentations of Kawasaki Disease or shock syndrome related to Kawasaki Disease, or even toxic shock syndrome, with the clinical picture being characterized by fever of difficult control, rash, conjunctivitis, peripheral edema, generalized pain in the extremities and gastrointestinal symptoms. CONCLUSIONS Although the vast majority of children with COVID-19 have mild symptoms, it is necessary to consider that some have a hyperinflammatory response. It is essential that health professionals receive information that can assist in the recognition of this clinical condition, differentiating it from other diagnoses, so that early and appropriate treatment is instituted.
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Affiliation(s)
| | - Luiz Antonio Del Ciampo
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Medical School of Ribeirão Preto, Departament of Childcare and Pediatrics - São Paulo (SP), Brazil
| | - Ivan Savioli Ferraz
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Medical School of Ribeirão Preto, Departament of Childcare and Pediatrics - São Paulo (SP), Brazil
| | | | | | - Fábio da Veiga Ued
- Universidade de São Paulo, Medical School of Ribeirão Preto, Department of Health Sciences- Ribeirão Preto (SP), Brazil
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Leung KKY, Chu S, Hon KLE, Yun Qian S. Are ventilators part of the problem or the solution for COVID-19 mortality? Pediatr Pulmonol 2021; 56:2787-2788. [PMID: 34111330 DOI: 10.1002/ppul.25524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 11/19/2020] [Accepted: 05/13/2021] [Indexed: 11/10/2022]
Affiliation(s)
- Karen Ka Yan Leung
- Paediatric Intensive Care Unit, Department of Paediatrics and Adolescent Medicine, The Hong Kong Children's Hospital, Hong Kong SAR, China
| | - Samantha Chu
- Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Kam Lun Ellis Hon
- Paediatric Intensive Care Unit, Department of Paediatrics and Adolescent Medicine, The Hong Kong Children's Hospital, Hong Kong SAR, China
| | - Su Yun Qian
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
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8
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Goyal M, Tewatia N, Vashisht H, Jain R, Kumar S. Novel corona virus (COVID-19); Global efforts and effective investigational medicines: A review. J Infect Public Health 2021; 14:910-921. [PMID: 34119845 PMCID: PMC8088038 DOI: 10.1016/j.jiph.2021.04.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/05/2021] [Accepted: 04/25/2021] [Indexed: 12/23/2022] Open
Abstract
Coronavirus disease-2019 (COVID-19), associated with the outbreak of deadly virus originating in Wuhan, China, is now a global health emergency and a matter of serious concern. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is rapidly spreading worldwide, and WHO declared the outbreak of this disease a pandemic on March 11, 2020. Though some of the countries have succeeded in slowing down the rate of the spread of this pandemic, most the countries across the globe are still continuing to experience an increasing trend in the growth and spread of this deadly disease. Hence, in the current scenario, is has now become essential to control and finally irradicate this deadly disease using an effective vaccine. One can expect the prominent role of already available antivirals, antibodies and anti-inflammatory drugs in the market, in this pandemic. Immunomodulatory and biological therapeutics are also in the high expectations to combat COVID-19. RNA based vaccines might be more advantageous over traditional vaccines, to deal with the pandemic threat. Aiming towards this direction, clinical trials for SARS-CoV-2 vaccine are currently underway all across the globe. Currently, about 150 health related organizations and research labs are in the progress for the evolution of COVID-19 vaccines, globally. The initial aim of these clinical trials is to assess vaccine's safety, which is tested in Phase I/II/III studies where the primary outcomes typically examine the frequency of adverse effects. The vaccine is about to undergo phase III testing in several countries such as India, USA, South Africa, Brazil and England. US Government, under Operation Wrap Speed is even ready to sponsor three candidates, namely-The University of Oxford and AstraZeneca's AZD1222; Moderna's mRNA-1273; and Pfizer and BioNTech's BNT162 for Phase III trials.
