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Wu X, Kuang Y, Guo Y, Wu J, Xiao L. Internet hospital response to the COVID-19 pandemic in a tertiary hospital in China: Perspectives based on a mixed-methods. Digit Health 2024; 10:20552076241228418. [PMID: 38303968 PMCID: PMC10832419 DOI: 10.1177/20552076241228418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 01/09/2024] [Indexed: 02/03/2024] Open
Abstract
Objective This study aimed to summarize the characteristics of the Internet hospital services of the Seventh Affiliated Hospital of Sun Yat-sen University (SAHSYSU), describe diagnosis and treatment patterns in each department, determine SAHSYSU Internet hospital's role in pandemic control, and explore development strategies in non-pandemic situations. Methods Mixed-methods was used in this study. Qualitative organizational behavior analysis was conducted on hospital meeting records and semi-structured interview records to determine the research analysis indicators. We quantitatively analyzed online consultation record data of SAHSYSU Internet hospital from January to December 2020, and conduct classification analysis on departmental case studies using K-means clustering algorithm. Results 29,944 patient data items were retrieved. Internet hospital services synchronized with COVID-19 pandemic development in China and Guangdong province. The service volume peaked during the period of January to March, which coincided with the height of the pandemic. Out of the total visits, 58.90% were conducted during office hours while 41.10% were conducted during non-office hours. The majority of the patients came from Guangdong (19.67%) and Hubei (9.09%) provinces. The cluster analysis identified three clusters, each with different change rates and magnitudes of change for various departments. Conclusion Internet hospitals complemented conventional medical services, providing crucial medical care during the COVID-19 pandemic. Internet hospitals are the future trend of medical services and should be improved based on each department's treatment characteristics.
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Affiliation(s)
- Xiaolong Wu
- Business School, Sun Yat-sen University, Shenzhen, China
| | - Yulin Kuang
- Business School, Sun Yat-sen University, Shenzhen, China
| | - Yonglin Guo
- School of Government, Sun Yat-sen University, Guangzhou, China
| | - Ji Wu
- School of Business, Sun Yat-sen University, Guangzhou, China
| | - Li Xiao
- Office of the SYSU CPC Committee, Sun Yat-sen University, Guangzhou, China
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Chicea R, Neagu AD, Chicea ED, Grindeanu AS, Bratu DG, Boicean AG, Roman MD, Fleacă SR, Chicea LM, Teacoe DA, Radu IA, Ognean ML. Impact of SARS-CoV-2 Infection on Maternal and Neonatal Outcome in Correlation with Sociodemographic Aspects: A Retrospective Case-Control Study. J Clin Med 2023; 12:6322. [PMID: 37834966 PMCID: PMC10573086 DOI: 10.3390/jcm12196322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 09/22/2023] [Accepted: 09/24/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND As the COVID-19 pandemic evolved, concerns grew about its impact on pregnant women. This study aimed to determine how SARS-CoV-2 affects pregnancy, birth, and newborns, in order to identify vulnerable individuals and provide proper care. METHODS This is a retrospective case-control study of 398 pregnant women who delivered at the Emergency Clinical County Hospital in Sibiu, Romania from 1 February 2020 to 31 March 2022. Patients were initially grouped and compared based on their RT-PCR SARS-CoV-2 test results into the COVID group (cases) (N = 199) and non-COVID group (control) (N = 199). The COVID cases were further divided and compared according to the pre-Delta (N = 105) and Delta/Omicron (N = 94) SARS-CoV-2 variants. COVID cases and control groups were compared to identify correlations between sociodemographic factors, pregnancy outcomes, and SARS-CoV-2 infection. The same comparisons were performed between pre-Delta and Delta/Omicron groups. RESULTS There were no significant differences concerning maternal residence, while educational level and employment proportion were higher among the positively tested patients. No significant differences were found for neonatal and pregnancy complications between COVID cases and control groups. Except for a lower mean gestational age, no significant differences were found between pre-Delta and Delta/Omicron periods. The maternal mortality in the infected group was 0.5% (1 case). CONCLUSIONS Our study showed that SARS-CoV-2 infection at birth did not significantly affect maternal and neonatal outcomes, not even considering the SARS-CoV-2 strain.
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Affiliation(s)
- Radu Chicea
- Faculty of Medicine, Lucian Blaga University Sibiu, 550024 Sibiu, Romania; (R.C.); (M.L.O.)
- Emergency Clinical County Hospital Sibiu, 550245 Sibiu, Romania
| | | | | | - Amina Simona Grindeanu
- Faculty of Medicine, Lucian Blaga University Sibiu, 550024 Sibiu, Romania; (R.C.); (M.L.O.)
- Emergency Clinical County Hospital Sibiu, 550245 Sibiu, Romania
| | - Dan Georgian Bratu
- Faculty of Medicine, Lucian Blaga University Sibiu, 550024 Sibiu, Romania; (R.C.); (M.L.O.)
- Emergency Clinical County Hospital Sibiu, 550245 Sibiu, Romania
| | - Adrian Gheorghe Boicean
- Faculty of Medicine, Lucian Blaga University Sibiu, 550024 Sibiu, Romania; (R.C.); (M.L.O.)
- Emergency Clinical County Hospital Sibiu, 550245 Sibiu, Romania
| | - Mihai Dan Roman
- Faculty of Medicine, Lucian Blaga University Sibiu, 550024 Sibiu, Romania; (R.C.); (M.L.O.)
- Emergency Clinical County Hospital Sibiu, 550245 Sibiu, Romania
| | - Sorin Radu Fleacă
- Faculty of Medicine, Lucian Blaga University Sibiu, 550024 Sibiu, Romania; (R.C.); (M.L.O.)
- Emergency Clinical County Hospital Sibiu, 550245 Sibiu, Romania
| | - Liana Maria Chicea
- Faculty of Medicine, Lucian Blaga University Sibiu, 550024 Sibiu, Romania; (R.C.); (M.L.O.)
- Emergency Clinical County Hospital Sibiu, 550245 Sibiu, Romania
| | | | - Ioana Andrada Radu
- Faculty of Medicine, Lucian Blaga University Sibiu, 550024 Sibiu, Romania; (R.C.); (M.L.O.)
- Emergency Clinical County Hospital Sibiu, 550245 Sibiu, Romania
| | - Maria Livia Ognean
- Faculty of Medicine, Lucian Blaga University Sibiu, 550024 Sibiu, Romania; (R.C.); (M.L.O.)
- Emergency Clinical County Hospital Sibiu, 550245 Sibiu, Romania
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Abstract
COVID-19 infection is an ongoing catastrophic global pandemic with significant morbidity and mortality that affects most of the world population. Respiratory manifestations predominate and largely determine patient prognosis, but gastrointestinal (GI) manifestations also frequently contribute to patient morbidity and occasionally affect mortality. GI bleeding is usually noted after hospital admission and is often one aspect of this multisystem infectious disease. Although the theoretical risk of contracting COVID-19 from GI endoscopy performed on COVID-19-infected patients remains, the actual risk does not seem to be high. The introduction of PPE and widespread vaccination gradually increased the safety and frequency of performing GI endoscopy in COVID-19-infected patients. Three important aspects of GI bleeding in COVID-19-infected patients are (1) GI bleeding is often from mucosal erosions from mucosal infalammation that causes mild GI bleeding; (2) severe upper GI bleeding is often from PUD or stress gastritis from COVID-19 pneumonia; and (3) lower GI bleeding frequently arises from ischemic colitis associated with thromboses and hypercoagulopathy from COVID-19 infection. The literature concerning GI bleeding in COVID-19 patients is presently reviewed.
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Romano C, Fehnel S, Stoddard J, Sadoff J, Lewis S, McNulty P, Chan EKH, Evans E, Jamieson C, Slagle AF, Mangel A, McQuarrie K. Development of a novel patient-reported outcome measure to assess signs and symptoms of COVID-19. J Patient Rep Outcomes 2022; 6:85. [PMID: 35904710 PMCID: PMC9336135 DOI: 10.1186/s41687-022-00471-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 05/25/2022] [Indexed: 12/29/2022] Open
Abstract
Background Given the urgent need for vaccines and treatments for coronavirus disease 2019 (COVID-19), the Symptoms of Infection with Coronavirus-19 (SIC), a comprehensive, patient-reported outcome (PRO) measure of signs and symptoms associated with COVID-19, was developed in full alignment with current US regulatory guidance to support evaluations of vaccines and treatments in development. Methods An initial version of the SIC was developed to address concepts identified through a targeted literature review and consultation with experts in infectious diseases and clinicians routinely managing COVID-19 in a hospital setting. A qualitative study was conducted in sites in the United States among 31 participants aged ≥ 18 years who were English-speaking and willing and able to provide informed consent and a self-reported history by telephone or online method. The measure was refined based on additional feedback from the clinicians and three iterative rounds of combined concept elicitation and cognitive debriefing interviews conducted with patients, caregivers, and healthy volunteers. Results Among 39 scientific articles identified in the literature review, 35 COVID-19 signs and symptoms were reported and confirmed during interviews with clinicians, patients, and caregivers. Patients and healthy participants suggested changes for refining the draft SIC to ensure consistent interpretation and endorsed both the 24-h recall period and use of an 11-point numeric rating scale (NRS) for capturing change in symptom severity. The final version of the SIC captures the daily presence or absence of 30 symptoms and a rating of severity for 25 of the 30 symptoms using an NRS for those symptoms reported as present. Conclusions The SIC comprehensively addresses observations described in the literature, by clinicians, and by patients, and captures patients’ experiences with COVID-19 in a manner that minimizes complexity and facilitates completion for both patients and healthy volunteers. This measure is thus appropriate for use in clinical trials of both therapeutics and vaccines for COVID-19. Supplementary Information The online version contains supplementary material available at 10.1186/s41687-022-00471-w.
