1
|
Das P, Akhtar Z, Mah-E-Muneer S, Islam MA, Rahman MZ, Rahman M, Rahman M, Rahman M, Billah MM, Alamgir A, Flora MS, Shirin T, Banu S, Chowdhury F. Establishing a sentinel surveillance system for the novel COVID-19 in a resource-limited country: methods, system attributes and early findings. BMJ Open 2021; 11:e055169. [PMID: 34857579 PMCID: PMC8640197 DOI: 10.1136/bmjopen-2021-055169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To establish a hospital-based platform to explore the epidemiological and clinical characteristics of patients screened for COVID-19. DESIGN Hospital-based surveillance. SETTING This study was conducted in four selected hospitals in Bangladesh during 10 June-31 August 2020. PARTICIPANTS In total, 2345 patients of all age (68% male) attending the outpatient and inpatient departments of surveillance hospitals with any one or more of the following symptoms within last 7 days: fever, cough, sore throat and respiratory distress. OUTCOME MEASURES The outcome measures were COVID-19 positivity and mortality rate among enrolled patients. Pearson's χ2 test was used to compare the categorical variables (sign/symptoms, comorbidities, admission status and COVID-19 test results). Regression analysis was performed to determine the association between potential risk factors and death. RESULTS COVID-19 was detected among 922 (39%) enrolled patients. It was more common in outpatients with a peak positivity in second week of July (112, 54%). The median age of the confirmed COVID-19 cases was 38 years (IQR: 30-50), 654 (71%) were male and 83 (9%) were healthcare workers. Cough (615, 67%) was the most common symptom, followed by fever (493, 53%). Patients with diabetes were more likely to get COVID-19 than patients without diabetes (48% vs 38%; OR: 1.5; 95% CI: 1.2 to 1.9). The death rate among COVID-19 positive was 2.3%, n=21. Death was associated with age ≥60 years (adjusted OR (AOR): 13.9; 95% CI: 5.5 to 34), shortness of breath (AOR: 9.7; 95% CI: 3.0 to 30), comorbidity (AOR: 4.8; 95% CI: 1.1 to 21.7), smoking history (AOR: 2.2, 95% CI: 0.7 to 7.1), attending the hospital in <2 days of symptom onset due to critical illness (AOR: 4.7; 95% CI: 1.2 to 17.8) and hospital admission (AOR: 3.4; 95% CI: 1.2 to 9.8). CONCLUSIONS COVID-19 positivity was observed in more than one-third of patients with suspected COVID-19 attending selected hospitals. While managing such patients, the risk factors identified for higher death rates should be considered.
Collapse
Affiliation(s)
- Pritimoy Das
- Infectious Diseases Division (IDD), International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Zubair Akhtar
- Infectious Diseases Division (IDD), International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Syeda Mah-E-Muneer
- Infectious Diseases Division (IDD), International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Md Ariful Islam
- Infectious Diseases Division (IDD), International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Mohammed Ziaur Rahman
- Infectious Diseases Division (IDD), International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Mustafizur Rahman
- Infectious Diseases Division (IDD), International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Mahmudur Rahman
- Infectious Diseases Division (IDD), International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Mahbubur Rahman
- Institute of Epidemiology Disease Control and Research, Dhaka, Bangladesh
| | | | - Asm Alamgir
- Institute of Epidemiology Disease Control and Research, Dhaka, Bangladesh
| | | | - Tahmina Shirin
- Institute of Epidemiology Disease Control and Research, Dhaka, Bangladesh
| | - Sayera Banu
- Infectious Diseases Division (IDD), International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Fahmida Chowdhury
- Infectious Diseases Division (IDD), International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| |
Collapse
|
2
|
Effects of COVID-19 on telemedicine practice patterns in outpatient otolaryngology. Am J Otolaryngol 2021; 42:103044. [PMID: 34091321 PMCID: PMC8046701 DOI: 10.1016/j.amjoto.2021.103044] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 04/05/2021] [Indexed: 12/03/2022]
Abstract
Objective Otolaryngology is considered high risk for Coronavirus Disease 2019 (COVID-19) exposure and spread. This has led to a transition to telemedicine and directly impacts patient volume, evaluation and management practices. The objective of this study is to determine the impact of COVID-19 on patient characteristics in relation to outpatient attendance, ancillary testing, medical therapy, and surgical decision making. Methods A retrospective case series at an academic medical center was performed. Outpatient appointments from October 2019 (pre-COVID) and March 16–April 10, 2020 (COVID) were analyzed. Prevalence rates and odds ratios were used to compare demographics, visit characteristics, ancillary tests, medication prescribing, and surgical decisions between telemedicine and in-person visits, before and during COVID. Results There was a decrease in scheduled visits during the COVID timeframe, for both in-person and telemedicine visits, with a comparable proportion of no-shows. There was a higher overall percentage of Hispanic/Latino patients who received care during the COVID timeframe (OR = 1.43; 95% CI = 1.07–1.90) in both groups, although primary language was not significantly associated with attendance. There were fewer ancillary tests ordered (OR = 0.54) and more medications prescribed (OR = 1.59) during COVID telemedicine visits compared with pre-COVID in-person visits. Conclusion COVID-19 has rapidly changed the use of telemedicine. Telemedicine can be used as a tool to reach patients with severe disease burden. Continued healthcare reform, expanded access to affordable care, and efficient use of resources is essential both during the current COVID-19 pandemic and beyond. Level of evidence IV.