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Affiliation(s)
- Madhusudan Goyal
- Department of Chemistry, Pt. J.L.N. Government College, Department of Higher Education, Faridabad 121002, Haryana, India.
| | - Nisha Tewatia
- Department of Chemistry, Pt. J.L.N. Government College, Department of Higher Education, Faridabad 121002, Haryana, India
| | - Hemlata Vashisht
- Department of Chemistry, Kirori Mal College, University of Delhi, Delhi 110007, India
| | - Reena Jain
- Department of Chemistry, Hindu College, University of Delhi, Delhi 110007,India
| | - Sudershan Kumar
- Department of Chemistry, Hindu College, University of Delhi, Delhi 110007,India
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Rapid High-Throughput Whole-Genome Sequencing of SARS-CoV-2 by Using One-Step Reverse Transcription-PCR Amplification with an Integrated Microfluidic System and Next-Generation Sequencing. J Clin Microbiol 2021; 59:JCM.02784-20. [PMID: 33653700 PMCID: PMC8091833 DOI: 10.1128/jcm.02784-20] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 02/24/2021] [Indexed: 12/13/2022] Open
Abstract
The long-lasting global COVID-19 pandemic demands timely genomic investigation of SARS-CoV-2 viruses. Here, we report a simple and efficient workflow for whole-genome sequencing utilizing one-step reverse transcription-PCR (RT-PCR) amplification on a microfluidic platform, followed by MiSeq amplicon sequencing. The long-lasting global COVID-19 pandemic demands timely genomic investigation of SARS-CoV-2 viruses. Here, we report a simple and efficient workflow for whole-genome sequencing utilizing one-step reverse transcription-PCR (RT-PCR) amplification on a microfluidic platform, followed by MiSeq amplicon sequencing. The method uses Fluidigm integrated fluidic circuit (IFC) and instruments to amplify 48 samples with 39 pairs of primers, including 35 custom-designed primer pairs and four additional primer pairs from the ARTIC network protocol v3. Application of this method on RNA samples from both viral isolates and clinical specimens demonstrates robustness and efficiency in obtaining the full genome sequence of SARS-CoV-2.
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Burden and prevalence of risk factors for severe COVID-19 in the ageing European population - a SHARE-based analysis. JOURNAL OF PUBLIC HEALTH-HEIDELBERG 2021; 30:2081-2090. [PMID: 33868899 PMCID: PMC8036158 DOI: 10.1007/s10389-021-01537-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 03/30/2021] [Indexed: 01/08/2023]
Abstract
Aim International health authorities suggest that individuals aged 65 years and above and people with underlying comorbidities such as hypertension, chronic lung disease, cardiovascular disease, cancer, diabetes, and obesity are at increased risk of severe Coronavirus Disease 2019 (COVID-19); however, the prevalence of risk factors is unknown in many countries. Therefore, we aimed to describe the distribution of these risk factors across Europe. Subject and methods Prevalence of risk factors for severe COVID-19 was identified based on interviews from 73,274 Europeans aged 50+ participating in the Survey of Health, Ageing and Retirement in Europe (SHARE) in 2017. Burden of disease was estimated using population data from Eurostat. Results A total of 75.3% of the study population (corresponding to approx. 60 million European men and 71 million women) had at least one risk factor for severe COVID-19, 45.9% (approx. 36 million men and 43 million women) had at least two factors, and 21.2% (approx. 17 million men and 20 million women) had at least three risk factors. The prevalence of underlying medical conditions ranged from 4.5% for cancer to 41.4% for hypertension, and the region-specific prevalence of having at least three risk factors ranged from 18.9% in Northern Europe to 24.6% in Eastern Europe. Conclusions Information about the prevalence of risk factors might help authorities to identify the most vulnerable subpopulations with multiple risk factors of severe COVID-19 and thus to decide appropriate strategies to mitigate the pandemic. Supplementary Information The online version contains supplementary material available at 10.1007/s10389-021-01537-7.
