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Zheng Y, Li Y, Li M, Wang R, Jiang Y, Zhao M, Lu J, Li R, Li X, Shi S. COVID-19 cooling: Nanostrategies targeting cytokine storm for controlling severe and critical symptoms. Med Res Rev 2024; 44:738-811. [PMID: 37990647 DOI: 10.1002/med.21997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 08/16/2023] [Accepted: 10/29/2023] [Indexed: 11/23/2023]
Abstract
As severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants continue to wreak havoc worldwide, the "Cytokine Storm" (CS, also known as the inflammatory storm) or Cytokine Release Syndrome has reemerged in the public consciousness. CS is a significant contributor to the deterioration of infected individuals. Therefore, CS control is of great significance for the treatment of critically ill patients and the reduction of mortality rates. With the occurrence of variants, concerns regarding the efficacy of vaccines and antiviral drugs with a broad spectrum have grown. We should make an effort to modernize treatment strategies to address the challenges posed by mutations. Thus, in addition to the requirement for additional clinical data to monitor the long-term effects of vaccines and broad-spectrum antiviral drugs, we can use CS as an entry point and therapeutic target to alleviate the severity of the disease in patients. To effectively combat the mutation, new technologies for neutralizing or controlling CS must be developed. In recent years, nanotechnology has been widely applied in the biomedical field, opening up a plethora of opportunities for CS. Here, we put forward the view of cytokine storm as a therapeutic target can be used to treat critically ill patients by expounding the relationship between coronavirus disease 2019 (COVID-19) and CS and the mechanisms associated with CS. We pay special attention to the representative strategies of nanomaterials in current neutral and CS research, as well as their potential chemical design and principles. We hope that the nanostrategies described in this review provide attractive treatment options for severe and critical COVID-19 caused by CS.
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Affiliation(s)
- Yu Zheng
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yuke Li
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Mao Li
- Health Management Centre, Clinical Medical College & Affiliated Hospital of Chengdu University, Chengdu University, Chengdu, China
| | - Rujing Wang
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yuhong Jiang
- School of Life Science and Engineering, Southwest Jiaotong University, Chengdu, China
| | - Mengnan Zhao
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jun Lu
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Rui Li
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiaofang Li
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Sanjun Shi
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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2
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Bhadola P, Chaudhary V, Markandan K, Talreja RK, Aggarwal S, Nigam K, Tahir M, Kaushik A, Rustagi S, Khalid M. Analysing role of airborne particulate matter in abetting SARS-CoV-2 outbreak for scheming regional pandemic regulatory modalities. ENVIRONMENTAL RESEARCH 2023; 236:116646. [PMID: 37481054 DOI: 10.1016/j.envres.2023.116646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/04/2023] [Accepted: 07/11/2023] [Indexed: 07/24/2023]
Abstract
The mutating SARS-CoV-2 necessitates gauging the role of airborne particulate matter in the COVID-19 outbreak for designing area-specific regulation modalities based on the environmental state-of-affair. To scheme the protocols, the hotspots of air pollutants such as PM2.5, PM10, NH3, NO, NO2, SO2, and and environmental factors including relative humidity (RH), and temperature, along with COVID-19 cases and mortality from January 2020 till December 2020 from 29 different ground monitoring stations spanning Delhi, are mapped. Spearman correlation coefficients show a positive relationship between SARS-COV-2 with particulate matter (PM2.5 with r > 0.36 and PM10 with r > 0.31 and p-value <0·001). Besides, SARS-COV-2 transmission showed a substantial correlation with NH3 (r = 0.41), NO2 (r = 0.36), and NO (r = 0.35) with a p-value <0.001, which is highly indicative of their role in SARS-CoV-2 transmission. These outcomes are associated with the source of PM and its constituent trace elements to understand their overtone with COVID-19. This strongly validates temporal and spatial variation in COVID-19 dependence on air pollutants as well as on environmental factors. Besides, the bottlenecks of missing latent data, monotonous dependence of variables, and the role air pollutants with secondary environmental variables are discussed. The analysis set the foundation for strategizing regional-based modalities considering environmental variables (i.e., pollutant concentration, relative humidity, temperature) as well as urban and transportation planning for efficient control and handling of future public health emergencies.
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Affiliation(s)
- Pradeep Bhadola
- Centre for Theoretical Physics & Natural Philosophy, Mahidol University, Nakhonsawan 60130, Thailand
| | - Vishal Chaudhary
- Department of Physics, Bhagini Nivedita College, University of Delhi, Delhi 110072, India.
| | - Kalaimani Markandan
- Department of Chemical & Petroleum Engineering, Faculty of Engineering, Technology and Built Environment, UCSI University, Cheras 56000, Kuala Lumpur, Malaysia
| | - Rishi Kumar Talreja
- Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi 110029, India
| | - Sumit Aggarwal
- Division of Epidemiology and Communicable Diseases (ECD), Indian Council of Medical Research (ICMR)-Headquaters, New Delhi 110029, India
| | - Kuldeep Nigam
- Division of Epidemiology and Communicable Diseases (ECD), Indian Council of Medical Research (ICMR)-Headquaters, New Delhi 110029, India
| | - Mohammad Tahir
- Department of Computing, University of Turku, FI-20014, Turun Yliopisto, Finland
| | - Ajeet Kaushik
- NanoBio Tech Laboratory, Department of Environmental Engineering, Florida Polytechnic University, Lakeland, FL, 33805, USA; School of Engineering, University of Petroleum and Energy Studies (UPES), Dehradun, Uttarakhand, India
| | - Sarvesh Rustagi
- School of Applied and Life Sciences, Uttaranchal University, Dehradun, Uttrakhand, India
| | - Mohammad Khalid
- Sunway Centre for Electrochemical Energy and Sustainable Technology (SCEEST), School of Engineering and Technology, Sunway University, No. 5, Jalan University, Bandar Sunway, 47500, Petaling Jaya, Selangor, Malaysia; Division of Research and Development, Lovely Professional University, Phagwara, 144411, Punjab, India; School of Engineering and Technology, Sharda University, Greater Noida, 201310, India.
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3
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Akase IE, Akintan PE, Otrofanowei E, Olopade OB, Olorunfemi G, Opawoye A, Ima-Edomwomyi UE, Akinbolagbe YO, Agabi OP, Nmadu DA, Akinbode GO, Olasope AC, Ogundare A, Bolarinwa AB, Otokiti EO, Enajeroh PJ, Karami M, Esezobor CI, Oshodi Y, Oluwole AA, Adeyemo WL, Bode CO. Clinical predictors of Covid-19 mortality in a tertiary hospital in Lagos, Nigeria: A retrospective cohort study. Niger J Clin Pract 2023; 26:424-431. [PMID: 37203106 DOI: 10.4103/njcp.njcp_454_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Background The predictors of mortality among patients presenting with severe to critical disease in Nigeria are presently unknown. Aim The aim of this study was to identify the predictors of mortality among patients with COVID-19 presenting for admission in a tertiary referral hospital in Lagos, Nigeria. Patients and Methods The study was a retrospective study. Patients' sociodemographics, clinical characteristics, comorbidities, complications, treatment outcomes, and hospital duration were documented. Pearson's Chi-square, Fischer's Exact test, or Student's t-test were used to assess the relationship between the variables and mortality. To compare the survival experience across medical comorbidities, Kaplan Meir plots and life tables were used. Univariable and multivariable Cox-proportional hazard analyses were conducted. Results A total of 734 patients were recruited. Participants' age ranged from five months to 92 years, with a mean ± SD of 47.4 ± 17.2 years, and a male preponderance (58.5% vs. 41.5%). The mortality rate was 9.07 per thousand person-days. About 73.9% (n = 51/69) of the deceased had one or more co-morbidities, compared to 41.6% (252/606) of those discharged. Patients who were older than 50 years, with diabetes mellitus, hypertension, chronic renal illness, and cancer had a statistically significant relationship with mortality. Conclusion These findings call for a more comprehensive approach to the control of non-communicable diseases, the allocation of sufficient resources for ICU care during outbreaks, an improvement in the quality of health care available to Nigerians, and further research into the relationship between obesity and COVID-19 in Nigerians.