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Hanif FM, Majid Z, Ahmed S, Luck NH, Mubarak M. Hepatic manifestations of coronavirus disease 2019 infection: Clinical and laboratory perspective. World J Virol 2022; 11:453-466. [PMID: 36483109 PMCID: PMC9724207 DOI: 10.5501/wjv.v11.i6.453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/17/2022] [Accepted: 11/07/2022] [Indexed: 11/23/2022] Open
Abstract
The novel coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2, has become a global challenge of unprecedented nature since December 2019. Although most patients with COVID-19 exhibit mild clinical manifestations and upper respiratory tract involvement, in approximately 5%-10% of patients, the disease is severe and involves multiple organs, leading to multi-organ dysfunction and failure. The liver and gastrointestinal tract are also frequently involved in COVID-19. In the context of liver involvement in patients with COVID-19, many key aspects need to be addressed in both native and transplanted organs. This review focuses on the clinical presentations and laboratory abnormalities of liver function tests in patients with COVID-19 with no prior liver disease, patients with pre-existing liver diseases and liver transplant recipients. A brief overview of the history of COVID-19 and etiopathogenesis of the liver injury will also be described as a prelude to better understanding the above aspects.
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Affiliation(s)
- Farina M Hanif
- Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan
| | - Zain Majid
- Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan
| | - Shoaib Ahmed
- Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan
| | - Nasir H Luck
- Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan
| | - Muhammed Mubarak
- Department of Pathology, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan
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Dolu S, Bengi G, Avkan-Oğuz V, Tertemiz KC, Sinem Gezer N, Çavuş SA, Alpaydın AÖ, Kuruüzüm Z, Ergan B, Sevinç C, Ömeroğlu Şimsek G, Kılınç O, Örmen M, Sayıner A, Somalı I, Çavdar C, Can G, Demir T, Akarsu M, Savran Y, Soytürk M. Prevalence of Gastrointestinal Symptoms and Clinical Outcomes in Hospitalized Coronavirus Disease 2019 Patients: A Single-Center Study from Turkey. THE TURKISH JOURNAL OF GASTROENTEROLOGY : THE OFFICIAL JOURNAL OF TURKISH SOCIETY OF GASTROENTEROLOGY 2022; 33:955-963. [PMID: 35946895 PMCID: PMC9797795 DOI: 10.5152/tjg.2022.21484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND In patients with coronavirus disease 2019, the gastrointestinal symptoms have been reported increasingly in addition to the respiratory system symptoms. The studies show that the prevalence of gastrointestinal system symptoms and how the gastrointestinal system contributes to the severity and prognosis of the disease is still not clear. This study aims to find the prevalence of gastrointestinal symptoms and the correlation between the gastrointestinal symptoms and the clinical results in hospitalized patients diagnosed with coronavirus disease 2019. METHODS This study retrospectively analyzes patients diagnosed with coronavirus disease 2019 and hospitalized in the pandemic unit between March 2020 and August 2020 and compares their demographic and clinical characteristics, laboratory and radiologic findings, coronavirus disease 2019 treatments received, the clinical course of the disease, and the gastrointestinal symptoms. RESULTS In our study, we included 322 patients diagnosed with coronavirus disease 2019 and hospitalized; 39 patients (12.1%) were admitted to the hospital with at least one gastrointestinal symptom (nausea and vomiting, diarrhea, abdominal pain, and the loss of taste). Nausea and vomiting are the most common gastrointestinal symptoms with a prevalence of 7.1%, followed by diarrhea with 2.8%, the loss of taste with 2.2%, and abdominal pain with 1.5%. The mean age and D-dimer levels of the patients showing gastrointestinal symptoms were lower than those who did not have any gastrointestinal symptoms. We did not find a significant correlation between the presence of the gastrointestinal symptoms and the severity of the disease, treatment received, risk of acute respiratory distress syndrome and septic shock, admission to the intensive care unit, the need for mechanical ventilation, the mortality rate or the length of hospitalization in the medical floor or the intensive care unit. CONCLUSION In this study, we observed that 12.1% of coronavirus disease 2019 patients apply to the hospital due to gastrointestinal symptoms. Furthermore, the gastrointestinal symptoms do not seem to affect the severity and the course of the disease, it is important to identify coronavirus disease 2019 patients showing unusual symptoms such as the gastrointestinal symptoms at an early stage to protect healthcare professionals from infection risk.
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Affiliation(s)
- Süleyman Dolu
- Department of Gastroenterology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey,Corresponding author: Süleyman Dolu, e-mail:
| | - Göksel Bengi
- Department of Gastroenterology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Vildan Avkan-Oğuz
- Department of Infectious Diseases and Clinical Microbiology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Kemal Can Tertemiz
- Department of Pulmonary Diseases, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Naciye Sinem Gezer
- Department of Radiology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Sema Alp Çavuş
- Department of Infectious Diseases and Clinical Microbiology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Aylin Özgen Alpaydın
- Department of Pulmonary Diseases, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Ziya Kuruüzüm
- Department of Infectious Diseases and Clinical Microbiology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Begüm Ergan
- Department of Pulmonary Diseases, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Can Sevinç
- Department of Pulmonary Diseases, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Gökçen Ömeroğlu Şimsek
- Department of Pulmonary Diseases, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Oğuz Kılınç
- Department of Pulmonary Diseases, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Murat Örmen
- Department of Biochemistry, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Arzu Sayıner
- Department of Medical Microbiology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Işıl Somalı
- Department of Medical Oncology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Caner Çavdar
- Department of Nephrology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Gerçek Can
- Department of Rheumatology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Tevfik Demir
- Department of Endocrinology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Mesut Akarsu
- Department of Gastroenterology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Yusuf Savran
- Department of Internal Medicine and Medical Intensive Care, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Müjde Soytürk
- Department of Gastroenterology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
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Zhao Y, Teh JJ, Kung V, Mallappa S. Bowel ischaemia in COVID-19 infection: a scoping review protocol. BMJ Open 2022; 12:e060566. [PMID: 36153022 PMCID: PMC9511006 DOI: 10.1136/bmjopen-2021-060566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION COVID-19 disease was declared as a pandemic by WHO since March 2020 and can have a myriad of clinical presentations affecting various organ systems. Patients with COVID-19 are known to have an increased risk of thromboembolism, including cardiovascular, pulmonary and cerebral ischaemic events. However, an increasing number of case studies have reported that COVID-19 infection is also associated with gastrointestinal ischaemia. This scoping review aims to collate the current evidence of COVID-19-related gastrointestinal ischaemia and raise awareness among healthcare professionals of this lesser known, but serious, non-pulmonary complication of COVID-19 infection. METHODS The proposed scoping review will be conducted as per the Arksey and O'Malley methodological framework (2005) the Joanna Briggs Institute methodology for scoping reviews. A systematic search will be undertaken on different databases including EMBASE, PubMed and MEDLINE. Two independent reviewers will screen titles, abstracts and full-text articles according to the inclusion criteria and extract relevant data from the included articles. Results will be presented in a tabular form with a narrative discussion. ETHICS AND DISSEMINATION Ethical approval will not be required for this scoping review. This scoping review will provide an extensive overview of the association between COVID-19 infection and bowel ischaemia. Further ethical and methodological challenges will also be discussed in our findings to define a new research agenda. Findings will be disseminated through peer-reviewed publications and presentations at both national and international conferences.
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Affiliation(s)
- Yi Zhao
- Imperial College London, London, UK
| | - Jhia Jiat Teh
- Imperial College London, London, UK
- General and Colorectal Surgery, Hillingdon Hospitals NHS Foundation Trust, Uxbridge, UK
| | - Victor Kung
- Department of Colorectal Surgery, St Thomas' Hospital, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - Sreelakshmi Mallappa
- General and Colorectal Surgery, Hillingdon Hospitals NHS Foundation Trust, Uxbridge, UK
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Bonaffini PA, Franco PN, Bonanomi A, Giaccherini C, Valle C, Marra P, Norsa L, Marchetti M, Falanga A, Sironi S. Ischemic and hemorrhagic abdominal complications in COVID-19 patients: experience from the first Italian wave. Eur J Med Res 2022; 27:165. [PMID: 36045452 PMCID: PMC9428880 DOI: 10.1186/s40001-022-00793-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 08/06/2022] [Indexed: 11/10/2022] Open
Abstract
PURPOSE To report ischemic and haemorrhagic abdominal complications in a series of COVID-19 patients. To correlate these complications with lung involvement, laboratory tests, comorbidities, and anticoagulant treatment. METHODS We retrospectively included 30 COVID-19 patients who undergone abdomen CECT for abdominal pain, between March 16 and May 19, 2020. Ischemic and haemorrhagic complications were compared with lung involvement (early, progressive, peak or absorption stage), blood coagulation values, anticoagulant therapy, comorbidities, and presence of pulmonary embolism (PE). RESULTS Ischemic complications were documented in 10 patients (7 receiving anticoagulant therapy, 70%): 6/10 small bowel ischemia (1 concomitant obstruction, 1 perforation) and 4/10 ischemic colitis. Main mesenteric vessels were patent except for 1 superior mesenteric vein thrombosis. Two ischemia cases also presented splenic infarctions. Bleeding complications were found in 20 patients (all receiving anticoagulant treatments), half with active bleeding: hematomas in soft tissues (15) and retroperitoneum (2) and gastro-intestinal bleeding (3). Platelet and lymphocyte were within the normal range. D-Dimer was significantly higher in ischemic cases (p < 0.001). Most of the patients had severe lung disease (45% peak, 29% absorption), two patients PE. CONCLUSIONS Ischemic and haemorrhagic abdominal complications may occur in COVID-19 patients, particularly associated to extended lung disease. CT plays a key role in the diagnosis of these potentially life- threatening conditions.