Collapse
|
3
|
Manabe T, Phan D, Nohara Y, Kambayashi D, Nguyen TH, Van Do T, Kudo K. Spatiotemporal distribution of COVID-19 during the first 7 months of the epidemic in Vietnam. BMC Infect Dis 2021; 21:1124. [PMID: 34717588 PMCID: PMC8556820 DOI: 10.1186/s12879-021-06822-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 10/26/2021] [Indexed: 04/03/2023] Open
Abstract
Background Understanding the spatiotemporal distribution of emerging infectious diseases is crucial for implementation of control measures. In the first 7 months from the occurrence of COVID-19 pandemic, Vietnam has documented comparatively few cases of COVID-19. Understanding the spatiotemporal distribution of these cases may contribute to development of global countermeasures. Methods We assessed the spatiotemporal distribution of COVID-19 from 23 January to 31 July 2020 in Vietnam. Data were collected from reports of the World Health Organization, the Vietnam Ministry of Health, and related websites. Temporal distribution was assessed via the transmission classification (local or quarantined cases). Geographical distribution was assessed via the number of cases in each province along with their timelines. The most likely disease clusters with elevated incidence were assessed via calculation of the relative risk (RR). Results Among 544 observed cases of COVID-19, the median age was 35 years, 54.8% were men, and 50.9% were diagnosed during quarantine. During the observation period, there were four phases: Phase 1, COVID-19 cases occurred sporadically in January and February 2020; Phase 2, an epidemic wave occurred from the 1st week of March to the middle of April (Wave 1); Phase 3, only quarantining cases were involved; and Phase 4, a second epidemic wave began on July 25th, 2020 (Wave 2). A spatial cluster in Phase 1 was detected in Vinh Phuc Province (RR, 38.052). In Phase 2, primary spatial clusters were identified in the areas of Hanoi and Ha Nam Province (RR, 6.357). In Phase 4, a spatial cluster was detected in Da Nang, a popular coastal tourist destination (RR, 70.401). Conclusions Spatial disease clustering of COVID-19 in Vietnam was associated with large cities, tourist destinations, people’s mobility, and the occurrence of nosocomial infections. Past experiences with outbreaks of emerging infectious diseases led to quick implementation of governmental countermeasures against COVID-19 and a general acceptance of these measures by the population. The behaviors of the population and the government, as well as the country’s age distribution, may have contributed to the low incidence and small number of severe COVID-19 cases. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06822-0.
Collapse
Affiliation(s)
- Toshie Manabe
- Nagoya City University Graduate School of Medicine, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan. .,Nagoya City University West Medical Center, Aichi, Japan.