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Martínez Redondo J, Comas Rodríguez C, Pujol Salud J, Crespo Pons M, García Serrano C, Ortega Bravo M, Palacín Peruga JM. Higher Accuracy of Lung Ultrasound over Chest X-ray for Early Diagnosis of COVID-19 Pneumonia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3481. [PMID: 33801638 PMCID: PMC8037158 DOI: 10.3390/ijerph18073481] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/24/2021] [Accepted: 03/25/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND The COVID-19 pandemic rapidly strained healthcare systems worldwide. The reference standard for diagnosis is a positive reverse transcription polymerase chain reaction (RT-PCR) test, but results are not immediate and sensibility is variable. AIM To evaluate the diagnostic accuracy of lung ultrasound compared to chest X-ray for COVID-19 pneumonia. DESIGN AND SETTING A retrospective analysis of symptomatic patients admitted into one primary care centre in Spain between March and September 2020. METHOD Patients' chest X-rays and lung ultrasounds were categorized as normal or pathologic. RT-PCR confirmed COVID-19 infection. Pathologic lung ultrasound images were further categorized as showing either local or diffuse interstitial disease. McNemar and Fisher tests were used to compare diagnostic accuracy. RESULTS Most of the 212 patients presented fever at admission, either as a standalone symptom (37.74% of patients) or together with others (72.17% of patients). The positive predictive value of the lung ultrasound was 90% for the diffuse interstitial pattern and 46.92% for local pattern. The lung ultrasound had a significantly higher sensitivity (82.75%) (p < 0.001), but lower specificity (71%) than the chest X-ray (54.02% and 86%, respectively) (p = 0.008) for identifying interstitial lung disease. Moreover, sensitivity of the lung ultrasound for severe interstitial disease was 100%, and was significantly higher than the chest X-ray (58.33%) (p = 0.002). CONCLUSION The lung ultrasound is more accurate than the chest X-ray for identifying patients with COVID-19 pneumonia and it is especially useful for those presenting diffuse interstitial disease.
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Affiliation(s)
- Javier Martínez Redondo
- Balaguer Primary Care Center, Institut Català de la Salut (ICS), 25600 Lleida, Spain; (J.M.R.); (J.P.S.); (M.C.P.); (C.G.S.)
| | | | - Jesús Pujol Salud
- Balaguer Primary Care Center, Institut Català de la Salut (ICS), 25600 Lleida, Spain; (J.M.R.); (J.P.S.); (M.C.P.); (C.G.S.)
- Biomedical Research Institute (IRB Lleida), Universitat de Lleida (UdL), 25198 Lleida, Spain
| | - Montserrat Crespo Pons
- Balaguer Primary Care Center, Institut Català de la Salut (ICS), 25600 Lleida, Spain; (J.M.R.); (J.P.S.); (M.C.P.); (C.G.S.)
| | - Cristina García Serrano
- Balaguer Primary Care Center, Institut Català de la Salut (ICS), 25600 Lleida, Spain; (J.M.R.); (J.P.S.); (M.C.P.); (C.G.S.)