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Affiliation(s)
- Pietro Andrea Bonaffini
- Department of Radiology, ASST Papa Giovanni XXIII Hospital, Piazza OMS 1, 24127, Bergamo, BG, Italy. .,School of Medicine, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126, Milan, MI, Italy.
| | - Paolo Niccolò Franco
- Department of Radiology, ASST Papa Giovanni XXIII Hospital, Piazza OMS 1, 24127, Bergamo, BG, Italy.,School of Medicine, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126, Milan, MI, Italy
| | - Alice Bonanomi
- Department of Radiology, ASST Papa Giovanni XXIII Hospital, Piazza OMS 1, 24127, Bergamo, BG, Italy.,School of Medicine, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126, Milan, MI, Italy
| | - Cinzia Giaccherini
- Unit of Immuno-Hematology and Transfusion Medicine and Center of Hemostasis and Thrombosis, Papa Giovanni XXIII Hospital, Piazza OMS 1, 24127, Bergamo, BG, Italy
| | - Clarissa Valle
- Department of Radiology, ASST Papa Giovanni XXIII Hospital, Piazza OMS 1, 24127, Bergamo, BG, Italy.,School of Medicine, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126, Milan, MI, Italy
| | - Paolo Marra
- Department of Radiology, ASST Papa Giovanni XXIII Hospital, Piazza OMS 1, 24127, Bergamo, BG, Italy.,School of Medicine, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126, Milan, MI, Italy
| | - Lorenzo Norsa
- Unit of Pediatric Hepatology Gastroenterology and Transplantation, Papa Giovanni XXIII Hospital, Piazza OMS 1, 24127, Bergamo, BG, Italy
| | - Marina Marchetti
- Unit of Immuno-Hematology and Transfusion Medicine and Center of Hemostasis and Thrombosis, Papa Giovanni XXIII Hospital, Piazza OMS 1, 24127, Bergamo, BG, Italy
| | - Anna Falanga
- School of Medicine, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126, Milan, MI, Italy.,Unit of Immuno-Hematology and Transfusion Medicine and Center of Hemostasis and Thrombosis, Papa Giovanni XXIII Hospital, Piazza OMS 1, 24127, Bergamo, BG, Italy
| | - Sandro Sironi
- Department of Radiology, ASST Papa Giovanni XXIII Hospital, Piazza OMS 1, 24127, Bergamo, BG, Italy.,School of Medicine, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126, Milan, MI, Italy
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Topchiy TВ, Ardatskaya MD, Butorova LI, Маslovskii LV, Мinushkin ОN. Features of the intestine conditions at patients with a new coronavirus infection. TERAPEVT ARKH 2022; 94:920-926. [DOI: 10.26442/00403660.2022.07.201768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 08/12/2022] [Indexed: 11/22/2022]
Abstract
COVID-19 infection may present with gastrointestinal lesions in up to 25% of patients. One of the target organs of the SARS-CoV-2 virus is the intestine. The pathogenesis of intestinal damage in a new coronavirus infection remains unclear and requires further in-depth study. Possible mechanisms include a direct cytotoxic effect of the virus, a persistent reduction in butyrate-producing bacteria, side effects of drugs, Clostridioides difficile infection, microvascular thrombosis, and the immune-mediated inflammatory reactions in the intestine. The most common symptom of intestinal damage during coronavirus infection, both in the acute phase and in the post-COVID period, is diarrhea. The impact of many aggressive factors on the intestines can form both long-term functional disorders and be the cause of the onset of organic diseases. Treatment should be aimed at possible causes of intestinal damage (Clostridioides difficile), as well as reducing inflammation, restoring intestinal permeability, cytoprotection of mucosal cells, replenishing butyric acid deficiency. When choosing a therapy for intestinal disorders, preference should be given to drugs with a pleiotropic effect in order to influence various possible pathogenetic mechanisms.
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10
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Chakraborty C, Sharma AR, Bhattacharya M, Dhama K, Lee SS. Altered gut microbiota patterns in COVID-19: Markers for inflammation and disease severity. World J Gastroenterol 2022; 28:2802-2822. [PMID: 35978881 PMCID: PMC9280735 DOI: 10.3748/wjg.v28.i25.2802] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 03/19/2022] [Accepted: 05/14/2022] [Indexed: 02/06/2023] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection leads to a severe respiratory illness and alters the gut microbiota, which dynamically interacts with the human immune system. Microbiota alterations include decreased levels of beneficial bacteria and augmentation of opportunistic pathogens. Here, we describe critical factors affecting the microbiota in coronavirus disease 2019 (COVID-19) patients. These include, such as gut microbiota imbalance and gastrointestinal symptoms, the pattern of altered gut microbiota composition in COVID-19 patients, and crosstalk between the microbiome and the gut-lung axis/gut-brain-lung axis. Moreover, we have illustrated the hypoxia state in COVID-19 associated gut microbiota alteration. The role of ACE2 in the digestive system, and control of its expression using the gut microbiota is discussed, highlighting the interactions between the lungs, the gut, and the brain during COVID-19 infection. Similarly, we address the gut microbiota in elderly or co-morbid patients as well as gut microbiota dysbiosis of in severe COVID-19. Several clinical trials to understand the role of probiotics in COVID-19 patients are listed in this review. Augmented inflammation is one of the major driving forces for COVID-19 symptoms and gut microbiome disruption and is associated with disease severity. However, understanding the role of the gut microbiota in immune modulation during SARS-CoV-2 infection may help improve therapeutic strategies for COVID-19 treatment.
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Affiliation(s)
| | - Ashish Ranjan Sharma
- Institute for Skeletal Aging & Orthopaedic Surgery, Hallym University, Chuncheon-si 24252, South Korea
| | | | - Kuldeep Dhama
- Division of Pathology, Indian Council of Agricultural Research (ICAR)-Indian Veterinary Research Institute (IVRI), Bareilly 243122, Uttar Pradesh, India
| | - Sang-Soo Lee
- Institute for Skeletal Aging & Orthopedic Surgery, Hallym University, Chuncheon-si 24252, South Korea
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Ramírez-Martínez G, Jiménez-Álvarez LA, Cruz-Lagunas A, Ignacio-Cortés S, Gómez-García IA, Rodríguez-Reyna TS, Choreño-Parra JA, Zúñiga J. Possible Role of Matrix Metalloproteinases and TGF-β in COVID-19 Severity and Sequelae. J Interferon Cytokine Res 2022; 42:352-368. [PMID: 35647937 PMCID: PMC9422783 DOI: 10.1089/jir.2021.0222] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The costs of coronavirus disease 2019 (COVID-19) are devastating. With millions of deaths worldwide, specific serological biomarkers, antiviral agents, and novel therapies are urgently required to reduce the disease burden. For these purposes, a profound understanding of the pathobiology of COVID-19 is mandatory. Notably, the study of immunity against other respiratory infections has generated reference knowledge to comprehend the paradox of the COVID-19 pathogenesis. Past studies point to a complex interplay between cytokines and other factors mediating wound healing and extracellular matrix (ECM) remodeling that results in exacerbated inflammation, tissue injury, severe manifestations, and a sequela of respiratory infections. This review provides an overview of the immunological process elicited after severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. Also, we analyzed available data about the participation of matrix metalloproteinases (MMPs) and transforming growth factor-beta (TGF-β) in immune responses of the lungs. Furthermore, we discuss their possible implications in severe COVID-19 and sequela, including pulmonary fibrosis, and remark on the potential of these molecules as biomarkers for diagnosis, prognosis, and treatment of convalescent COVID-19 patients. Our review provides a theoretical framework for future research aimed to discover molecular hallmarks that, combined with clinical features, could serve as therapeutic targets and reliable biomarkers of the different clinical forms of COVID-19, including convalescence.
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Affiliation(s)
- Gustavo Ramírez-Martínez
- Laboratory of Immunobiology and Genetics, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas," Mexico City, Mexico
| | - Luis Armando Jiménez-Álvarez
- Laboratory of Immunobiology and Genetics, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas," Mexico City, Mexico
| | - Alfredo Cruz-Lagunas
- Laboratory of Immunobiology and Genetics, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas," Mexico City, Mexico
| | - Sergio Ignacio-Cortés
- Laboratory of Immunobiology and Genetics, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas," Mexico City, Mexico.,Escuela de Medicina y Ciencias de la Salud, Tecnológico de Monterrey, Mexico City, Mexico
| | - Itzel Alejandra Gómez-García
- Laboratory of Immunobiology and Genetics, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas," Mexico City, Mexico.,Escuela de Medicina y Ciencias de la Salud, Tecnológico de Monterrey, Mexico City, Mexico
| | - Tatiana Sofia Rodríguez-Reyna
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - José Alberto Choreño-Parra
- Laboratory of Immunobiology and Genetics, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas," Mexico City, Mexico.,Escuela de Medicina y Ciencias de la Salud, Tecnológico de Monterrey, Mexico City, Mexico
| | - Joaquín Zúñiga
- Laboratory of Immunobiology and Genetics, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas," Mexico City, Mexico.,Escuela de Medicina y Ciencias de la Salud, Tecnológico de Monterrey, Mexico City, Mexico
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12
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Yu L, Wang A, Li T, Jin W, Tian G, Yun C, Gao F, Fan X, Wang H, Zhang H, Sun D. A Retrospective and Multicenter Study on COVID-19 in Inner Mongolia: Evaluating the Influence of Sampling Locations on Nucleic Acid Test and the Dynamics of Clinical and Prognostic Indexes. Front Med (Lausanne) 2022; 9:830484. [PMID: 35433742 PMCID: PMC9007405 DOI: 10.3389/fmed.2022.830484] [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: 12/11/2021] [Accepted: 03/07/2022] [Indexed: 01/08/2023] Open
Abstract
COVID-19 is spreading widely, and the pandemic is seriously threatening public health throughout the world. A comprehensive study on the optimal sampling types and timing for an efficient SARS-CoV-2 test has not been reported. We collected clinical information and the values of 55 biochemical indices for 237 COVID-19 patients, with 37 matched non-COVID-19 pneumonia patients and 131 healthy people in Inner Mongolia as control. In addition, the results of dynamic detection of SARS-CoV-2 using oropharynx swab, pharynx swab, and feces were collected from 197 COVID-19 patients. SARS-CoV-2 RNA positive in feces specimen was present in approximately one-third of COVID-19 patients. The positive detection rate of SARS-CoV-2 RNA in feces was significantly higher than both in the oropharynx and nasopharynx swab (P < 0.05) in the late period of the disease, which is not the case in the early period of the disease. There were statistically significant differences in the levels of blood LDH, CRP, platelet count, neutrophilic granulocyte count, white blood cell number, and lymphocyte count between COVID-19 and non-COVID-19 pneumonia patients. Finally, we developed and compared five machine-learning models to predict the prognosis of COVID-19 patients based on biochemical indices at disease onset and demographic characteristics. The best model achieved an area under the curve of 0.853 in the 10-fold cross-validation.