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Affiliation(s)
- I E Akase
- Department of Medicine, College of Medicine, University of Lagos, Lagos, Nigeria
| | - P E Akintan
- Department of Pediatrics, College of Medicine, University of Lagos, Lagos, Nigeria
| | - E Otrofanowei
- Department of Medicine, College of Medicine, University of Lagos, Lagos, Nigeria
| | - O B Olopade
- Department of Medicine, Lagos University Teaching Hospital, Lagos, Nigeria
| | - G Olorunfemi
- Division of Epidemiology and Biostatistics, School of Public Health, University of Witwatersrand, Johannesburg, South Africa
| | - A Opawoye
- Department of Medicine, Lagos University Teaching Hospital, Lagos, Nigeria
| | - U E Ima-Edomwomyi
- Department of Medicine, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Y O Akinbolagbe
- Department of Pediatrics, College of Medicine, University of Lagos, Lagos, Nigeria
| | - O P Agabi
- Department of Medicine, College of Medicine, University of Lagos, Lagos, Nigeria
| | - D A Nmadu
- Department of Medicine, Lagos University Teaching Hospital, Lagos, Nigeria
| | - G O Akinbode
- Department of Surgery, Lagos University Teaching Hospital, Lagos, Nigeria
| | - A C Olasope
- Department of Medicine, Lagos University Teaching Hospital, Lagos, Nigeria
| | - A Ogundare
- Department of Medicine, Lagos University Teaching Hospital, Lagos, Nigeria
| | - A B Bolarinwa
- Department of Hematology and Blood Transfusion, Lagos University Teaching Hospital, Lagos, Nigeria
| | - E O Otokiti
- Department of Hematology and Blood Transfusion, Lagos University Teaching Hospital, Lagos, Nigeria
| | - P J Enajeroh
- Department of Medicine, Lagos University Teaching Hospital, Lagos, Nigeria
| | - M Karami
- Department of Medicine, Lagos University Teaching Hospital, Lagos, Nigeria
| | - C I Esezobor
- Department of Medicine, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Y Oshodi
- Department of Psychiatry, College of Medicine, University of Lagos, Lagos, Nigeria
| | - A A Oluwole
- Department of Obstetrics and Gynaecology, College of Medicine, University of Lagos, Lagos, Nigeria
| | - W L Adeyemo
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos, Lagos, Nigeria
| | - C O Bode
- Department of Surgery, College of Medicine, University of Lagos, Lagos, Nigeria
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Varela AR, Gurruchaga AP, Restrepo SR, Martin JD, Landazabal YDC, Tamayo-Cabeza G, Contreras-Arrieta S, Caballero-Díaz Y, Florez LJH, González JM, Santos-Barbosa JC, Pinzón JD, Yepes-Nuñez JJ, Laajaj R, Buitrago Gutierrez G, Florez MV, Fuentes Castillo J, Quinche Vargas G, Casas A, Medina A, Behrentz E, Guevara YPR, Sanchez DR, Guevara-Suarez M, Hidalgo M, Betancourt P. Effectiveness and adherence to closed face shields in the prevention of COVID-19 transmission: a non-inferiority randomized controlled trial in a middle-income setting (COVPROSHIELD). Trials 2022; 23:698. [PMID: 35987694 PMCID: PMC9391623 DOI: 10.1186/s13063-022-06606-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 07/29/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The use of respiratory devices can mitigate the spread of diseases such as COVID-19 in community settings. We aimed to determine the effectiveness of closed face shields with surgical face masks to prevent SARS-CoV-2 transmission in working adults during the COVID-19 pandemic in Bogotá, Colombia.
Methods
An open-label non-inferiority randomized controlled trial that randomly assigned participants to one of two groups: the intervention group was instructed to wear closed face shields with surgical face masks, and the active control group was instructed to wear only surgical face masks. The primary outcome was a positive reverse transcription polymerase chain reaction test, IgG/IgM antibody test for SARS-CoV-2 detection, or both during and at the end of the follow-up period of 21 days. The non-inferiority limit was established at − 5%.
Results
A total of 316 participants were randomized, 160 participants were assigned to the intervention group and 156 to the active control group. In total, 141 (88.1%) participants in the intervention group and 142 (91.0%) in the active control group completed the follow-up. Primary outcome: a positive SARS-CoV-2 test result was identified in one (0.71%) participant in the intervention group and three (2.1%) in the active control group. In the intention-to-treat analysis, the absolute risk difference was − 1.40% (95% CI [− 4.14%, 1.33%]), and in the per-protocol analysis, the risk difference was − 1.40% (95% CI [− 4.20, 1.40]), indicating non-inferiority of the closed face shield plus face mask (did not cross the non-inferiority limit).
Conclusions
The use of closed face shields and surgical face masks was non-inferior to the surgical face mask alone in the prevention of SARS-CoV-2 infection in highly exposed groups. Settings with highly active viral transmission and conditions such as poor ventilation, crowding, and high mobility due to occupation may benefit from the combined use of masks and closed face shields to mitigate SARS-CoV-2 transmission.
Trial registration
ClinicalTrials.gov NCT04647305. Registered on November 30, 2020
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Sharif N, Alzahrani KJ, Ahmed SN, Khan A, Banjer HJ, Alzahrani FM, Parvez AK, Dey SK. Genomic surveillance, evolution and global transmission of SARS-CoV-2 during 2019-2022. PLoS One 2022; 17:e0271074. [PMID: 35913920 PMCID: PMC9342790 DOI: 10.1371/journal.pone.0271074] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 06/23/2022] [Indexed: 12/19/2022] Open
Abstract
In spite of the availability of vaccine, the health burden associated with the COVID-19 pandemic continues to increase. An estimated 5 million people have died with SARS-CoV-2 infection. Analysis of evolution and genomic diversity can provide sufficient information to reduce the health burden of the pandemic. This study focused to conduct worldwide genomic surveillance. About 7.6 million genomic data were analyzed during 2019 to 2022. Multiple sequence alignment was conducted by using maximum likelihood method. Clade GK (52%) was the most predominant followed by GRY (12%), GRA (11%), GR (8%), GH (7%), G (6%), GV (3%), and O (1%), respectively. VOC Delta (66%) was the most prevalent variant followed by VOC Alpha (18%), VOC Omicron (13%), VOC Gamma (2%) and VOC Beta (1%), respectively. The frequency of point mutations including E484K, N501Y, N439K, and L452R at spike protein has increased 10%-92%. Evolutionary rate of the variants was 23.7 substitution per site per year. Substitution mutations E484K and N501Y had significant correlation with cases (r = .45, r = .23), fatalities (r = .15, r = .44) and growth rate R0 (r = .28, r = .54). This study will help to understand the genomic diversity, evolution and the impact of the variants on the outcome of the COVID-19 pandemic.