- Research Group in Therapies in Primary Care (GRETAPS), 25007 Lleida, Spain
| | - Marta Ortega Bravo
- Research Group in Therapies in Primary Care (GRETAPS), 25007 Lleida, Spain
- Research Support Unit Lleida, Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 25007 Lleida, Spain
| | - Jose María Palacín Peruga
- Onze de Setembre Primary Care Center, Institut Català de la Salut (ICS), Passeig Onze de Setembre, 10, 25005 Lleida, Spain
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Fu S, Wang B, Zhou J, Xu X, Liu J, Ma Y, Li L, He X, Li S, Niu J, Luo B, Zhang K. Meteorological factors, governmental responses and COVID-19: Evidence from four European countries. ENVIRONMENTAL RESEARCH 2021; 194:110596. [PMID: 33307083 PMCID: PMC7724291 DOI: 10.1016/j.envres.2020.110596] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 12/02/2020] [Accepted: 12/04/2020] [Indexed: 05/20/2023]
Abstract
With the global lockdown, meteorological factors are highly discussed for COVID-19 transmission. In this study, national-specific and region-specific data sets from Germany, Italy, Spain and the United Kingdom were used to explore the effect of temperature, absolute humidity and diurnal temperature range (DTR) on COVID-19 transmission. From February 1st to November 1st, a 7-day COVID-19 case doubling time (Td), meteorological factors with cumulative 14-day-lagged, government response index and other factors were fitted in the distributed lag nonlinear models. The overall relative risk (RR) of the 10th and the 25th percentiles temperature compared to the median were 0.0074 (95% CI: 0.0023, 0.0237) and 0.1220 (95% CI: 0.0667, 0.2232), respectively. The pooled RR of lower (10th, 25th) and extremely high (90th) absolute humidity were 0.3266 (95% CI: 0.1379, 0.7734), 0.6018 (95% CI: 0.4693, 0.7718) and 0.3438 (95% CI: 0.2254, 0.5242), respectively. While the DTR did not have a significant effect on Td. The total cumulative effect of temperature (10th) and absolute humidity (10th, 90th) on Td increased with the change of lag days. Similarly, a decline in temperature and absolute humidity at cumulative 14-day-lagged corresponded to the lower RR on Td in pooled region-specific effects. In summary, the government responses are important factors in alleviating the spread of COVID-19. After controlling that, our results indicate that both the cold and the dry environment also likely facilitate the COVID-19 transmission.
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Affiliation(s)
- Shihua Fu
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China
| | - Bo Wang
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China
| | - Ji Zhou
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Bureau, Shanghai, 200030, People's Republic of China
| | - Xiaocheng Xu
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China
| | - Jiangtao Liu
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China
| | - Yueling Ma
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China
| | - Lanyu Li
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China
| | - Xiaotao He
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China
| | - Sheng Li
- The First Hospital of Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China
| | - Jingping Niu
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China
| | - Bin Luo
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China; Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Bureau, Shanghai, 200030, People's Republic of China; Shanghai Typhoon Institute, China Meteorological Administration, Shanghai, 200030, China.
| | - Kai Zhang
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, 77030, USA; Southwest Center for Occupational and Environmental Health, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, 77030, USA; Department of Environmental Health Sciences School of Public Health University at Albany, State University of New York One University Place Rensselaer, NY, 12144, USA
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13
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Hon KL, Leung KKY, Tang JW, Leung AKC, Li Y. COVID-19 in Hong Kong - Public health, food safety, and animal vectors perspectives. J Virol Methods 2020; 290:114036. [PMID: 33285191 PMCID: PMC7717881 DOI: 10.1016/j.jviromet.2020.114036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 11/21/2020] [Accepted: 12/02/2020] [Indexed: 12/16/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic, caused by infection with a novel coronavirus (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2), has led to escalating morbidity and mortality in all nations and cities. SARS-CoV-2 lies within the same coronavirus family as SARS-CoV (2003) and MERS-CoV (2012), though there are genetic and epidemiological differences between the viruses, as well as different clinical presentations in the patients. Despite this, Hong Kong has so far managed to control the pandemic very successfully. Here we offer a Hong Kong perspective on different aspects of the pandemic virus (SARS-CoV-2) and the disease : public health (diagnosis and control), food safety (reducing transmission in the workplace) and animal vectors (controlling potential reservoirs of the virus and their movements).