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Affiliation(s)
- Lan Yu
- Inner Mongolia Key Laboratory of Gene Regulation of the Metabolic Diseases, Clinical Medical Research Center, Inner Mongolia People's Hospital, Hohhot, China.,Endocrinology Department, Inner Mongolia People's Hospital, Hohhot, China
| | - Ailan Wang
- Geneis (Beijing) Co., Ltd., Beijing, China.,Qingdao Geneis Institute of Big Data Mining and Precision Medicine, Qingdao, China
| | - Tianbao Li
- Geneis (Beijing) Co., Ltd., Beijing, China.,Qingdao Geneis Institute of Big Data Mining and Precision Medicine, Qingdao, China
| | - Wen Jin
- Inner Mongolia Key Laboratory of Gene Regulation of the Metabolic Diseases, Clinical Medical Research Center, Inner Mongolia People's Hospital, Hohhot, China
| | - Geng Tian
- Geneis (Beijing) Co., Ltd., Beijing, China.,Qingdao Geneis Institute of Big Data Mining and Precision Medicine, Qingdao, China
| | - Chunmei Yun
- Key Laboratory of National Health Commission for the Diagnosis and Treatment of COPD, Department of Pulmonary and Critical Care Medicine, Inner Mongolia People's Hospital, Hohhot, China
| | - Fei Gao
- Department of Pulmonary and Critical Care Medicine, The Fourth Hospital of Inner Mongolia, Hohhot, China
| | - Xiuzhen Fan
- Department of Pulmonary and Critical Care Medicine, Xilin Gol League Central Hospital, Xilinhot, China
| | - Huimin Wang
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou, China
| | - Huajun Zhang
- Department of Mathematics, Shaoxing University, Shaoxing, China
| | - Dejun Sun
- Key Laboratory of National Health Commission for the Diagnosis and Treatment of COPD, Department of Pulmonary and Critical Care Medicine, Inner Mongolia People's Hospital, Hohhot, China
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13
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Monroe I, Dale M, Schwabe M, Schenkel R, Schenarts PJ. The COVID-19 Patient in the Surgical Intensive Care Unit. Surg Clin North Am 2022; 102:1-21. [PMID: 34800379 PMCID: PMC8479422 DOI: 10.1016/j.suc.2021.09.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
COVID-19 continues to rampage around the world. Noncritical care-trained physicians may be deployed into the intensive care unit to manage these complex patients. Although COVID-19 is primarily a respiratory disease, it is also associated with significant pathology in the brain, heart, vasculature, lungs, gastrointestinal tract, and kidneys. This article provides an overview of COVID-19 using an organ-based, systematic approach.
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14
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Patel AP, Sanders TK, Prakash P, Law J, Alvencar S, Choi A, Shah J, Patel K, Srivoleti P, Chauhan K, Weissman S, Holzwanger E, Dhingra R, Nguyen M, Kim D, Sidhu T, Stallwood C, Dickstein A, Parekh N, Altayar O, Ciorba MA, Yu J, Chen LA, Tabibian JH, Limketkai BN. Gastrointestinal Manifestations of Coronavirus Disease 2019 Across the United States: A Multicenter Cohort Study. GASTRO HEP ADVANCES 2022; 1:909-915. [PMID: 35874930 PMCID: PMC9293374 DOI: 10.1016/j.gastha.2022.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 07/06/2022] [Indexed: 01/25/2023]
Abstract
Background and Aims Gastrointestinal (GI) symptoms occur among patients diagnosed with coronavirus disease 2019 (COVID-19), and there is clear evidence that SARS-CoV-2, the causative pathogen, infects the GI tract. In this large, multicenter cohort study, we evaluated variations in gastrointestinal and hepatic manifestations of COVID-19 throughout the United States (US). Methods Patients hospitalized with a positive COVID-19 test prior to October 2020 were identified at 7 US academic centers. Demographics, presenting symptoms, laboratory data, and hospitalization outcomes were abstracted. Descriptive and regression analyses were used to evaluate GI manifestations and their potential predictors. Results Among 2031 hospitalized patients with COVID-19, GI symptoms were present in 18.9%; diarrhea was the most common (15.2%), followed by nausea and/or vomiting (12.6%) and abdominal pain (6.0%). GI symptoms were less common in the Western cohort (16.0%) than the Northeastern (25.6%) and Midwestern (26.7%) cohorts. Compared to nonintensive care unit (ICU) patients, ICU patients had a higher prevalence of abnormal aspartate aminotransferase (58.1% vs 37.3%; P < .01), alanine aminotransferase (37.5% vs 29.3%; P = .01), and total bilirubin (12.7% vs 9.0%; P < .01). ICU patients also had a higher mortality rate (22.7% vs 4.7%; P < .01). Chronic liver disease was associated with the development of GI symptoms. Abnormal aspartate aminotransferase or alanine aminotransferase was associated with an increased risk of ICU admission. Conclusion We present the largest multicenter cohort of patients with COVID-19 across the United States. GI manifestations were common among patients hospitalized with COVID-19, although there was significant variability in prevalence and predictors across the United States.
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Key Words
- ALT, alanine aminotransferase
- AST, aspartate aminotransferase
- BMI, body mass index
- CI, confidence interval
- COVID-19
- COVID-19, coronavirus disease 2019
- Coronavirus Disease 2019
- GI, gastrointestinal
- Gastrointestinal
- ICU, intensive care unit
- OR, odds ratio
- SARS-CoV-2
- SD, standard deviation
- UCLA, University of California Los Angeles
- aOR, adjusted odds ratio
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Affiliation(s)
- Ankur P. Patel
- Vatche & Tamar Manoukian Division of Digestive Diseases, UCLA School of Medicine, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California,Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Troy K. Sanders
- Vatche & Tamar Manoukian Division of Digestive Diseases, UCLA School of Medicine, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - Preeti Prakash
- Vatche & Tamar Manoukian Division of Digestive Diseases, UCLA School of Medicine, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - Jade Law
- Division of Gastroenterology, Department of Medicine, Olive View-UCLA Medical Center, Sylmar, California
| | - Sujay Alvencar
- Division of Gastroenterology, Tufts Medical Center, Boston, Massachusetts
| | - Alyssa Choi
- Division of Gastroenterology, University of California Irvine, Irvine, California
| | - Janaki Shah
- Inflammatory Bowel Diseases Center, Washington University in St. Louis, Saint Louis, Missouri
| | - Karishma Patel
- Division of Gastroenterology and Hepatology, Oregon Health & Science University, Portland, Oregon
| | - Padmavathi Srivoleti
- Department of Medicine, Saint Elizabeth’s Medical Center, Brighton, Massachusetts
| | - Kirtan Chauhan
- Department of Medicine, Baylor College of Medicine, Houston, Texas,Division of Gastroenterology and Hepatology, NYU Langone Health, New York, New York
| | - Simcha Weissman
- Department of Medicine, Hackensack University Medical Center, Hackensack, New Jersey
| | - Erik Holzwanger
- Division of Gastroenterology, Tufts Medical Center, Boston, Massachusetts
| | - Rohit Dhingra
- Division of Gastroenterology, Tufts Medical Center, Boston, Massachusetts
| | - Michelle Nguyen
- Division of Gastroenterology, Tufts Medical Center, Boston, Massachusetts
| | - Daniel Kim
- Division of Gastroenterology, University of California Irvine, Irvine, California
| | - Tahnee Sidhu
- Department of Medicine, Saint Elizabeth’s Medical Center, Brighton, Massachusetts
| | | | - Aaron Dickstein
- Division of Gastroenterology, Tufts Medical Center, Boston, Massachusetts
| | - Nimisha Parekh
- Division of Gastroenterology, University of California Irvine, Irvine, California
| | - Osama Altayar
- Inflammatory Bowel Diseases Center, Washington University in St. Louis, Saint Louis, Missouri
| | - Matthew A. Ciorba
- Inflammatory Bowel Diseases Center, Washington University in St. Louis, Saint Louis, Missouri
| | - Jessica Yu
- Division of Gastroenterology and Hepatology, Oregon Health & Science University, Portland, Oregon
| | - Lea Ann Chen
- Division of Gastroenterology and Hepatology, Rutgers University New Brunswick, New Jersey
| | - James H. Tabibian
- Vatche & Tamar Manoukian Division of Digestive Diseases, UCLA School of Medicine, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California,Division of Gastroenterology, Department of Medicine, Olive View-UCLA Medical Center, Sylmar, California
| | - Berkeley N. Limketkai
- Vatche & Tamar Manoukian Division of Digestive Diseases, UCLA School of Medicine, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California,Vatche & Tamar Manoukian Division of Digestive Diseases, UCLA School of Medicine, Los Angeles, California,Correspondence: Address correspondence to: Berkeley N. Limketkai, MD, PhD, Westwood Digestive Diseases, 100 Medical Plaza, Suite 345, Los Angeles, California 90024
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15
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Epidemiology, transmission and pathogenesis of SARS-CoV-2. COMPUTATIONAL APPROACHES FOR NOVEL THERAPEUTIC AND DIAGNOSTIC DESIGNING TO MITIGATE SARS-COV-2 INFECTION 2022. [PMCID: PMC9300483 DOI: 10.1016/b978-0-323-91172-6.00015-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2) has caused Coronavirus disease-2019 (COVID-19), the worst pandemic of the 21st century. Globally, millions of lives have been lost due to COVID-19. Transmission of SARS-CoV-2 occurs human-to-human through air droplets. SARS-CoV-2 is thought to originate from a bat Coronavirus, which might have reached human beings through intermediate hosts. SARS-CoV-2 causes a variable degree of illness in human beings, including patients being an asymptomatic, mild, moderate, and severe disease, which requires hospitalization. The common symptoms of COVID-19 include fever, cough, myalgia, dyspnea, sore throat, anosmia, ageusia, and diarrhea. The pathogenesis of COVID-19 involves the attachment, entry, and replication of the virus in the host cells. The gains entry into human cells through engagement of angiotensin-converting enzyme 2 receptor with its spike proteins. The overproduction of highly inflammatory cytokines results in a cytokine storm, leading to an increased risk of acute respiratory distress syndrome, coagulopathy, and multiorgan failure. This chapter provides insight into the epidemiology, transmission, and pulmonary and extrapulmonary pathogenesis of COVID-19.