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Affiliation(s)
- Nadim Sharif
- Department of Microbiology, Jahangirnagar University, Savar, Dhaka, Bangladesh
| | - Khalid J. Alzahrani
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Shamsun Nahar Ahmed
- Department of Microbiology, Jahangirnagar University, Savar, Dhaka, Bangladesh
| | - Afsana Khan
- Department of Statistics, Jahangirnagar University, Savar, Dhaka, Bangladesh
| | - Hamsa Jameel Banjer
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Fuad M. Alzahrani
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | | | - Shuvra Kanti Dey
- Department of Microbiology, Jahangirnagar University, Savar, Dhaka, Bangladesh
- * E-mail:
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6
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Chaudhary V, Bhadola P, Kaushik A, Khalid M, Furukawa H, Khosla A. Assessing temporal correlation in environmental risk factors to design efficient area-specific COVID-19 regulations: Delhi based case study. Sci Rep 2022; 12:12949. [PMID: 35902653 PMCID: PMC9333075 DOI: 10.1038/s41598-022-16781-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 07/15/2022] [Indexed: 12/12/2022] Open
Abstract
Amid ongoing devastation due to Serve-Acute-Respiratory-Coronavirus2 (SARS-CoV-2), the global spatial and temporal variation in the pandemic spread has strongly anticipated the requirement of designing area-specific preventive strategies based on geographic and meteorological state-of-affairs. Epidemiological and regression models have strongly projected particulate matter (PM) as leading environmental-risk factor for the COVID-19 outbreak. Understanding the role of secondary environmental-factors like ammonia (NH3) and relative humidity (RH), latency of missing data structuring, monotonous correlation remains obstacles to scheme conclusive outcomes. We mapped hotspots of airborne PM2.5, PM10, NH3, and RH concentrations, and COVID-19 cases and mortalities for January, 2021-July,2021 from combined data of 17 ground-monitoring stations across Delhi. Spearmen and Pearson coefficient correlation show strong association (p-value < 0.001) of COVID-19 cases and mortalities with PM2.5 (r > 0.60) and PM10 (r > 0.40), respectively. Interestingly, the COVID-19 spread shows significant dependence on RH (r > 0.5) and NH3 (r = 0.4), anticipating their potential role in SARS-CoV-2 outbreak. We found systematic lockdown as a successful measure in combatting SARS-CoV-2 outbreak. These outcomes strongly demonstrate regional and temporal differences in COVID-19 severity with environmental-risk factors. The study lays the groundwork for designing and implementing regulatory strategies, and proper urban and transportation planning based on area-specific environmental conditions to control future infectious public health emergencies.
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Affiliation(s)
- Vishal Chaudhary
- Research Cell and Department of Physics, Bhagini Nivedita College, University of Delhi, New Delhi, 110043, India.
| | - Pradeep Bhadola
- Centre for Theoretical Physics and Natural Philosophy, Nakhonsawan Studiorum for Advanced Studies, Mahidol University, Nakhonsawan, 60130, Thailand.
| | - Ajeet Kaushik
- NanoBioTech Laboratory, Health System Engineering, Department of Environmental Engineering, Florida Polytechnic University, Lakeland, FL, 33805, USA.,School of Engineering, University of Petroleum and Energy Studies (UPES) , Dehradun, Uttarakhand, India
| | - Mohammad Khalid
- Graphene and Advanced 2D Materials Research Group (GAMRG), School of Engineering and Technology, Sunway University, No. 5, Jalan University, Bandar Sunway, 47500, Petaling Jaya, Selangor, Malaysia.,Sunway Materials Smart Science & Engineering (SMS2E) Research Cluster, Sunway University, No. 5, Jalan Universiti, Bandar Sunway, 47500, Petaling Jaya, Selangor, Malaysia
| | - Hidemitsu Furukawa
- Department of Mechanical Systems Engineering, Graduate School of Science and Engineering, Yamagata University, Yonezawa, Yamagata, 992-8510, Japan
| | - Ajit Khosla
- School of Advanced Materials and Nanotechnology, Xidian University, Xi'an, 710126, People's Republic of China.
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7
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Brust KB, Papineni V, Columbus C, Arroliga AC. COVID-19—from emerging global threat to ongoing pandemic crisis. Proc AMIA Symp 2022; 35:468-475. [DOI: 10.1080/08998280.2022.2068940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- Karen B. Brust
- Division of Infectious Disease, Department of Internal Medicine, Baylor Scott & White Medical Center – Temple, Temple, Texas
| | - Vinayika Papineni
- Texas A&M Health Science Center, Texas A&M University, Austin, Texas
| | - Cristie Columbus
- Division of Infectious Diseases, Department of Internal Medicine, Baylor University Medical Center, Dallas, Texas
| | - Alejandro C. Arroliga
- Division of Pulmonary and Critical Care and Sleep Medicine, Department of Internal Medicine, Baylor Scott and White Medical Center – Temple, Temple, Texas
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8
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Horve PF, Dietz LG, Bowles G, MacCrone G, Olsen-Martinez A, Northcutt D, Moore V, Barnatan L, Parhizkar H, Van Den Wymelenberg KG. Longitudinal analysis of built environment and aerosol contamination associated with isolated COVID-19 positive individuals. Sci Rep 2022; 12:7395. [PMID: 35513399 PMCID: PMC9070971 DOI: 10.1038/s41598-022-11303-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 04/12/2022] [Indexed: 12/13/2022] Open
Abstract
The indoor environment is the primary location for the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19), largely driven by respiratory particle accumulation in the air and increased connectivity between the individuals occupying indoor spaces. In this study, we aimed to track a cohort of subjects as they occupied a COVID-19 isolation dormitory to better understand the impact of subject and environmental viral load over time, symptoms, and room ventilation on the detectable viral load within a single room. We find that subject samples demonstrate a decrease in overall viral load over time, symptoms significantly impact environmental viral load, and we provide the first real-world evidence for decreased aerosol SARS-CoV-2 load with increasing ventilation, both from mechanical and window sources. These results may guide environmental viral surveillance strategies and be used to better control the spread of SARS-CoV-2 within built environments and better protect those caring for individuals with COVID-19.
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Affiliation(s)
- Patrick F Horve
- Institute of Molecular Biology, University of Oregon, Eugene, OR, 97403, USA.,Biology and the Built Environment Center, University of Oregon, Eugene, OR, 97403, USA
| | - Leslie G Dietz
- Biology and the Built Environment Center, University of Oregon, Eugene, OR, 97403, USA
| | - Garis Bowles
- Biology and the Built Environment Center, University of Oregon, Eugene, OR, 97403, USA
| | - Georgia MacCrone
- Biology and the Built Environment Center, University of Oregon, Eugene, OR, 97403, USA
| | | | - Dale Northcutt
- Biology and the Built Environment Center, University of Oregon, Eugene, OR, 97403, USA.,Energy Studies in Buildings Laboratory, University of Oregon, Eugene, OR, 97403, USA
| | - Vincent Moore
- Biology and the Built Environment Center, University of Oregon, Eugene, OR, 97403, USA
| | - Liliana Barnatan
- Biology and the Built Environment Center, University of Oregon, Eugene, OR, 97403, USA
| | - Hooman Parhizkar
- Energy Studies in Buildings Laboratory, University of Oregon, Eugene, OR, 97403, USA.,Institute for Health and the Built Environment, University of Oregon, Portland, OR, 97209, USA
| | - Kevin G Van Den Wymelenberg
- Biology and the Built Environment Center, University of Oregon, Eugene, OR, 97403, USA. .,Energy Studies in Buildings Laboratory, University of Oregon, Eugene, OR, 97403, USA. .,Institute for Health and the Built Environment, University of Oregon, Portland, OR, 97209, USA.