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Affiliation(s)
- K L Hon
- Department of Paediatrics and Adolescent Medicine, The Hong Kong Children's Hospital, Hong Kong Special Administrative Region.
| | - K K Y Leung
- Department of Paediatrics and Adolescent Medicine, The Hong Kong Children's Hospital, Hong Kong Special Administrative Region
| | - Julian W Tang
- Leicester Royal Infirmary, University Hospitals Of Leicester, Department of Infection, Immunity and Inflammation, UK
| | - Alexander K C Leung
- Department of Pediatrics, The University of Calgary, the Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Yuguo Li
- Department of Mechanical Engineering, The University of Hong Kong, Hong Kong Special Administrative Region
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Oh HS, Ryu M. Prospective diary survey of preschool children's social contact patterns: A pilot study. CHILD HEALTH NURSING RESEARCH 2020; 26:393-401. [PMID: 35004483 PMCID: PMC8650865 DOI: 10.4094/chnr.2020.26.4.393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 08/24/2020] [Accepted: 09/19/2020] [Indexed: 11/06/2022] Open
Abstract
Purpose This pilot study aimed to describe children's social contact patterns and to analyze factors related to their social contacts. Methods The participants were 30 children aged ≥13 months to <7 years, whose teachers at childcare centers and parents at home were asked to maintain diaries of their social contacts prospectively for 24 hours. Data were collected from November 30, 2018, to January 7, 2019. Results The 30 participating children were in contact with 363 persons in a 24-hours period (mean, 12.1±9.1). The number of contacts showed significant relationships with day of the week (p<.001), number of family members/cohabitants (p=.015), area of residence (p=.003), and type of housing (p=.002). A multiple regression model showed significantly higher numbers of contacts on weekdays (B=10.64, p=.010). Physical versus non-physical types of contact showed significant differences in terms of duration, location, and frequency (p<.001). The duration of contacts showed significant relationships with their location and frequency (p<.001), while the frequency of contacts was significantly related to their location (p<.001). Conclusion This is the first survey describing the characteristics of Korean preschool children's social contacts. Further large-scale social contact studies of children should be conducted.
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Affiliation(s)
- Hyang Soon Oh
- Associate Professor, Department of Nursing, College of Life Science and Natural Resources, Sunchon National University, Suncheon, Korea
| | - Mikyung Ryu
- Assistant Professor, Department of Nursing, Daegu University, Daegu, Korea
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Ahrenfeldt LJ, Nielsen CR, Möller S, Christensen K, Lindahl-Jacobsen R. Burden and prevalence of risk factors for severe COVID-19 disease in the ageing European population - A SHARE-based analysis. RESEARCH SQUARE 2020:rs.3.rs-73657. [PMID: 32935092 PMCID: PMC7491580 DOI: 10.21203/rs.3.rs-73657/v1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Aim: International health authorities suggest that individuals aged 65 years and above and people with underlying comorbidities such as hypertension, chronic lung disease, cardiovascular disease, cancer, diabetes, and obesity are at increased risk of severe Coronavirus Disease 2019 (COVID-19); however, the prevalence of risk factors is unknown in many countries. Therefore, we aim to describe the distribution of these risk factors across Europe. Subject and Methods: Prevalence of risk factors for severe COVID-19 was identified based on interview for 73,274 Europeans aged 50+ participating in the Survey of Health, Ageing and Retirement in Europe (SHARE) in 2017. Burden of disease was estimated using population data from Eurostat. Results: A total of 75.3% of the study population (corresponding to app. 60 million European men and 71 million women) had at least one risk factor for severe COVID-19, 45.9% (app. 36 million men and 43 million women) had at least two factors and 21.2% (app. 17 million men and 20 million women) had at least three risk factors. The prevalences of underlying medical conditions ranged from 4.5% for cancer to 41.4% for hypertension, and the region-specific prevalence of having at least three risk factors ranged from 18.9% in Northern Europe to 24.6% in Eastern Europe. Conclusions: Information about the prevalences of risk factors might help authorities to identify the most vulnerable subpopulations with multiple risk factors of severe COVID-19 disease and thus to decide appropriate strategies to mitigate the pandemic.