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16
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Alaithan FA, Aljawad MH, Ghawas AH, Althobaiti AS, Almuslem QA, Bin Nasif MH, Algharbi FF, Alshehri RA, Al Gethami YK, Altowayan KW, Alzahrani FK, Suwaylih AA, Alwadai AS, Badawi AM, Alshammari M. Pulmonary Embolism in COVID-19 Patients: A Retrospective Case-Control Study. Cureus 2021; 13:e18887. [PMID: 34820215 PMCID: PMC8600393 DOI: 10.7759/cureus.18887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2021] [Indexed: 01/08/2023] Open
Abstract
Background: Coagulopathy is a well-recognized complication in patients with coronavirus disease 2019 (COVID-19). Pulmonary embolism (PE) has substantial morbidity and mortality if the diagnosis is missed or the management is delayed. Computed tomography pulmonary angiography (CT-PA) is the imaging modality of choice for PE. Therefore, this study aimed to investigate the positive rate of CT-PA for PE among patients with COVID-19. Methods: We conducted a retrospective study examining the diagnostic yield of CT-PA in patients with confirmed COVID-19 and compared it with that in patients without COVID-19. The study included all adult patients with confirmed COVID-19 who presented from June 2020 to June 2021. Results: The study included 316 patients, including 158 patients with COVID-19, who underwent CT-PA for ruling out PE. Overall, 76 patients were found to have PE on the CT-PA scan, yielding a positive rate of 24.1%, with a significant difference between patients with COVID-19 (8.2%) and those without COVID-19 (39.9%). Further, 138 (87.3%) patients with COVID-19 had elevated D-dimer levels compared with 34 (21.5%) patients without COVID-19. A multivariable regression analysis model revealed that the smoking status (odds ratio [OR] = 1.94; 95% confidence interval [CI]: 1.4-3.8) and obesity (OR = 4.1; 95% CI: 1.5-8.9) were independent predictors of PE among patients with COVID-19. However, the elevated D-dimer level was not significantly associated with PE among patients with COVID-19 (OR = 0.7; 95% CI: 0.4-1.8). Conclusion: The study found that the positive rate of CT-PA for PE was lower among patients with PE indicating probable overutilization of investigation in these patients. Additionally, patients with COVID-19 had a higher proportion of elevated D-dimer levels that may be a contributor to the increased investigation for PE. Lastly, patients with COVID-19 who were current smokers had a higher tendency of having PE.
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Affiliation(s)
| | | | - Asia H Ghawas
- General Practice, Dhurma General Hospital, Dhurma, SAU
| | | | | | | | | | | | | | | | | | | | | | | | - Malak Alshammari
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, SAU
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17
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Fadel C, Phan N, Kaur A. Liberal Intravenous Fluid Administration in a Rare Case of Severe Rhabdomyolysis Secondary to SARS-CoV-2. Cureus 2021; 13:e17234. [PMID: 34540461 PMCID: PMC8443426 DOI: 10.7759/cureus.17234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2021] [Indexed: 01/04/2023] Open
Abstract
SARS-CoV-2 entered the world by storm when it made its appearance at the end of 2019 in Wuhan, China. The severity can range from asymptomatic infection, which occurs in approximately 33% of infected patients, to death. Worldwide deaths due to SARS-CoV-2 are currently approximated at 3.8 million people with close to 600,000 deaths in the United States alone, reiterating the significant impact this virus has on the population. SARS-CoV-2 can affect systems of the body such as respiratory, gastrointestinal tract, neurological, cardiac, renal, and even skeletal muscle tissue. A few cases of rhabdomyolysis are reported in SARS-CoV-2 infection, but the significant level of creatinine kinase in the hundreds of thousands is rare. Our case demonstrates the rarity of SARS-CoV-2 manifestation in a 33-year-old African American male with severe rhabdomyolysis with a creatinine kinase on the admission of 362,445 IU/L. The patient was treated aggressively with intravenous fluids, monitoring electrolytes, renal function, and respiratory status closely. His management includes liberal administration of fluid to treat his rhabdomyolysis, without compromising his respiratory status. He was subsequently discharged home after seven days of hospitalization. We strive to share this information in hopes to share our management for future similar cases.
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Affiliation(s)
- Celine Fadel
- Internal Medicine, Northeast Georgia Medical Center Gainsville, Gainesville, USA
| | - Ngoc Phan
- Internal Medicine, Northeast Georgia Medical Center Gainsville, Gainesville, USA
| | - Aman Kaur
- Internal Medicine, Northeast Georgia Medical Center Gainsville, Gainesville, USA
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18
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Zinellu A, Sotgia S, Fois AG, Mangoni AA. Serum CK-MB, COVID-19 severity and mortality: An updated systematic review and meta-analysis with meta-regression. Adv Med Sci 2021; 66:304-314. [PMID: 34256241 PMCID: PMC8260505 DOI: 10.1016/j.advms.2021.07.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 06/25/2021] [Accepted: 07/03/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVES We conducted a systematic review and meta-analysis with meta-regression of creatine kinase-MB (CK-MB), a biomarker of myocardial injury, in COVID-19 patients. METHODS We searched PubMed, Web of Science and Scopus, for studies published between January 2020 and January 2021 that reported CK-MB, COVID-19 severity and mortality (PROSPERO registration number: CRD42021239657). RESULTS Fifty-five studies in 11,791 COVID-19 patients were included in the meta-analysis. The pooled results showed that CK-MB concentrations were significantly higher in patients with high disease severity or non-survivor status than patients with low severity or survivor status (standardized mean difference, SMD, 0.81, 95% CI 0.61 to 1.01, p<0.001). The rate of patients with CK-MB values above the normal range was also significantly higher in the former than the latter (60/350 vs 98/1,780; RR = 2.84, 95%CI 1.89 to 4.27, p<0.001; I2 = 19.9, p = 0.254). Extreme between-study heterogeneity was observed (I2 = 93.4%, p<0.001). Sensitivity analysis, performed by sequentially removing each study and re-assessing the pooled estimates, showed that the magnitude and direction of the effect size was not modified (effect size range, 0.77 to 0.84). Begg's (p = 0.50) and Egger's (p = 0.86) t-tests did not show publication bias. In meta-regression analysis, the SMD was significantly and positively associated with the white blood count, aspartate aminotransferase, myoglobin, troponin, brain natriuretic peptide, lactate dehydrogenase, and D-dimer. CONCLUSIONS Higher CK-MB concentrations were significantly associated with severe disease and mortality in COVID-19 patients. This biomarker of myocardial injury might be useful for risk stratification in this group.
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Affiliation(s)
- Angelo Zinellu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Salvatore Sotgia
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Alessandro G Fois
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Arduino A Mangoni
- Discipline of Clinical Pharmacology, College of Medicine and Public Health, Flinders University and Flinders Medical Centre, Adelaide, Australia.
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19
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Fang LG, Zhou Q. Remarkable gastrointestinal and liver manifestations of COVID-19: A clinical and radiologic overview. World J Clin Cases 2021; 9:4969-4979. [PMID: 34307547 PMCID: PMC8283617 DOI: 10.12998/wjcc.v9.i19.4969] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 03/13/2021] [Accepted: 05/15/2021] [Indexed: 02/06/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) raging around the world still has not been effectively controlled in most countries and regions. As a severe acute respiratory syndrome coronavirus, in addition to the most common infectious pneumonia, it can also cause digestive system disease such as diarrhea, nausea, vomiting, liver function damage, etc. In medical imaging, it manifests as thickening of the intestinal wall, intestinal perforation, pneumoperitoneum, ascites and decreased liver density. Angiotensin-converting enzyme 2 has great significance in COVID-19-related digestive tract diseases. In this review, we summarized the data on the clinical and imaging manifestations of gastrointestinal and liver injury caused by COVID-19 so far and explored its possible pathogenesis.
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Affiliation(s)
- Li-Guang Fang
- Department of Medical Imaging, Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics Guangdong Province), Guangzhou 510630, Guangdong Province, China
| | - Quan Zhou
- Department of Medical Imaging, Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics Guangdong Province), Guangzhou 510630, Guangdong Province, China
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20
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Cordie A, Gaber Y, AbdAllah M, Vergori A, Kharono B, Omran S, Afify S, Karkouri M, Chakroun M, Musa S, Moorhouse M, Esmat G. Gastrointestinal manifestations of human immunodeficiency virus and coronavirus disease 2019: Understanding the intersecting regions between the two epidemics. Arab J Gastroenterol 2021; 22:75-87. [PMID: 34120849 PMCID: PMC8149211 DOI: 10.1016/j.ajg.2021.05.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 04/07/2021] [Accepted: 05/24/2021] [Indexed: 01/08/2023]
Abstract
In March 2020, the World Health Organization declared coronavirus disease (COVID-19) a pandemic. As of February 2021, there were 107 million COVID-19 cases worldwide. As a comparison, there are approximately 38 million people living with human immunodeficiency virus (PLHIV) worldwide. The coexistence of both epidemics, and the syndemic effect of both viruses could lead to a delirious impact both at individual and community levels. Many intersecting points were found between severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the causative agent of COVID-19, and HIV; among which, gastrointestinal (GI) manifestations are the most notable. GI manifestations represent a common clinical presentation in both HIV and SARS-CoV-2. The emergence of GI symptoms as a result of SARS-CoV-2 infection provides a new dynamic to COVID-19 diagnosis, management, and infection control measures, and adds an additional diagnostic challenge in case of coinfection with HIV. The presence of GI manifestations in PLHIV during the COVID-19 pandemic could be referred to HIV enteropathy, presence of opportunistic infection, adverse effect of antiretrovirals, or coinfection with COVID-19. Thus, it is important to exclude SARS-CoV-2 in patients who present with new-onset GI manifestations, especially in PLHIV, to avoid the risk of disease transmission during endoscopic interventions. Structural similarities between both viruses adds a valuable intersecting point, which has mutual benefits in the management of both viruses. These similarities led to the hypothesis that antiretrovirals such as lopinavir/Rironavir have a role in the management of COVID-19, which was the target of our search strategy using the available evidence. These similarities may also facilitate the development of an efficient HIV vaccine in the future using the advances in COVID-19 vaccine development.