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9
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Dumache R, Enache A, Macasoi I, Dehelean CA, Dumitrascu V, Mihailescu A, Popescu R, Vlad D, Vlad CS, Muresan C. SARS-CoV-2: An Overview of the Genetic Profile and Vaccine Effectiveness of the Five Variants of Concern. Pathogens 2022; 11:pathogens11050516. [PMID: 35631037 PMCID: PMC9144800 DOI: 10.3390/pathogens11050516] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 04/21/2022] [Accepted: 04/25/2022] [Indexed: 12/13/2022] Open
Abstract
With the onset of the COVID-19 pandemic, enormous efforts have been made to understand the genus SARS-CoV-2. Due to the high rate of global transmission, mutations in the viral genome were inevitable. A full understanding of the viral genome and its possible changes represents one of the crucial aspects of pandemic management. Structural protein S plays an important role in the pathogenicity of SARS-CoV-2, mutations occurring at this level leading to viral forms with increased affinity for ACE2 receptors, higher transmissibility and infectivity, resistance to neutralizing antibodies and immune escape, increasing the risk of infection and disease severity. Thus, five variants of concern are currently being discussed, Alpha, Beta, Gamma, Delta and Omicron. In the present review, a comprehensive summary of the following critical aspects regarding SARS-CoV-2 has been made: (i) the genomic characteristics of SARS-CoV-2; (ii) the pathological mechanism of transmission, penetration into the cell and action on specific receptors; (iii) mutations in the SARS-CoV-2 genome; and (iv) possible implications of mutations in diagnosis, treatment, and vaccination.
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Affiliation(s)
- Raluca Dumache
- Ethics and Human Identification Research Center, Department of Neurosciences, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (R.D.); (A.E.); (A.M.); (C.M.)
| | - Alexandra Enache
- Ethics and Human Identification Research Center, Department of Neurosciences, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (R.D.); (A.E.); (A.M.); (C.M.)
| | - Ioana Macasoi
- Departament of Toxicology and Drug Industry, Faculty of Pharmacy, “Victor Babeş” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timişoara, Romania
- Research Center for Pharmaco-Toxicological Evaluations, Faculty of Pharmacy, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
- Correspondence: (I.M.); (C.A.D.)
| | - Cristina Adriana Dehelean
- Departament of Toxicology and Drug Industry, Faculty of Pharmacy, “Victor Babeş” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timişoara, Romania
- Research Center for Pharmaco-Toxicological Evaluations, Faculty of Pharmacy, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
- Correspondence: (I.M.); (C.A.D.)
| | - Victor Dumitrascu
- Department of Pharmacology and Biochemistry, Discipline of Pharmacology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (V.D.); (D.V.); (C.S.V.)
| | - Alexandra Mihailescu
- Ethics and Human Identification Research Center, Department of Neurosciences, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (R.D.); (A.E.); (A.M.); (C.M.)
- Genetics, Genomic Medicine Research Center, Department of Microscopic Morphology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Roxana Popescu
- Department of Microscopic Morphology, Discipline of Molecular and Cell Biology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Daliborca Vlad
- Department of Pharmacology and Biochemistry, Discipline of Pharmacology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (V.D.); (D.V.); (C.S.V.)
| | - Cristian Sebastian Vlad
- Department of Pharmacology and Biochemistry, Discipline of Pharmacology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (V.D.); (D.V.); (C.S.V.)
| | - Camelia Muresan
- Ethics and Human Identification Research Center, Department of Neurosciences, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (R.D.); (A.E.); (A.M.); (C.M.)
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Newey CR, Olausson AT, Applegate A, Reid AA, Robison RA, Grose JH. Presence and stability of SARS-CoV-2 on environmental currency and money cards in Utah reveals a lack of live virus. PLoS One 2022; 17:e0263025. [PMID: 35077511 PMCID: PMC8789161 DOI: 10.1371/journal.pone.0263025] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 01/10/2022] [Indexed: 01/22/2023] Open
Abstract
The highly contagious nature of SARS-CoV-2 has led to several studies on the transmission of the virus. A little studied potential fomite of great concern in the community is currency, which has been shown to harbor microbial pathogens in several studies. Since the onset of the COVID-19 pandemic, many businesses in the United States have limited the use of banknotes in favor of credit cards. However, SARS-CoV-2 has shown greater stability on plastic in several studies. Herein, the stability of SARS-CoV-2 at room temperature on banknotes, money cards and coins was investigated. In vitro studies with live virus suggested SARS-CoV-2 was highly unstable on banknotes, showing an initial rapid reduction in viable virus and no viral detection by 24 hours. In contrast, SARS-CoV-2 displayed increased stability on money cards with live virus detected after 48 hours. Environmental swabbing of currency and money cards on and near the campus of Brigham Young University supported these results, with no detection of SARS-CoV-2 RNA on banknotes, and a low level on money cards. However, no viable virus was detected on either. These preliminary results suggest that the use of money cards over banknotes in order to slow the spread of this virus may be ill-advised. These findings should be investigated further through larger environmental studies involving more locations.
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Affiliation(s)
- Colleen R. Newey
- Department of Microbiology and Molecular Biology, College of Life Sciences, Brigham Young University, Provo, UT, United States of America
| | - Abigail T. Olausson
- Department of Microbiology and Molecular Biology, College of Life Sciences, Brigham Young University, Provo, UT, United States of America
| | - Alyssa Applegate
- Department of Microbiology and Molecular Biology, College of Life Sciences, Brigham Young University, Provo, UT, United States of America
| | - Ann-Aubrey Reid
- Department of Microbiology and Molecular Biology, College of Life Sciences, Brigham Young University, Provo, UT, United States of America
| | - Richard A. Robison
- Department of Microbiology and Molecular Biology, College of Life Sciences, Brigham Young University, Provo, UT, United States of America
| | - Julianne H. Grose
- Department of Microbiology and Molecular Biology, College of Life Sciences, Brigham Young University, Provo, UT, United States of America
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Sivasankarapillai VS, Madaswamy SL, Dhanusuraman R. Role of nanotechnology in facing SARS-CoV-2 pandemic: Solving crux of the matter with a hopeful arrow in the quiver. SENSORS INTERNATIONAL 2021; 2:100096. [PMID: 34766054 PMCID: PMC8069635 DOI: 10.1016/j.sintl.2021.100096] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 04/19/2021] [Accepted: 04/19/2021] [Indexed: 01/01/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a positive-sense single-stranded RNA virus species with a zoonotic origin and responsible for the coronavirus disease 2019(COVID-19). This novel virus has an extremely high infectious rate, which occurs through the contact of contaminated surfaces and also by cough, sneeze, hand-to-mouth-to-eye contact with an affected person. The progression of infection, which goes beyond complications of pneumonia to affecting other physiological functions which cause gastrointestinal, Renal, and neurological complication makes this a life threatening condition. Intense efforts are going across the scientific community in elucidating various aspects of this virus, such as understanding the pathophysiology of the disease, molecular biology, and cellular pathways of viral replication. We hope that nanotechnology and material science can provide a significant contribution to tackle this problem through both diagnostic and therapeutic strategies. But the area is still in the budding phase, which needs urgent and significant attention. This review provides a brief idea regarding the various nanotechnological approaches reported for managing COVID-19 infection. The nanomaterials recently said to have good antiviral activities like Carbon nanotubes (CNTs) and quantum dots (QDs) were also discussed since they are also in the emerging stage of attaining research interest regarding antiviral applications.