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COVID‐19 and obesity in childhood and adolescence: a clinical review. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2020. [PMCID: PMC7413153 DOI: 10.1016/j.jpedp.2020.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Objetivo Identificar fatores que contribuem para o aumento da suscetibilidade e gravidade da COVID‐19 em crianças e adolescentes obesos e suas consequências para a saúde. Fontes de dados Estudos publicados entre 2000 e 2020 nas bases de dados PubMed, Medline, Scopus, SciELO e Cochrane. Síntese dos dados A obesidade é uma comorbidade altamente prevalente em casos graves de COVID‐19 em crianças e adolescentes e o isolamento social pode levar ao aumento do acúmulo de gordura. Tecido adiposo excessivo, déficit de massa magra, resistência à insulina, dislipidemia, hipertensão, altos níveis de citocinas pró‐inflamatórias e baixa ingestão de nutrientes essenciais são fatores que comprometem o funcionamento dos órgãos e sistemas no indivíduo obeso. Esses fatores estão associados a danos nos sistemas imunológico, cardiovascular, respiratório e urinário, juntamente com a modificação da microbiota intestinal (disbiose). Na infecção por SARS‐CoV‐2, essas alterações orgânicas causadas pela obesidade podem aumentar a necessidade de assistência ventilatória, risco de tromboembolismo, taxa de filtração glomerular reduzida, alterações na resposta imune inata e adaptativa e perpetuação da resposta inflamatória crônica. Conclusões A necessidade de isolamento social pode ter o efeito de causar ou agravar a obesidade e suas comorbidades e pediatras precisam estar cientes desse problema. Diante de crianças com suspeita ou confirmação de COVID‐19, os profissionais de saúde devem 1) diagnosticar o excesso de peso; 2) aconselhar sobre cuidados de saúde em tempos de isolamento; 3) fazer a triagem de comorbidades, garantindo que o tratamento não seja interrompido; 4) medir os níveis de imunonutrientes; 5) orientar a família respeitando as especificidades da situação; e 6) encaminhamento a unidades qualificadas para cuidar de crianças e adolescentes obesos, quando necessário.
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Nogueira-de-Almeida CA, Del Ciampo LA, Ferraz IS, Del Ciampo IRL, Contini AA, Ued FDV. COVID-19 and obesity in childhood and adolescence: a clinical review. J Pediatr (Rio J) 2020; 96:546-558. [PMID: 32768388 PMCID: PMC7402231 DOI: 10.1016/j.jped.2020.07.001] [Citation(s) in RCA: 102] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 07/23/2020] [Accepted: 07/23/2020] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE To identify factors that contribute to the increased susceptibility and severity of COVID-19 in obese children and adolescents, and its health consequences. SOURCES Studies published between 2000 and 2020 in the PubMed, MEDLINE, Scopus, SciELO, and Cochrane databases. SUMMARY OF FINDINGS Obesity is a highly prevalent comorbidity in severe cases of COVID-19 in children and adolescents; social isolation may lead to increase fat accumulation. Excessive adipose tissue, deficit in lean mass, insulin resistance, dyslipidemia, hypertension, high levels of proinflammatory cytokines, and low intake of essential nutrients are factors that compromise the functioning of organs and systems in obese individuals. These factors are associated with damage to immune, cardiovascular, respiratory, and urinary systems, along with modification of the intestinal microbiota (dysbiosis). In severe acute respiratory syndrome coronavirus 2 infection, these organic changes from obesity may increase the need for ventilatory assistance, risk of thromboembolism, reduced glomerular filtration rate, changes in the innate and adaptive immune response, and perpetuation of the chronic inflammatory response. CONCLUSIONS The need for social isolation can have the effect of causing or worsening obesity and its comorbidities, and pediatricians need to be aware of this issue. Facing children with suspected or confirmed COVID-19, health professionals should 1) diagnose excess weight; 2) advise on health care in times of isolation; 3) screen for comorbidities, ensuring that treatment is not interrupted; 4) measure levels of immunonutrients; 5) guide the family in understanding the specifics of the situation; and 6) refer to units qualified to care for obese children and adolescents when necessary.