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Affiliation(s)
- Ahmed Cordie
- Endemic Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Yasmine Gaber
- Endemic Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Mohamed AbdAllah
- Medical Research Division, National Research Center, Giza, Egypt
| | - Alessandra Vergori
- HIV/AIDS Unit, National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, Italy.
| | | | - Salma Omran
- Endemic Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Shimaa Afify
- National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt
| | - Mehdi Karkouri
- Association de Lutte Contre le Sida/Coalition Plus, Faculté de Médecine et de Pharmacie, Université Hassan II, Casablanca, Morocco
| | - Mohamed Chakroun
- Infectious Diseases Department, University Hospital of Monastir, Tunisia
| | - Sherief Musa
- Endemic Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
| | | | - Gamal Esmat
- Endemic Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
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Mahler M, Meroni PL, Infantino M, Buhler KA, Fritzler MJ. Circulating Calprotectin as a Biomarker of COVID-19 Severity. Expert Rev Clin Immunol 2021; 17:431-443. [PMID: 33750254 PMCID: PMC8054493 DOI: 10.1080/1744666x.2021.1905526] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 03/16/2021] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Although demographic and clinical parameters such as sex, age, comorbidities, genetic background and various biomarkers have been identified as risk factors, there is an unmet need to predict the risk and onset of severe inflammatory disease leading to poor clinical outcomes. In addition, very few mechanistic biomarkers are available to inform targeted treatment of severe (auto)-inflammatory conditions associated with COVID-19. Calprotectin, also known as S100A8/S100A9, MRP8/14 (Myeloid-Related Protein) or L1, is a heterodimer involved in neutrophil-related inflammatory processes. In COVID-19 patients, calprotectin levels were reported to be associated with poor clinical outcomes such as significantly reduced survival time, especially in patients with severe pulmonary disease. AREAS COVERED Pubmed was searched using the following keywords: Calprotectin + COVID19, S100A8/A9 + COVID19, S100A8 + COVID-19, S100A9 + COVID-19, MRP8/14 + COVID19; L1 + COVID-19 between May 2020 and 8 March 2021. The results summarized in this review provide supporting evidence and propose future directions that define calprotectin as an important biomarker in COVID-19. EXPERT OPINION Calprotectin represents a promising serological biomarker for the risk assessment of COVID-19 patients.
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Affiliation(s)
- Michael Mahler
- Research and Development, Inova Diagnostics, San Diego, CA, USA
| | - Pier-Luigi Meroni
- Allergy, Clinical Immunology and Rheumatology Unit, Immunorheumatology Research Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Maria Infantino
- Immunology and Allergology Laboratory Unit, Rheumatology Unit, S. Giovanni Di Dio Hospital, Florence, Italy
| | - Katherine A. Buhler
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Marvin J. Fritzler
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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22
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Ahmad A, Ishtiaq SM, Khan JA, Aslam R, Ali S, Arshad MI. COVID-19 and comorbidities of hepatic diseases in a global perspective. World J Gastroenterol 2021; 27:1296-1310. [PMID: 33833483 PMCID: PMC8015303 DOI: 10.3748/wjg.v27.i13.1296] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/17/2021] [Accepted: 03/19/2021] [Indexed: 02/06/2023] Open
Abstract
The worldwide outbreak of coronavirus disease 2019 (COVID-19) has challenged the priorities of healthcare system in terms of different clinical management and infection transmission, particularly those related to hepatic-disease comorbidities. Epidemiological data evidenced that COVID-19 patients with altered liver function because of hepatitis infection and cholestasis have an adverse prognosis and experience worse health outcomes. COVID-19-associated liver injury is correlated with various liver diseases following a severe acute respiratory syndrome-coronavirus type 2 (SARS-CoV-2) infection that can progress during the treatment of COVID-19 patients with or without pre-existing liver disease. SARS-CoV-2 can induce liver injury in a number of ways including direct cytopathic effect of the virus on cholangiocytes/hepatocytes, immune-mediated damage, hypoxia, and sepsis. Indeed, immediate cytopathogenic effects of SARS-CoV-2 via its potential target, the angiotensin-converting enzyme-2 receptor, which is highly expressed in hepatocytes and cholangiocytes, renders the liver as an extra-respiratory organ with increased susceptibility to pathological outcomes. But, underlying COVID-19-linked liver disease pathogenesis with abnormal liver function tests (LFTs) is incompletely understood. Hence, we collated COVID-19-associated liver injuries with increased LFTs at the nexus of pre-existing liver diseases and COVID-19, and defining a plausible pathophysiological triad of COVID-19, hepatocellular damage, and liver disease. This review summarizes recent findings of the exacerbating role of COVID-19 in pre-existing liver disease and vice versa as well as international guidelines of clinical care, management, and treatment recommendations for COVID-19 patients with liver disease.
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Affiliation(s)
- Aqsa Ahmad
- Institute of Microbiology, University of Agriculture Faisalabad, Faisalabad 38040, Punjab, Pakistan
| | - Syeda Momna Ishtiaq
- Institute of Physiology and Pharmacology, University of Agriculture Faisalabad, Faisalabad 38040, Punjab, Pakistan
| | - Junaid Ali Khan
- Institute of Physiology and Pharmacology, University of Agriculture Faisalabad, Faisalabad 38040, Punjab, Pakistan
| | - Rizwan Aslam
- Institute of Microbiology, University of Agriculture Faisalabad, Faisalabad 38040, Punjab, Pakistan
| | - Sultan Ali
- Institute of Microbiology, University of Agriculture Faisalabad, Faisalabad 38040, Punjab, Pakistan
| | - Muhammad Imran Arshad
- Institute of Microbiology, University of Agriculture Faisalabad, Faisalabad 38040, Punjab, Pakistan
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23
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Unal Y, Demirkilic U, Balik I, Aydin K, Zor MH, Bozkurt AK. Pilot Study of Application of Combined Transbronchial and Intravenous Ultraviolet C (UVC) and Laser Beam Application for the Treatment of Critical COVID-19 Infection. JOURNAL OF CLINICAL AND EXPERIMENTAL INVESTIGATIONS 2021. [DOI: 10.29333/jcei/10811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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24
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Yan D, Zhang X, Chen C, Jiang D, Liu X, Zhou Y, Huang C, Zhou Y, Guan Z, Ding C, Chen L, Lan L, Fu X, Wu J, Li L, Yang S. Characteristics of Viral Shedding Time in SARS-CoV-2 Infections: A Systematic Review and Meta-Analysis. Front Public Health 2021; 9:652842. [PMID: 33816427 PMCID: PMC8017277 DOI: 10.3389/fpubh.2021.652842] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 02/22/2021] [Indexed: 12/13/2022] Open
Abstract
Background: The viral shedding time (VST) of SARS-CoV-2 mainly determines its transmission and duration of infectiousness. However, it was heterogeneous in the existing studies. Here, we performed a meta-analysis to comprehensively summarize the VST of SARS-CoV-2. Methods: We searched PubMed, Web of Science, MedRxiv, BioRxiv, CNKI, CSTJ, and Wanfang up to October 25, 2020, for studies that reported VSTs of SARS-CoV-2. Pooled estimates and 95% CIs for the VSTs were calculated using log-transformed data. The VSTs in SARS-CoV-2 infections based on different demographic and clinical characteristics, treatments and specimens were stratified by subgroup analysis. Results: A total of 35 studies involving 3,385 participants met the inclusion criteria. The pooled mean VST was 16.8 days (95% CI: 14.8-19.4, I2 = 99.56%) in SARS-CoV-2 infections. The VST was significantly longer in symptomatic infections (19.7 days, 95% CI: 17.2-22.7, I2 = 99.34%) than in asymptomatic infections (10.9 days, 95% CI: 8.3-14.3, I2 = 98.89%) (P < 0.05). The VST was 23.2 days (95% CI: 19.0-28.4, I2 = 99.24%) in adults, which was significantly longer than that in children (9.9 days, 95% CI: 8.1-12.2, I2 = 85.74%) (P < 0.05). The VST was significantly longer in persons with chronic diseases (24.2 days, 95% CI: 19.2-30.2, I2 = 84.07%) than in those without chronic diseases (11.5 days, 95% CI: 5.3-25.0, I2 = 82.11%) (P < 0.05). Persons receiving corticosteroid treatment (28.3 days, 95% CI: 25.6-31.2, I2 = 0.00%) had a longer VST than those without corticosteroid treatment (16.2 days, 95% CI: 11.5-22.5, I2 = 92.27%) (P = 0.06). The VST was significantly longer in stool specimens (30.3 days, 95% CI: 23.1-39.2, I2 = 92.09%) than in respiratory tract specimens (17.5 days, 95% CI: 14.9-20.6, I2 = 99.67%) (P < 0.05). Conclusions: A longer VST was found in symptomatic infections, infected adults, persons with chronic diseases, and stool specimens.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Jie Wu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, College of Medicine, The First Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Lanjuan Li
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, College of Medicine, The First Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Shigui Yang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, College of Medicine, The First Affiliated Hospital, Zhejiang University, Hangzhou, China
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25
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Machado-Lima A, Alonso AC, Gozzo D, Zanca GG, Brech GC, Montiel JM, Bastos MF, Longo PL, Mota-Ortiz SR. Self-Perception of Changes in Routines in Adults and Older Adults Associated to Social Distancing Due to COVID-19-A Study in São Paulo, Brazil. Front Psychol 2021; 12:607559. [PMID: 33708158 PMCID: PMC7940366 DOI: 10.3389/fpsyg.2021.607559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 01/07/2021] [Indexed: 01/14/2023] Open
Abstract
COVID-19 is an acute respiratory illness with higher mortality in older adults. This condition is spread person-to-person through close contact, and among policies employed to decrease transmission are the improvement of hygiene habits and physical distancing. Although social distancing has been recognized as the best way to prevent the transmission, there are concerns that it may promote increased depression symptoms risk and anxiety, mainly in older adults. This cross-sectional study aimed to verify self-concept of social distancing in adults compared to older adults. All participants, over 18 years and residents of São Paulo state (Brazil), were invited to join this research study by a message application and answered an interdisciplinary questionnaire during the period from May 23 to June 23, 2020. The questions were divided into the following aspects: sociodemographic data, financial conditions, routine-related perception, perception of health, physical and emotional state, and eating habits. The younger adult group was composed of 139 participants, with a mean age of 43.15 years (±10.92), and the older adult group was composed of 437 participants with a mean age of 67.59 years (±6.13) of both sex. Changes in routine during the period of social distance were reported by 95% of adults and 96.8% of older adults, but adults indicated more significant alterations in routine. Although there was no difference between groups for several aspects, adults revealed greater alterations in sleep quality, evacuation frequency, and more difficulty to perform daily activities at home. Further studies are necessary to follow up the impacts of social distancing among adults and older adults in different socioeconomic contexts to better understand the long-term alterations and the necessity of interventions.