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Affiliation(s)
- Vishnu Sankar Sivasankarapillai
- Nano Electrochemistry Lab(NEL), Department of Chemistry, National Institute of Technology Puducherry, Karaikal, 609-609, India
| | - Suba Lakshmi Madaswamy
- Nano Electrochemistry Lab(NEL), Department of Chemistry, National Institute of Technology Puducherry, Karaikal, 609-609, India
| | - Ragupathy Dhanusuraman
- Nano Electrochemistry Lab(NEL), Department of Chemistry, National Institute of Technology Puducherry, Karaikal, 609-609, India
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Klunk A, Holloway R, Babaoff A, Jelin EB. Rapid return to normal activities at a residential summer camp during the COVID-19 pandemic. JOURNAL OF PUBLIC HEALTH-HEIDELBERG 2021; 30:2657-2663. [PMID: 34493964 PMCID: PMC8412395 DOI: 10.1007/s10389-021-01597-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 05/17/2021] [Indexed: 11/26/2022]
Abstract
Aim Infection prevention and control (IPC) within residential settings is a central focus of the coronavirus disease 2019 (COVID-19) pandemic. Youth residential summer camps are an excellent model for such environments and have thus far had mixed results. The aim of this report was to describe the successful implementation of a seven-week overnight summer camp with rapid return to normal activities from June to August 2020. Subjects and methods This retrospective study included 427 individuals who traveled from 24 US states. All staff and campers were tested by serial nasopharyngeal PCR tests in the context of strict infection prevention and control (IPC) measures, including cohorts and masking. The entire camp population was isolated from non-camp personnel with special measures for food, supply, and mail delivery. Results During the two-week staff session, one staff member tested positive for SARS-CoV-2, was isolated, and sent safely off premises. All other campers and staff had three negative PCR tests: 1-8 days before arrival, upon arrival, and 5-6 days after arrival. After these three negative tests, 6 days into camp, most IPCs, including masking, were successfully lifted and a normal camp experience was possible. Conclusions These findings indicate that serial PCR-based testing and strict adherence to IPC measures among cohorts can allow for successful assumption of near normal group activities in a residential setting during the COVID-19 pandemic. This result at an overnight summer camp has broad implications for similar residential communities such as boarding schools, other youth education and development programs, as well as nursing homes and military installations. Supplementary Information The online version contains supplementary material available at 10.1007/s10389-021-01597-9.
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Affiliation(s)
- A. Klunk
- Philadelphia College of Osteopathic Medicine, 4170 City Avenue, Philadelphia, PA 19131 USA
- Department of Bone Marrow Transplant and Immune Deficiency, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229 USA
| | - R. Holloway
- University of Cincinnati College of Medicine, 3230 Eden Avenue, Cincinnati, OH 45267 USA
| | - A. Babaoff
- Department of Emergency Medicine, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229 USA
| | - E. B. Jelin
- Department of Surgery, Division of Pediatric Surgery, Johns Hopkins University, Johns Hopkins Charlotte R. Bloomberg Children’s Center 1800 Orleans Street, Baltimore, MD 21287 USA
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Herzog M, Beule AG, Lüers JC, Guntinas-Lichius O, Grafmans D, Deitmer T. [The first year of the SARS-CoV-2 pandemic-impact on otorhinolaryngology]. HNO 2021; 69:615-622. [PMID: 33620505 PMCID: PMC7900796 DOI: 10.1007/s00106-021-01015-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND The first year of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has already affected our public health care system to an enormous extent and will continue to do so in the future. Otorhinolaryngologists (ORLs) are suspected to be at high risk of infection, due to the high viral load in the mucosa of the upper airways. The current review evaluates the impact of the pandemic on ORLs' activities and assesses the risk infection. METHODS A selective literature research was conducted using relevant English and German terms for ORL, SARS-CoV‑2, risk, and infection at PubMed, medRxiv, and bioRxiv, as well as in the Deutsches Ärzteblatt and on the websites of the Robert Koch Institute and the Johns Hopkins University. RESULTS Protection recommendations for ORL include general hygiene measures and wearing KN95 masks for routine professional activities. When in contact with coronavirus disease 2019 (COVID-19) patients, it is recommended to extend the personal protective equipment by eye protection, gloves, cap, and gown. International otorhinolaryngology societies have released guidelines for procedures (e.g., tracheostomy, sinus surgery), propagating personal protection for the surgical team and reduction of aerosols. Testing for SARS-CoV‑2 in patients and medical staff can contribute to reducing the risk of infection. Vaccination would provide some additional protection for ORLs and other health care professionals with increased exposure to aerosols. There is increasing evidence that ORLs are at a high risk of contracting SARS-CoV‑2. CONCLUSION Consequent personal protection, frequent testing of patients and health care professionals, and the promised SARS-CoV‑2 vaccinations may provide adequate protection for highly exposed persons.
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Affiliation(s)
- M Herzog
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Carl-Thiem-Klinikum, Thiemstraße 111, 03048, Cottbus, Deutschland.
- Klinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Halschirurgie, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland.
| | - A G Beule
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Münster, Münster, Deutschland
- Klinik und Poliklinik für Hals‑, Nasen‑, Ohrenkrankheiten, Kopf- und Halschirurgie, Universitätsmedizin Greifswald, Greifswald, Deutschland
| | - J-C Lüers
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Medizinische Fakultät, Uniklinik Köln, Köln, Deutschland
| | - O Guntinas-Lichius
- Klinik und Poliklinik für HNO-Heilkunde, Universitätsklinikum Jena, Jena, Deutschland
| | - D Grafmans
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Carl-Thiem-Klinikum, Thiemstraße 111, 03048, Cottbus, Deutschland
| | - T Deitmer
- Deutsche Gesellschaft für HNO-Heilkunde, Kopf- und Hals-Chirurgie e. V., Bonn, Deutschland
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Schramm MWJ, Sheikh AJ, Chave-Cox R, McQuaid J, Whitty RCW, Ilyinskaya E. Surgically generated aerosol and mitigation strategies: combined use of irrigation, respirators and suction massively reduces particulate matter aerosol. Acta Neurochir (Wien) 2021; 163:1819-1827. [PMID: 34031774 PMCID: PMC8143442 DOI: 10.1007/s00701-021-04874-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 05/09/2021] [Indexed: 11/14/2022]
Abstract
Background Aerosol is a health risk to theatre staff. This laboratory study quantifies the reduction in particulate matter aerosol concentrations produced by electrocautery and drilling when using mitigation strategies such as irrigation, respirator filtration and suction in a lab environment to prepare for future work under live OR conditions. Methods We combined one aerosol-generating procedure (monopolar cutting or coagulating diathermy or high-speed diamond- or steel-tipped drilling of cadaveric porcine tissue) with one or multiple mitigation strategies (instrument irrigation, plume suction and filtration using an FFP3 respirator filter) and using an optical particle counter to measure particulate matter aerosol size and concentrations. Results Significant aerosol concentrations were observed during all aerosol-generating procedures with concentrations exceeding 3 × 106 particles per 100 ml. Considerable reductions in concentrations were observed with mitigation. In drilling, suction, FFP3 filtration and wash alone respectively reduced aerosol by 19.3–31.6%, 65.1–70.8% and 97.2 to > 99.9%. The greatest reduction (97.38 to > 99.9%) was observed when combining irrigation and filtration. Coagulating diathermy reduced concentrations by 88.0–96.6% relative to cutting, but produced larger particles. Suction alone, and suction with filtration reduced aerosol concentration by 41.0–49.6% and 88.9–97.4% respectively. No tested mitigation strategies returned aerosol concentrations to baseline. Conclusion Aerosol concentrations are significantly reduced through the combined use of filtration, suction and irrigation. Further research is required to characterise aerosol concentrations in the live OR and to find acceptable exposure limits, and in their absence, to find methods to further reduce exposure to theatre staff.