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Affiliation(s)
| | - Luiz A Del Ciampo
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Puericultura e Pediatria, Ribeirão Preto, SP, Brazil
| | - Ivan S Ferraz
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Puericultura e Pediatria, Ribeirão Preto, SP, Brazil
| | - Ieda R L Del Ciampo
- Universidade Federal de São Carlos, Departamento de Medicina, São Carlos, SP, Brazil
| | - Andrea A Contini
- Universidade Federal de São Carlos, Departamento de Medicina, São Carlos, SP, Brazil
| | - Fábio da V Ued
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Ciências da Saúde, Ribeirão Preto, SP, Brazil
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Loo SKF, Hon KL, Leung AK, Yung TC, Yam MC. Kawasaki disease in siblings and a review of drug treatment. Drugs Context 2020; 9:dic-2020-4-1. [PMID: 32699547 PMCID: PMC7357683 DOI: 10.7573/dic.2020-4-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 06/05/2020] [Accepted: 06/08/2020] [Indexed: 12/11/2022] Open
Abstract
We have managed two anonymized siblings with Kawasaki disease (KD). The occurrence of KD in the elder brother alerted us to the occurrence of incomplete KD in the younger brother. Both siblings were treated with intravenous immunoglobulin and a high dose of dipyridamole with resolution of the coronary artery aneurysm. Dipyridamole was used instead of aspirin because both siblings were glucose-6-phosphate dehydrogenase deficient for which aspirin was contraindicated. To prevent damage to the coronary arteries, treatment should be started as soon as the diagnosis is made. There have been a lot of advances in medical therapy in recent years, which are reviewed together with conventional proven therapy for KD. Early diagnosis and prompt treatment are important to achieve optimal treatment outcome in KD. Family history of KD among siblings enables clinicians for an earlier diagnosis so as to prevent the disease complications particularly in patients with incomplete features.
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Affiliation(s)
- Steven King-Fan Loo
- The Hong Kong Institute of Integrative Medicine, The Chinese University of Hong Kong
| | - Kam Lun Hon
- Department of Paediatrics & The Hong Kong Institute of Integrative Medicine, The Chinese University of Hong Kong
| | - Alexander Kc Leung
- Department of Pediatrics, The University of Calgary and The Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Tak Cheung Yung
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Hong Kong
| | - Man Ching Yam
- Department of Paediatrics, Prince of Wales Hospital, Hong Kong
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Hon KL, Leung KKY, Leung AKC, Sridhar S, Qian S, Lee SL, Colin AA. Overview: The history and pediatric perspectives of severe acute respiratory syndromes: Novel or just like SARS. Pediatr Pulmonol 2020; 55:1584-1591. [PMID: 32483934 PMCID: PMC7301034 DOI: 10.1002/ppul.24810] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 04/27/2020] [Accepted: 04/29/2020] [Indexed: 12/12/2022]
Abstract
Many respiratory viral infections such as influenza and measles result in severe acute respiratory symptoms and epidemics. In the spring of 2003, an epidemic of coronavirus pneumonia spread from Guangzhou to Hong Kong and subsequently to the rest of the world. The WHO coined the acronym SARS (severe acute respiratory syndrome) and subsequently the causative virus as SARS-CoV. In the summer of 2012, epidemic of pneumonia occurred again in Saudi Arabia which was subsequently found to be caused by another novel coronavirus. WHO coined the term MERS (Middle East respiratory syndrome) to denote the Middle East origin of the novel virus (MERS-CoV). In the winter of 2019, another outbreak of pneumonia occurred in Wuhan, China which rapidly spread globally. Yet another novel coronavirus was identified as the culprit and has been named SARS-CoV-2 due to its similarities with SARS-CoV, and the disease as coronavirus disease-2019. This overview aims to compare and contrast the similarities and differences of these three major episodes of coronavirus outbreak, and conclude that they are essentially the same viral respiratory syndromes caused by similar strains of coronavirus with different names. Coronaviruses have caused major epidemics and outbreaks worldwide in the last two decades. From an epidemiological perspective, they are remarkably similar in the mode of spread by droplets. Special focus is placed on the pediatric aspects, which carry less morbidity and mortality in all three entities.