| | - Dung Phan
- Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia
| | - Yasuhiro Nohara
- Utsunomiya University Center for Regional Design, Tochigi, Japan
| | - Dan Kambayashi
- Nagoya City University Graduate School of Medicine, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan.,Showa Pharmaceutical University Center for Education and Research on Clinical Pharmacy, Tokyo, Japan
| | - Thang Huu Nguyen
- School for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Thanh Van Do
- Center for Tropical Diseases, Bach Mai Hospital, Hanoi, Vietnam
| | - Koichiro Kudo
- Yurin Hospital, Tokyo, Japan.,Waseda University, Tokyo, Japan
| |
Collapse
|
4
|
Kaye AD, Cornett EM, Brondeel KC, Lerner ZI, Knight HE, Erwin A, Charipova K, Gress KL, Urits I, Urman RD, Fox CJ, Kevil CG. Biology of COVID-19 and related viruses: Epidemiology, signs, symptoms, diagnosis, and treatment. Best Pract Res Clin Anaesthesiol 2021; 35:269-292. [PMID: 34511219 PMCID: PMC7723419 DOI: 10.1016/j.bpa.2020.12.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 12/01/2020] [Accepted: 12/02/2020] [Indexed: 02/06/2023]
Abstract
Coronaviruses belong to the family Coronaviridae order Nidovirales and are known causes of respiratory and intestinal disease in various mammalian and avian species. Species of coronaviruses known to infect humans are referred to as human coronaviruses (HCoVs). While traditionally, HCoVs have been a significant cause of the common cold, more recently, emergent viruses, including severe acute respiratory syndrome coronavirus (SARS-CoV-2) has caused a global pandemic. Here, we discuss coronavirus disease (COVID-19) biology, pathology, epidemiology, signs and symptoms, diagnosis, treatment, and recent clinical trials involving promising treatments.
Collapse
Affiliation(s)
- Alan D. Kaye
- LSU Health Shreveport, 1501 Kings Highway, Shreveport LA 71103, USA
| | - Elyse M. Cornett
- Department of Anesthesiology, LSU Health Shreveport, 1501 Kings Highway, Shreveport LA 71103, USA
| | | | - Zachary I. Lerner
- LSU Health Sciences Center New Orleans, 1901 Perdido Street, New Orleans, LA 70112, USA
| | - Haley E. Knight
- Louisiana State University Health Sciences Center, New Orleans, LA, 70112, USA
| | - Abigail Erwin
- LSU Health Sciences Center New Orleans, 1901 Perdido Street, New Orleans, LA 70112, USA
| | - Karina Charipova
- Georgetown University School of Medicine, Washington, D.C., 20007, USA
| | - Kyle L. Gress
- Georgetown University School of Medicine, Washington, D.C., 20007, USA
| | - Ivan Urits
- Department of Anesthesiology, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Richard D. Urman
- Department of Anesthesiology, Perioperative and Pain Medicine, Harvard Medical School, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115, USA,Corresponding author
| | - Charles J. Fox
- Department of Anesthesiology, LSU Health Shreveport, 1501 Kings Highway, Shreveport LA 71103, USA
| | | |
Collapse
|
5
|
Atchessi N, Edjoc R, Striha M, Waddell L, Bresee N, Dawson T. Epidemiologic and clinical characteristics of multisystem inflammatory syndrome in adults: a rapid review. CANADA COMMUNICABLE DISEASE REPORT = RELEVE DES MALADIES TRANSMISSIBLES AU CANADA 2021; 47:305-315. [PMID: 34421386 PMCID: PMC8340674 DOI: 10.14745/ccdr.v47i78a03] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Multisystem inflammatory disease in children (MIS-C) is one of the severe presentations of the coronavirus disease 2019 (COVID-19) that has been described in the literature since the beginning of the pandemic. Although MIS-C refers to children, cases with similar clinical characteristics have been recently described in adults. A description of the epidemiologic and clinical characteristics of multisystem inflammatory disease in adults (MIS-A) is a starting point for better knowledge and understanding of this emerging disease. We identified nine case reports of MIS-A in the literature, five from the United States, two from France and two from the United Kingdom. The case descriptions revealed similarities in clinical features, including occurrence during post-acute disease phase, fever, digestive symptoms, cardiac involvement and elevated inflammatory markers. All the patients were hospitalized, three required admission to the intensive care unit and one died. The most common treatments were intravenous immunoglobulin, prednisolone and aspirin. These findings suggest that MIS-A is a severe complication of COVID-19 disease that can lead to death. Further studies to improve our understanding of the pathogenesis of MIS-A, which will help improve treatment decisions and prevent sequelae or death.