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Abstract
The body of a deceased with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection is considered infectious. In this study, we present the results of infectivity testing of the body and testing of mortuary staff for SARS-CoV-2. We performed real-time quantitative polymerase chain reaction (RT-qPCR) for SARS-CoV-2 on 33 decedents with ante mortem confirmed SARS-CoV-2 infection. Swabs of the body surface from five different body regions and from the body bag or coffin were examined. A subset of the swabs was brought into cell culture. In addition, screening of 25 Institute of Legal Medicine (ILM) personnel for ongoing or past SARS-CoV-2 infection was performed at two different time points during the pandemic. Swabs from all locations of the body surface and the body environment were negative in cases of negative post mortem nasopharyngeal testing (n=9). When the post mortem nasopharyngeal swab tested positive (n=24), between 0 and 5 of the body surface swabs were also positive, primarily the perioral region. In six of the cases, the body bag also yielded a positive result. The longest postmortem interval with positive SARS-CoV-2 RT-qPCR at the body surface was nine days. In no case viable SARS-CoV-2 was found on the skin of the bodies or the body bags. One employee (autopsy technician) had possible occupational infection with SARS-CoV-2; all other employees were tested negative for SARS-CoV-2 RNA or antibody twice. Our data indicate that with adequate management of general safety precautions, transmission of SARS-CoV-2 through autopsies and handling of bodies is unlikely.
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16
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Zhou L, Ayeh SK, Chidambaram V, Karakousis PC. Modes of transmission of SARS-CoV-2 and evidence for preventive behavioral interventions. BMC Infect Dis 2021; 21:496. [PMID: 34049515 PMCID: PMC8160404 DOI: 10.1186/s12879-021-06222-4] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 05/21/2021] [Indexed: 01/12/2023] Open
Abstract
COVID-19 is a novel disease caused by SARS-CoV-2. During the global vaccination rollout, it is vital to thoroughly understand the modes of transmission of the virus in order to prevent further spread of variants and ultimately to end the pandemic. The current literature suggests that SARS-CoV-2 is transmitted among the human population primarily through respiratory droplets and, to a lesser extent, via aerosols. Transmission appears to be affected by temperature, humidity, precipitation, air currents, pH, and radiation in the ambient environment. Finally, the use of masks or facial coverings, social distancing, and hand washing are effective public health strategies in reducing the risk of exposure and transmission. Additional research is needed to further characterize the relative benefits of specific nonpharmaceutical interventions.
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Affiliation(s)
- Lucas Zhou
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Samuel K Ayeh
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Vignesh Chidambaram
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Petros C Karakousis
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Koch Cancer Research Building, 1550 Orleans St., Room 110, Baltimore, MD, 21287, USA.
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Herzog M, Beule AG, Lüers JC, Guntinas-Lichius O, Sowerby LJ, Grafmans D. Results of a national web-based survey on the SARS-CoV-2 infectious state of otorhinolaryngologists in Germany. Eur Arch Otorhinolaryngol 2021; 278:1247-1255. [PMID: 32897443 PMCID: PMC7477736 DOI: 10.1007/s00405-020-06345-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 08/28/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE SARS-CoV-2 is detected on the mucosa of the upper airways to a high degree. In the course of the COVID-19 pandemic, otorhinolaryngologists (ORL) are assumed to be at high risk due to close contact with the mucosa of the upper airways. No data are yet available providing evidence that ORLs have an increased risk of infection. METHODS German ORLs were invited via e-mail through the German Society of ORL, Head and Neck Surgery and the German ENT Association to participate in a web-based survey about infection with SARS-CoV-2 and development of COVID-19. Data of infections and concomitant parameters in German ORLs were collected and compared to the total number of infections in Germany. RESULTS Out of 6383 German ORLs, 970 (15%) participated. 54 ORLs reported testing positive for SARS-CoV-2. Compared to the total population of Germany, ORLs have a relative risk of 3.67 (95% CI 2.82; 4.79) of contracting SARS-CoV-2. Domestic quarantine was conducted in 96.3% of cases. Two individuals were admitted to hospital without intensive care. No casualties were reported. In 31 cases, the source of infection was not identifiable whereas 23 had a clear medical aetiology: infected patients: n = 5, 9.26%; medical staff: n = 13, 14.1%. 9.26% (n = 5) of the identified cases were related to contact to infected family members (n = 3), closer neighbourhood (n = 1) or general public (n = 1). There was no identified increased risk of infection due to performing surgery. CONCLUSION German ORLs have an almost 3.7-fold risk of contracting SARS-CoV-2 compared to the population baseline level. Appropriate protection appears to be necessary for this occupational group.
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Affiliation(s)
- Michael Herzog
- Department of Otorhinolaryngology, Head and Neck Surgery, Klinik für Hals-Nasen-Ohrenheilkunde, Carl-Thiem-Klinikum, Thiemstr. 111, 03048, Cottbus, Germany.
| | - Achim G Beule
- Department of Otorhinolaryngology, University Hospital Münster, Munster, Germany
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medicine Greifswald, Greifswald, Germany
| | - Jan-Christoffer Lüers
- Department of Otorhinolaryngology, Medical Faculty, University of Cologne, Cologne, Germany
| | | | - Leigh J Sowerby
- Department of Otolaryngology, Head and Neck Surgery, Western University, London, ON, Canada
| | - Daniel Grafmans
- Department of Otorhinolaryngology, Head and Neck Surgery, Klinik für Hals-Nasen-Ohrenheilkunde, Carl-Thiem-Klinikum, Thiemstr. 111, 03048, Cottbus, Germany
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Licina A, Silvers A. Use of powered air-purifying respirator(PAPR) as part of protective equipment against SARS-CoV-2-a narrative review and critical appraisal of evidence. Am J Infect Control 2021; 49:492-499. [PMID: 33186678 PMCID: PMC7654369 DOI: 10.1016/j.ajic.2020.11.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/04/2020] [Accepted: 11/05/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND The last 2 decades have seen an increasing frequency of zoonotic origin viral diseases leaping from animal to human hosts including Severe Acute Respiratory Syndrome Coronaviruses (SARS-CoV-2). Respiratory component of the infectious disease program against SARS-CoV-2 incorporates use of protective airborne respiratory equipment. METHODS In this narrative review, we explore the features of Powered Air Purifying Respirators (PAPR) as well as logistical and evidence-based advantages and disadvantages. RESULTS Simulation study findings support increased heat tolerance and wearer comfort with a PAPR, versus decreased communication ability, mobility, and dexterity. Although PAPRs have been recommended for high-risk procedures on suspected or confirmed COVID-19 patients, this recommendation remains controversial due to lack of evidence. Guidelines for appropriate use of PAPR during the current pandemic are sparse. International regulatory bodies do not mandate the use of PAPR for high-risk aerosol generating procedures in patients with SARS-CoV-2. Current reports of the choice of protective respiratory technology during the SARS-CoV-2 pandemic are disparate. Patterns of use appear to be related to geographical locations. DISCUSSION Field observational studies do not indicate a difference in healthcare worker infection utilizing PAPR devices versus other compliant respiratory equipment in healthcare workers performing AGPs in patients with SARS-CoV-2. Whether a higher PAPR filtration factor translates to decreased infection rates of HCWs remains to be elucidated. Utilization of PAPR with high filtration efficiency may represent an example of "precautionary principle" wherein action taken to reduce risk is guided by logistical advantages of PAPR system.