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Affiliation(s)
- Kam Lun Hon
- Department of Paediatrics and Adolescent MedicineThe Hong Kong Children's HospitalHong Kong SARChina
| | - Karen Ka Yan Leung
- Department of Paediatrics and Adolescent MedicineThe Hong Kong Children's HospitalHong Kong SARChina
| | - Alexander K. C. Leung
- Department of PediatricsThe University of Calgary, Alberta Children's HospitalCalgaryCanada
| | - Siddharth Sridhar
- Department of MicrobiologyThe University of Hong KongHong Kong SARChina
| | - Suyun Qian
- Pediatric Intensive Care Unit, Beijing Children's HospitalCapital Medical University, National Center for Children's HealthBeijingChina
| | - So Lun Lee
- Department of Paediatrics and Adolescent MedicineQueen Mary HospitalHong Kong SARChina
| | - Andrew A. Colin
- Division of Pediatric PulmonologyMiller School of Medicine, University of MiamiMiamiFlorida
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Hon KL, Leung KKY, Leung AK, Qian SY, Chan VP, Ip P, Wong IC. Coronavirus disease 2019 (COVID-19): latest developments in potential treatments. Drugs Context 2020; 9:dic-2020-4-15. [PMID: 32655654 PMCID: PMC7328712 DOI: 10.7573/dic.2020-4-15] [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] [Revised: 05/27/2020] [Accepted: 05/28/2020] [Indexed: 12/24/2022] Open
Abstract
Many viral respiratory infections can cause severe acute respiratory symptoms leading to mortality and morbidity. In the spring of 2003, the severe acute respiratory syndrome (SARS) outbreak caused by SARS-CoV spread globally. In the summer of 2012, the Middle East respiratory syndrome (MERS) outbreak caused by MERS-CoV occurred in Saudi Arabia. In the winter of 2019, the coronavirus disease 2019 (COVID-19) outbreak caused by a novel coronavirus SARS-CoV-2 occurred in China which rapidly spread worldwide causing a global pandemic. Up until 27 May 2020, there are 5.5 million confirmed cases of COVID-19 and 347,587 COVID-19 related deaths worldwide, and there has also been an unprecedented increase in socioeconomic and psychosocial issues related to COVID-19. This overview aims to review the current developments in preventive treatments and therapies for COVID-19. The development of vaccines for SARS-CoV-2 is ongoing and various clinical trials are currently underway around the world. It is hoped that existing antivirals including remdesivir and lopinavir-ritonavir might have roles in the treatment of COVID-19, but results from trials thus far have not been promising. COVID-19 causes a mild respiratory disease in the majority of cases, but in some cases, cytokine activation causes sepsis and acute respiratory distress syndrome, leading to morbidity and mortality. Immunomodulatory treatments and biologics are also being actively explored as therapeutics for COVID-19. On the other hand, the use of steroidal and nonsteroidal anti-inflammatory drugs (NSAIDs) has been discouraged based on concerns about their adverse effects. Over the past two decades, coronaviruses have caused major epidemics and outbreaks worldwide, whilst modern medicine has been playing catch-up all along.
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Affiliation(s)
- Kam Lun Hon
- Department of Paediatrics and Adolescent Medicine, The Hong Kong Children's Hospital, Hong Kong SAR, China
| | - Karen Ka Yan Leung
- Department of Paediatrics and Adolescent Medicine, The Hong Kong Children's Hospital, Hong Kong SAR, China
| | - Alexander Kc Leung
- Department of Pediatrics, The University of Calgary and The Alberta Children's Hospital, Calgary, AB, Canada
| | - Su Yun Qian
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Vivian Py Chan
- Department of Pharmacy, The Hong Kong Children's Hospital, Hong Kong SAR, China
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Ian Ck Wong
- Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong SAR, China.,Centre for Medicines Optimisation Research and Education (CMORE), Research Department of Practice and Policy, UCL School of Pharmacy, London
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