Collapse
Affiliation(s)
- Nicole Atchessi
- Health Security Infrastructure Branch, Public Health Agency of Canada, Ottawa, ON
| | - Rojiemiahd Edjoc
- Health Security Infrastructure Branch, Public Health Agency of Canada, Ottawa, ON
| | - Megan Striha
- Health Security Infrastructure Branch, Public Health Agency of Canada, Ottawa, ON
| | - Lisa Waddell
- Public Health Risk Sciences Division, National Microbiology Laboratory, Public Health Agency of Canada, Guelph, ON
| | | | - Thomas Dawson
- Health Security Infrastructure Branch, Public Health Agency of Canada, Ottawa, ON
| |
Collapse
|
6
|
Satsangi S, Gupta N, Kodan P. Current and New Drugs for COVID-19 Treatment and Its Effects on the Liver. J Clin Transl Hepatol 2021; 9:436-446. [PMID: 34221930 PMCID: PMC8237135 DOI: 10.14218/jcth.2020.00174] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 03/11/2021] [Accepted: 03/18/2021] [Indexed: 12/15/2022] Open
Abstract
Corona virus disease (COVID)-19 is caused by the novel severe acute respiratory syndrome coronavirus-2 (commonly referred to as SARS-CoV-2). In March 2020, the World Health Organization declared the COVID-19 outbreak a pandemic. Though the target organ for the virus is primarily the lungs, with the recent understanding of the pathobiology of this disease and the immune dysregulation associated with it, it is now clear that COVID-19 affects multiple organ systems. Several drugs and therapies have been tried or repurposed to combat the wrath posed by this disease. On October 22, 2020, the USA Food and Drug Administration approved remdesivir for use in adults and pediatric patients (12 years of age and older). Several of the drugs being tried against COVID-19 have hepatotoxicity as their potential side effect. This review aims to provide the latest insights on various drugs being used in the treatment of COVID-19 and their effects on the liver.
Collapse
Affiliation(s)
- Sandeep Satsangi
- Department of Apollo comprehensive Liver Care, Apollo Hospital, Bangalore, Karnataka, India
- Correspondence to: Sandeep Satsangi, Consultant Hepatologist & Liver Transplant Physician, Department of Apollo comprehensive Liver Care, Apollo Hospital, Bangalore, Karnataka 560076, India. Tel: +91-7899243962, E-mail:
| | - Nitin Gupta
- Department of Infectious Diseases, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Parul Kodan
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
7
|
Fukushi I, Pokorski M, Okada Y. Mechanisms underlying the sensation of dyspnea. Respir Investig 2020; 59:66-80. [PMID: 33277231 DOI: 10.1016/j.resinv.2020.10.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/13/2020] [Accepted: 10/17/2020] [Indexed: 01/17/2023]
Abstract
Dyspnea is defined as a subjective experience of breathing discomfort that consists of qualitatively distinct sensations that vary in intensity. It is a common symptom among patients with respiratory diseases that reduces daily activities, induces deconditioning, and is self-perpetuating. Although clinical interventions are needed to reduce dyspnea, its underlying mechanism is poorly understood depending on the intertwined peripheral and central neural mechanisms as well as emotional factors. Nonetheless, experimental and clinical observations suggest that dyspnea results from dissociation or a mismatch between the intended respiratory motor output set caused by the respiratory neuronal network in the lower brainstem and the ventilatory output accomplished. The brain regions responsible for detecting the mismatch between the two are not established. The mechanism underlying the transmission of neural signals for dyspnea to higher sensory brain centers is not known. Further, information from central and peripheral chemoreceptors that control the milieu of body fluids is summated at higher brain centers, which modify dyspneic sensations. The mental status also affects the sensitivity to and the threshold of dyspnea perception. The currently used methods for relieving dyspnea are not necessarily fully effective. The search for more effective therapy requires further insights into the pathophysiology of dyspnea.
Collapse
Affiliation(s)
- Isato Fukushi
- Faculty of Health Sciences, Uekusa Gakuen University, 1639-3 Ogura-cho, Wakaba-ku, Chiba, 264-0007, Japan; Clinical Research Center, Murayama Medical Center, 2-37-1 Gakuen, Musashimurayama, Tokyo, 208-0011, Japan.
| | - Mieczyslaw Pokorski
- Clinical Research Center, Murayama Medical Center, 2-37-1 Gakuen, Musashimurayama, Tokyo, 208-0011, Japan; Faculty of Health Sciences, The Jan Dlugosz University in Czestochowa, 4/8 Jerzego Waszyngtona Street, 42-200, Czestochowa, Poland
| | - Yasumasa Okada
- Clinical Research Center, Murayama Medical Center, 2-37-1 Gakuen, Musashimurayama, Tokyo, 208-0011, Japan
| |
Collapse
|