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Affiliation(s)
- Ana Licina
- VMO Anaesthesia, Austin Health, Melbourne, Victoria, Australia.
| | - Andrew Silvers
- VMO Anaesthesia, Monash Medical Centre, Adjunct Senior Lecturer, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.
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Inchingolo AD, Inchingolo AM, Bordea IR, Malcangi G, Xhajanka E, Scarano A, Lorusso F, Farronato M, Tartaglia GM, Isacco CG, Marinelli G, D’Oria MT, Hazballa D, Santacroce L, Ballini A, Contaldo M, Inchingolo F, Dipalma G. SARS-CoV-2 Disease Adjuvant Therapies and Supplements Breakthrough for the Infection Prevention. Microorganisms 2021; 9:525. [PMID: 33806624 PMCID: PMC7999785 DOI: 10.3390/microorganisms9030525] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 02/28/2021] [Accepted: 03/01/2021] [Indexed: 12/17/2022] Open
Abstract
The SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) is a high-risk viral agent involved in the recent pandemic stated worldwide by the World Health Organization. The infection is correlated to a severe systemic and respiratory disease in many cases, which is clinically treated with a multi-drug pharmacological approach. The purpose of this investigation was to evaluate through a literature overview the effect of adjuvant therapies and supplements for the SARS-CoV-2 infection. The research has analyzed the advantage of the EK1C4, by also assessing the studies on the resveratrol, vitamin D, and melatonin as adjuvant supplements for long hauler patients' prognosis. The evaluated substances reported important benefits for the improvement of the immune system and as a potential inhibitor molecules against SARS-CoV-2, highlighting the use of sartans as therapy. The adjuvant supplements seem to create an advantage for the healing of the long hauler patients affected by chronic symptoms of constant chest and heart pain, intestinal disorders, headache, difficulty concentrating, memory loss, and tachycardia.
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Affiliation(s)
- Alessio Danilo Inchingolo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (C.G.I.); (G.M.); (M.T.D.); (D.H.); (L.S.); (F.I.); (G.D.)
| | - Angelo Michele Inchingolo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (C.G.I.); (G.M.); (M.T.D.); (D.H.); (L.S.); (F.I.); (G.D.)
| | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, Faculty of Dentistry, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Giuseppina Malcangi
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (C.G.I.); (G.M.); (M.T.D.); (D.H.); (L.S.); (F.I.); (G.D.)
| | - Edit Xhajanka
- Dental Prosthesis Department, Medical University of Tirana, UMT, Rruga e Dibrës, Tirana 1001, Albania;
| | - Antonio Scarano
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Felice Lorusso
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Marco Farronato
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, UOC Maxillo-Facial Surgery and Dentistry, Fondazione IRCCS Ca Granda, Ospedale Maggiore Policlinico, 20100 Milan, Italy; (M.F.); (G.M.T.)
| | - Gianluca Martino Tartaglia
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, UOC Maxillo-Facial Surgery and Dentistry, Fondazione IRCCS Ca Granda, Ospedale Maggiore Policlinico, 20100 Milan, Italy; (M.F.); (G.M.T.)
| | - Ciro Gargiulo Isacco
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (C.G.I.); (G.M.); (M.T.D.); (D.H.); (L.S.); (F.I.); (G.D.)
- Human Stem Cells Research Center HSC of Ho Chi Minh, Ho Chi Minh 70000, Vietnam
- Embryology and Regenerative Medicine and Immunology, Pham Chau Trinh University of Medicine Hoi An, Hoi An 70000, Vietnam
| | - Grazia Marinelli
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (C.G.I.); (G.M.); (M.T.D.); (D.H.); (L.S.); (F.I.); (G.D.)
| | - Maria Teresa D’Oria
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (C.G.I.); (G.M.); (M.T.D.); (D.H.); (L.S.); (F.I.); (G.D.)
- Department of Medical and Biological Sciences, Via delle Scienze, Università degli Studi di Udine, 206, 33100 Udine, Italy
| | - Denisa Hazballa
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (C.G.I.); (G.M.); (M.T.D.); (D.H.); (L.S.); (F.I.); (G.D.)
- Kongresi Elbasanit, Rruga: Aqif Pasha, 3001 Elbasan, Albania
| | - Luigi Santacroce
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (C.G.I.); (G.M.); (M.T.D.); (D.H.); (L.S.); (F.I.); (G.D.)
| | - Andrea Ballini
- Department of Biosciences, Biotechnologies and Biopharmaceutics, Campus Universitario, University of Bari, 70125 Bari, Italy;
- Department of Precision Medicine, University of Campania, 80138 Naples, Italy
| | - Maria Contaldo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi de Crecchio, 6, 80138 Naples, Italy;
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (C.G.I.); (G.M.); (M.T.D.); (D.H.); (L.S.); (F.I.); (G.D.)
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (C.G.I.); (G.M.); (M.T.D.); (D.H.); (L.S.); (F.I.); (G.D.)
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20
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Jain N, Kaur S, Kopsachilis N, Zia R. Risk of Airborne COVID-19 Transmission While Performing Humphrey Visual Field Testing. J Glaucoma 2021; 30:219-222. [PMID: 33394847 DOI: 10.1097/ijg.0000000000001771] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 12/08/2020] [Indexed: 01/13/2023]
Abstract
PRECIS Designing and demonstrating an experiment that shows the risk of airborne transmission of COVID-19 between patients having visual fields analyzed is low. PURPOSE The aim was to investigate the possibility of airborne transmission of COVID-19 during Humphrey visual field testing in a real-world scenario. METHODS A particle counter was placed within the bowl of Humphrey visual field analyzer (HFA) before and after turning on the machine to ascertain the effect of the air current produced by the ventilation system on aerosols. A second experiment was run where the particle counter was placed in the bowl and recorded particulates, in the air, as a 24-2 SITA standard was performed by a mock patient and then again immediately after the patient had moved away. We measured aerosol particle counts sized ≤0.3 μm, >0.3≤0.5 μm, >0.5≤1 μm, >1≤2.5 μm, >2.5≤5 μm, and >5≤10 μm. RESULTS Particulates of all sizes were shown to be significantly reduced within the bowl after turning the machine on, demonstrating that the air current produced by the HFA pushes air out of the bowl and it cannot stagnate. There was no significant difference in measurement of aerosol while there was a patient performing the test and immediately after they had moved away, suggesting that aerosols breathed out by the patient are not able to remain in suspension in the bowl because of the ventilation current. CONCLUSION There is no significant difference between aerosol count in the bowl of a HFA before, during and after testing. This suggests the risk of airborne transmission of COVID-19 is low between subsequent patients. This is in keeping with manufacturer's guidance on Humphrey visual field testing.