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Affiliation(s)
- Adriana Machado-Lima
- Postgraduate Program in Aging Sciences, São Judas Tadeu University, São Paulo, Brazil
| | | | - Débora Gozzo
- Postgraduate Program in Aging Sciences, São Judas Tadeu University, São Paulo, Brazil
| | - Gisele Garcia Zanca
- Postgraduate Program in Aging Sciences, São Judas Tadeu University, São Paulo, Brazil
| | | | - José Maria Montiel
- Postgraduate Program in Aging Sciences, São Judas Tadeu University, São Paulo, Brazil
| | - Marta Ferreira Bastos
- Postgraduate Program in Aging Sciences, São Judas Tadeu University, São Paulo, Brazil
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Antwi-Amoabeng D, Beutler BD, Awad M, Kanji Z, Mahboob S, Ghuman J, Boppana SH, Sheikh M, Ulanja MB, Gullapalli N. Sociodemographic Predictors of Outcomes in COVID-19: Examining the Impact of Ethnic Disparities in Northern Nevada. Cureus 2021; 13:e13128. [PMID: 33728145 PMCID: PMC7936576 DOI: 10.7759/cureus.13128] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background On March 11, 2020, the World Health Organization declared coronavirus disease-19 (COVID-19) a pandemic. Nearly five million individuals have since been diagnosed with this increasingly common and potentially lethal viral infection. Emerging evidence suggests a disproportionate burden of illness and death among minority communities. We aimed to evaluate the effect of ethnicity on outcomes among patients diagnosed with COVID-19 in Northern Nevada. Methods The electronic health records of 172 patients diagnosed with COVID-19 were obtained from a 946-bed tertiary referral center serving Northern Nevada. Demographic and clinical characteristics were compared by ethnic group (Hispanic versus non-Hispanic). Logistic regression was used to determine predictors of mortality. Results Among 172 patients who were diagnosed with COVID-19 between March 12 and May 8, 2020, 87 (50.6%) identified as Hispanic and 81 (47.1%) as non-Hispanic. Hispanic individuals were significantly more likely to be uninsured and to live in low-income communities as compared to their non-Hispanic counterparts (27.6% versus 8.2% and 52.9% versus 30.6%, respectively). Hispanic patients were also less likely than non-Hispanics to have a primary care provider (42.5% versus 61.2%). However, mortality was significantly higher among the non-Hispanic population (15.3% versus 5.8%). Conclusion The COVID-19 pandemic has disproportionately affected Hispanic individuals in Northern Nevada, who account for only 25.7% of the population but over half of the confirmed cases. The underlying causes of ethnic disparities in COVID-19 incidence remain to be established, but further investigation may lead to more effective community- and systems-based interventions.
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Affiliation(s)
| | - Bryce D Beutler
- Radiology, University of Southern California Keck School of Medicine, Los Angeles, USA
| | - Munadel Awad
- Internal Medicine, University of Nevada Reno School of Medicine, Reno, USA
| | - Zahara Kanji
- Internal Medicine, University of Nevada Reno School of Medicine, Reno, USA
| | - Sumaiya Mahboob
- Internal Medicine, University of Nevada Reno School of Medicine, Reno, USA
| | - Jasmine Ghuman
- Internal Medicine, University of Nevada Reno School of Medicine, Reno, USA
| | - Sri Harsha Boppana
- Internal Medicine, University of Nevada Reno School of Medicine, Reno, USA
| | - Mohammad Sheikh
- Internal Medicine, University of Nevada Reno School of Medicine, Reno, USA
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27
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Pirsalehi A, Salari S, Baghestani A, Sanadgol G, Shirini D, Baerz MM, Abdi S, Akbari ME, Bashash D. Differential alteration trend of white blood cells (WBCs) and monocytes count in severe and non-severe COVID-19 patients within a 7-day follow-up. IRANIAN JOURNAL OF MICROBIOLOGY 2021; 13:8-16. [PMID: 33889357 PMCID: PMC8043835 DOI: 10.18502/ijm.v13i1.5486] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND OBJECTIVES Several studies have focused on the alterations of hematological parameters for a better understanding of the COVID-19 pathogenesis and also their potential for predicting disease prognosis and severity. Although some evidence has indicated the prognostic values of thrombocytopenia, neutrophilia, and lymphopenia, there are conflicting results concerning the leukocyte and monocyte count. MATERIALS AND METHODS In this retrospective Double Centre study, we reviewed the results of WBC and monocyte counts of 1320 COVID-19 patients (243 of whom (18.4%) had severe disease) both on admission and within a 7-day follow-up. RESULTS We found that both the number of monocytes and the percentage of monocytosis were higher in the severe group; however, it was not statistically significant. On the other hand, we found that not only the mean number of WBCs was significantly higher in the severe cases also leukocytosis was a common finding in this group; indicating that an increased number of WBC may probably predict a poor prognosis. Also, the monocyte count was not affected by age; however, univariate analysis showed that the percentage of leukocytosis was significantly greater in the older group (>50) with an odds ratio of 1.71 (P: 0.003). CONCLUSION Alteration of monocytes either on admission or within hospitalization would not provide valuable data about the prediction of COVID-19 prognosis. Although the rapidly evolving nature of COVID-19 is the major limitation of the present study, further investigations in the field of laboratory biomarkers will pave the way to manage patients with severe disease better.
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Affiliation(s)
- Ali Pirsalehi
- Department of Internal Medicine, School of Medicine, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sina Salari
- Department of Medical Oncology, Hematology and Bone Marrow Transplantation, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ahmadreza Baghestani
- Physiotherapy Research Center & Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ghazal Sanadgol
- Department of Internal Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Dorsa Shirini
- Department of Internal Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Moghbel Baerz
- Department of Internal Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Saeed Abdi
- Basic and Molecular Epidemiology of Gastroenterological Disorder Research Center, Research Institute for Gastroenterology and Liver Disease, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Davood Bashash
- Department of Hematology and Blood Banking, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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28
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Cheng C, Huang Y, Xie L, Zhu X, Chen D, Cheng C. Therapy of diarrhea in COVID-19 with external treatment of traditional Chinese medicine: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e24120. [PMID: 33429783 PMCID: PMC7793404 DOI: 10.1097/md.0000000000024120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 12/09/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Evaluating the effectiveness and safety of external treatment of traditional Chinese medicine therapy for COVID-19 with diarrhea is the primary purpose of this systematic evaluation program. METHODS We will search the randomized controlled trials from inception to November 2020. The following database is our focus area: Cochrane Central Register of Controlled Trials, Embase, PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Database (CBM), VIP database for Chinese technical Periodicals, and Wanfang Database. We will choose articles published both in Chinese and English. Two reviewers will conduct the study selection, data extraction, and assessment independently. The assessment of risk of bias and data synthesis will be carried out using Review Manager Software V.5.3. RESULTS The results will provide high-quality synthesis of current evidence for researchers in this subject area. CONCLUSION This studys decision will provide evidence of whether external treatment of traditional Chinese medicine is an effective and safe intervention for coronavirus disease 2019 with diarrhea. REGISTRATION NUMBER INPLASY2020110095 (DOI number: 10.37766/inplasy2020.11.0095).
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Perisetti A, Goyal H. Successful Distancing: Telemedicine in Gastroenterology and Hepatology During the COVID-19 Pandemic. Dig Dis Sci 2021; 66:945-953. [PMID: 33655456 PMCID: PMC7925138 DOI: 10.1007/s10620-021-06874-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/19/2021] [Indexed: 12/11/2022]
Abstract
Telemedicine involves delivering healthcare and preventative care services to patients without the need for in-person encounters. Traditionally, telemedicine has been used for acute events (e.g., stroke, used to relay essential information to the emergency department) and chronic disease management (e.g., diabetes and chronic kidney disease management). Though the utilization of telemedicine in gastroenterology and hepatology has been modest at best, especially for inflammatory bowel diseases and chronic liver disease management, since the onset of coronavirus disease 2019 (COVID-19) pandemic, utilization of telemedicine in gastroenterology increased by 4000% in the first two weeks, equivalent to the last six years of growth before the pandemic. The Center for Medicare and Medicaid (CMS) relaxed rules for the use of telemedicine with easing restrictions on reimbursements, location, licensing requirements (across state lines), and the need for a prior provider-patient relationship. These changes increased the use of telemedicine in inpatient and outpatient settings for gastroenterology-related referrals. The use of inpatient telephonic or video consults helps provide timely care during the pandemic while conserving personal protective equipment and decreasing provider and patient exposure. Nevertheless, telehealth use comes at the cost of no direct patient contact and lesser reimbursements. The appropriate use of technology and equipment, training of healthcare providers, use of platforms that can be integrated into the electronic health record while protecting the privacy and the flow of information are essential components of telemedicine. Furthermore, encouraging patients to seek medical care remotely with the proper equipment and improving digital literacy without the need for physical examinations is a challenge, further compounded in elderly or hard-of-hearing patients and in patients who are more comfortable with in-person visits. The authors will systematically review and discuss how telemedicine can be integrated into the practice of gastroenterology and hepatology, with emphasis placed on discussing barriers to success and the ways they can be mitigated.
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Affiliation(s)
- Abhilash Perisetti
- grid.241054.60000 0004 4687 1637Department of Gastroenterology and Hepatology, University of Arkansas for Medical Sciences, Little Rock, AR USA
| | - Hemant Goyal
- The Wright Center for Graduate Medical Education, 501 S. Washington Avenue, Scranton, PA 18505 USA ,grid.259906.10000 0001 2162 9738Mercer University School of Medicine, 707 Pine St, Macon, GA 31201 USA
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30
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A novel perspective approach to explore pros and cons of face mask in prevention the spread of SARS-CoV-2 and other pathogens. Saudi Pharm J 2020; 29:121-133. [PMID: 33398228 PMCID: PMC7773545 DOI: 10.1016/j.jsps.2020.12.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 12/23/2020] [Indexed: 12/13/2022] Open
Abstract
Corona virus disease 2019 (COVID-19) outbreak has become a severe community health threat across the world. Covid-19 is a major illness, presently there is no as such any medicine and vaccine those can claim for complete treatment. It is spreading particularly in a feeble immune people and casualties are expanding abruptly and put the health system under strain. Among the strategic measures face mask is one of the most used measures to prevent spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Wearing a face mask possibly create a false sense of security lead to decline others measures. Face mask could be risk for the people of under lying medical conditions, old age group, outdoor exercise, acute and chronic respiratory disorders and feeble innate immune. Restrictive airflow due to face mask is the main cause of retention of CO2 called hypercapnia that can lead to respiratory failure with symptoms of tachycardia, flushed skin, dizziness, papilledema, seizure and depression. According to latest updates face shield and social distancing could be better substitute of face mask.
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31
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Vodnar DC, Mitrea L, Teleky BE, Szabo K, Călinoiu LF, Nemeş SA, Martău GA. Coronavirus Disease (COVID-19) Caused by (SARS-CoV-2) Infections: A Real Challenge for Human Gut Microbiota. Front Cell Infect Microbiol 2020; 10:575559. [PMID: 33363049 PMCID: PMC7756003 DOI: 10.3389/fcimb.2020.575559] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 11/16/2020] [Indexed: 01/08/2023] Open
Abstract
The current COVID-19 pandemic is a great challenge for worldwide researchers in the human microbiota area because the mechanisms and long-term effects of the infection at the GI level are not yet deeply understood. In the current review, scientific literature including original research articles, clinical studies, epidemiological reports, and review-type articles concerning human intestinal infection with SARS-CoV-2 and the possible consequences on the microbiota were reviewed. Moreover, the following aspects pertaining to COVID-19 have also been discussed: transmission, resistance in the human body, the impact of nutritional status in relation to the intestinal microbiota, and the impact of comorbid metabolic disorders such as inflammatory bowel disease (IBS), obesity, and type two diabetes (T2D). The articles investigated show that health, age, and nutritional status are associated with specific communities of bacterial species in the gut, which could influence the clinical course of COVID-19 infection. Fecal microbiota alterations were associated with fecal concentrations of SARS-CoV-2 and COVID-19 severity. Patients suffering from metabolic and gastrointestinal (GI) disorders are thought to be at a moderate-to-high risk of infection with SARS-CoV-2, indicating the direct implication of gut dysbiosis in COVID-19 severity. However, additional efforts are required to identify the initial GI symptoms of COVID-19 for possible early intervention.
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Affiliation(s)
- Dan-Cristian Vodnar
- Institute of Life Sciences, University of Agricultural Sciences and Veterinary Medicine, Cluj-Napoca, Romania
- Faculty of Food Science and Technology, University of Agricultural Sciences and Veterinary Medicine, Cluj-Napoca, Romania
| | - Laura Mitrea
- Institute of Life Sciences, University of Agricultural Sciences and Veterinary Medicine, Cluj-Napoca, Romania
| | - Bernadette-Emoke Teleky
- Institute of Life Sciences, University of Agricultural Sciences and Veterinary Medicine, Cluj-Napoca, Romania
| | - Katalin Szabo
- Institute of Life Sciences, University of Agricultural Sciences and Veterinary Medicine, Cluj-Napoca, Romania
| | - Lavinia-Florina Călinoiu
- Institute of Life Sciences, University of Agricultural Sciences and Veterinary Medicine, Cluj-Napoca, Romania
| | - Silvia-Amalia Nemeş
- Institute of Life Sciences, University of Agricultural Sciences and Veterinary Medicine, Cluj-Napoca, Romania
- Faculty of Food Science and Technology, University of Agricultural Sciences and Veterinary Medicine, Cluj-Napoca, Romania
| | - Gheorghe-Adrian Martău
- Institute of Life Sciences, University of Agricultural Sciences and Veterinary Medicine, Cluj-Napoca, Romania
- Faculty of Food Science and Technology, University of Agricultural Sciences and Veterinary Medicine, Cluj-Napoca, Romania
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32
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Mitsuyama K, Tsuruta K, Takedatsu H, Yoshioka S, Morita M, Niwa M, Matsumoto S. Clinical Features and Pathogenic Mechanisms of Gastrointestinal Injury in COVID-19. J Clin Med 2020; 9:E3630. [PMID: 33187280 PMCID: PMC7696882 DOI: 10.3390/jcm9113630] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/08/2020] [Accepted: 11/09/2020] [Indexed: 02/07/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of the global coronavirus disease 2019 (COVID-19) outbreak. Along with the respiratory tract, the gastrointestinal (GI) tract is one of the main extra-pulmonary targets of SARS-CoV-2 with respect to symptom occurrence and is a potential route for virus transmission, most likely due to the presence of angiotensin-converting enzyme 2. Therefore, understanding the mechanisms of GI injury is crucial for a harmonized therapeutic strategy against COVID-19. This review summarizes the current evidence for the clinical features of and possible pathogenic mechanisms leading to GI injury in COVID-19.
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Affiliation(s)
- Keiichi Mitsuyama
- Inflammatory Bowel Disease Center, Kurume University Hospital, 67 Asahimachi, Kurume, Fukuoka 830-0011, Japan; (K.T.); (H.T.); (S.Y.); (M.M.)
- Division of Gastroenterology, Department of Medicine, School of Medicine, Kurume University, 67 Asahimachi, Kurume, Fukuoka 830-0011, Japan
| | - Kozo Tsuruta
- Inflammatory Bowel Disease Center, Kurume University Hospital, 67 Asahimachi, Kurume, Fukuoka 830-0011, Japan; (K.T.); (H.T.); (S.Y.); (M.M.)
- Division of Gastroenterology, Department of Medicine, School of Medicine, Kurume University, 67 Asahimachi, Kurume, Fukuoka 830-0011, Japan
| | - Hidetoshi Takedatsu
- Inflammatory Bowel Disease Center, Kurume University Hospital, 67 Asahimachi, Kurume, Fukuoka 830-0011, Japan; (K.T.); (H.T.); (S.Y.); (M.M.)
- Division of Gastroenterology, Department of Medicine, School of Medicine, Kurume University, 67 Asahimachi, Kurume, Fukuoka 830-0011, Japan
| | - Shinichiro Yoshioka
- Inflammatory Bowel Disease Center, Kurume University Hospital, 67 Asahimachi, Kurume, Fukuoka 830-0011, Japan; (K.T.); (H.T.); (S.Y.); (M.M.)
- Division of Gastroenterology, Department of Medicine, School of Medicine, Kurume University, 67 Asahimachi, Kurume, Fukuoka 830-0011, Japan
| | - Masaru Morita
- Inflammatory Bowel Disease Center, Kurume University Hospital, 67 Asahimachi, Kurume, Fukuoka 830-0011, Japan; (K.T.); (H.T.); (S.Y.); (M.M.)
- Division of Gastroenterology, Department of Medicine, School of Medicine, Kurume University, 67 Asahimachi, Kurume, Fukuoka 830-0011, Japan
| | - Mikio Niwa
- Institute for Advanced Sciences, 1-1-1 Umezono, Tsukuba, Ibaraki 305-8560, Japan;
| | - Satoshi Matsumoto
- Yakult Central Institute for Microbiological Research, Kunitachi, Tokyo 186-0011, Japan;
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Buonsenso D, Iodice F, Cinicola B, Raffaelli F, Sowa S, Ricciardi W. Management of Malaria in Children Younger Than 5 Years Old During Coronavirus Disease 2019 Pandemic in Sierra Leone: A Lesson Learned? Front Pediatr 2020; 8:587638. [PMID: 33643963 PMCID: PMC7902686 DOI: 10.3389/fped.2020.587638] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 11/26/2020] [Indexed: 12/21/2022] Open
Abstract
Growing evidences are showing the potential indirect effects of the Coronavirus Disease 2019 (COVID-19) on the health systems of low-resource settings, where diseases such as Tuberculosis, Human Immunodeficiency Virus (HIV) and Malaria represent major killers. Therefore, we performed a retrospective study aimed to evaluate the impact of COVID-19 on Malaria programs in a peripheral region of Sierra Leone, previously involved by the Ebola outbreak in 2015, when malaria care have been impaired since local health systems were overwhelmed by Ebola cases. During COVID-19 in Sierra Leone, we did not notice a significant drop in malaria diagnosis in children, suggesting that a proactive approach in the management of malaria in endemic countries during COVID-19 may have had a positive impact. A comprehensive approach that include also educational activities to sensitize the local population, was useful to guarantee successful malaria diagnosis and treatment, and prevents excess of malaria deaths due to potential disruption of the local health systems related to the SARS-CoV-2 pandemic.
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Affiliation(s)
- Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy.,Center for Global Health Research and Studies, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Iodice
- Institute of Neurology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Bianca Cinicola
- Department of Pediatrics, Sapienza University of Rome, Policliclinico Umberto I, Rome, Italy
| | - Francesca Raffaelli
- Dipartimento Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Solia Sowa
- Konta Wallah Community Health Center, Port Loko, Sierra Leone
| | - Walter Ricciardi
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Sezione di Igiene, Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
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