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Affiliation(s)
- Nikhil Jain
- University College Hospitals NHS Foundation Trust, London
| | - Simerdip Kaur
- East Kent Hospitals NHS Foundation Trust, Kent and Canterbury Hospital Ethelbert Road, Canterbury
| | - Nikolaos Kopsachilis
- East Kent Hospitals NHS Foundation Trust, Kent and Canterbury Hospital Ethelbert Road, Canterbury
- New Hayesbank Ophthalmology Services, Cemetery Lane, Kennington, Kent, UK
| | - Rashid Zia
- East Kent Hospitals NHS Foundation Trust, Kent and Canterbury Hospital Ethelbert Road, Canterbury
- New Hayesbank Ophthalmology Services, Cemetery Lane, Kennington, Kent, UK
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21
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Wang G, Luo FM, Liu D, Liu JS, Wang Y, Chen H, Tian PW, Fan T, Tang L, Yu H, Wang L, Feng M, Ni Z, Wang B, Song ZF, Wu XL, Wang HJ, Tong X, Xue M, Lei XY, Long B, Jia C, Xiao J, Shang J, Xiong N, Luo JF, Liang ZA, Li WM. Differences in the clinical characteristics and outcomes of COVID-19 patients in the epicenter and peripheral areas of the pandemic from China: a retrospective, large-sample, comparative analysis. BMC Infect Dis 2021; 21:206. [PMID: 33627072 PMCID: PMC7903397 DOI: 10.1186/s12879-020-05728-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 12/21/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND There is limited information on the difference in epidemiology, clinical characteristics and outcomes of the initial outbreak of the coronavirus disease (COVID-19) in Wuhan (the epicenter) and Sichuan (the peripheral area) in the early phase of the COVID-19 pandemic. This study was conducted to investigate the differences in the epidemiological and clinical characteristics of patients with COVID-19 between the epicenter and peripheral areas of pandemic and thereby generate information that would be potentially helpful in formulating clinical practice recommendations to tackle the COVID-19 pandemic. METHODS The Sichuan & Wuhan Collaboration Research Group for COVID-19 established two retrospective cohorts that separately reflect the epicenter and peripheral area during the early pandemic. The epidemiology, clinical characteristics and outcomes of patients in the two groups were compared. Multivariate regression analyses were used to estimate the adjusted odds ratios (aOR) with regard to the outcomes. RESULTS The Wuhan (epicenter) cohort included 710 randomly selected patients, and the peripheral (Sichuan) cohort included 474 consecutive patients. A higher proportion of patients from the periphery had upper airway symptoms, whereas a lower proportion of patients in the epicenter had lower airway symptoms and comorbidities. Patients in the epicenter had a higher risk of death (aOR=7.64), intensive care unit (ICU) admission (aOR=1.66), delayed time from illness onset to hospital and ICU admission (aOR=6.29 and aOR=8.03, respectively), and prolonged duration of viral shedding (aOR=1.64). CONCLUSIONS The worse outcomes in the epicenter could be explained by the prolonged time from illness onset to hospital and ICU admission. This could potentially have been associated with elevated systemic inflammation secondary to organ dysfunction and prolonged duration of virus shedding independent of age and comorbidities. Thus, early supportive care could achieve better clinical outcomes.
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Affiliation(s)
- Gang Wang
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-related Molecular Network, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Feng Ming Luo
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-related Molecular Network, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Dan Liu
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Jia Sheng Liu
- Department of Gastrointestinal Surgery, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, China
| | - Ye Wang
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Hong Chen
- Department of Critical Care Medicine, Public Health Clinical Center of Chengdu, Chengdu, 610061, Sichuan, China
| | - Pan Wen Tian
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Tao Fan
- Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Li Tang
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - He Yu
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Lan Wang
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Mei Feng
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Zhong Ni
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Bo Wang
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Zhi Fang Song
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Xiao Ling Wu
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Hong Jun Wang
- Department of Respiratory Medicine, Dazhou Central Hospital, Dazhou, 635000, Sichuan, China
| | - Xiang Tong
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Miao Xue
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Xian Ying Lei
- Department of Critical Care Medicine, Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Bo Long
- Mianyang 404 Hospital, Mianyang, 621000, Sichuan, China
| | - Chao Jia
- Department of Critical Care Medicine, Mianyang Central Hospital, Mianyang, 621000, Sichuan, China
| | - Jun Xiao
- Department of Respiratory and Critical Care Medicine, People's Hospital of Ganzi Prefecture, Ganzi, 626700, Sichuan, China
| | - Juan Shang
- Department of Critical Care Medicine, Nanchong Central Hospital, Nanchong, 637000, Sichuan, China
| | - Nian Xiong
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China.
- Wuhan Red Cross Hospital, Wuhan, 430015, Hubei, China.
| | - Jian Fei Luo
- Department of Gastrointestinal Surgery, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, China.
| | - Zong An Liang
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
| | - Wei Min Li
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
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22
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Ronca SE, Sturdivant RX, Barr KL, Harris D. SARS-CoV-2 Viability on 16 Common Indoor Surface Finish Materials. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2021; 14:49-64. [PMID: 33618545 DOI: 10.1177/1937586721991535] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIM This study investigated the stability of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on 16 common environmental surface materials. BACKGROUND SARS-CoV-2 is the causative agent of severe coronavirus disease, a significant public health concern that quickly led to a pandemic. Contamination of environmental surface materials is of concern, with previous studies identifying long-term detection of infectious particles on surfaces. These contaminated surfaces create an increased risk for contact transmission. METHODS Surface materials were inoculated with 10,000 plaque forming units and samples were collected 4, 8, 12, 24, 30, 48, and 168 hours post infection (hpi). Viral titers were determined for each sample and time point using plaque assays. Nonparametric modeling utilized the Turnbull algorithm for interval-censored data. Maximum likelihood estimates for the survival curve were calculated. Parametric proportional hazards regression models for interval censored data were used to explore survival time across the surface materials. RESULTS There was a sharp decline in recoverable virus after 4 hpi for all tested surfaces. By 12 hpi, infectious SARS-CoV-2 was recoverable from only four surfaces; and by 30 hr, the virus was recoverable from only one surface. There were differences in survival curves based on the materials although some groups of materials are similar, both statistically and practically. CONCLUSIONS While very low amounts of infectious SARS-CoV-2 are recoverable over time, there remains a risk of viral transmission by surface contamination in indoor environments. Individuals and institutions must follow appropriate procedures to decontaminate indoor environment and increase diligence for hand hygiene and personal protective equipment.
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Affiliation(s)
- Shannon E Ronca
- Department of Pediatrics, National School of Tropical Medicine, 3989Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | | | - Kelli L Barr
- Department of Biology, 14643Baylor University, Waco, TX, USA
| | - Debra Harris
- Department of Human Sciences and Design, 14643Baylor University, Waco, TX, USA
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23
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Fernández-Raga M, Díaz-Marugán L, García Escolano M, Bort C, Fanjul V. SARS-CoV-2 viability under different meteorological conditions, surfaces, fluids and transmission between animals. ENVIRONMENTAL RESEARCH 2021; 192:110293. [PMID: 33017611 PMCID: PMC7531924 DOI: 10.1016/j.envres.2020.110293] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/28/2020] [Accepted: 09/29/2020] [Indexed: 05/17/2023]
Abstract
Since the COVID-19 outbreak, researchers have tried to characterise the novel coronavirus SARS-CoV-2 to better understand the pathogenic mechanisms of the virus and prevent further dissemination. As a consequence, there has been a bloom in scientific research papers focused on the behaviour of the virus in different environmental contexts. Nevertheless, despite these efforts and due to its novelty, available information about this coronavirus is limited, as several research studies are still ongoing. This review aims to shed light on this issue. To that end, we have examined the scientific literature to date regarding the viability of SARS-CoV-2 on surfaces and fluids or under different environmental conditions (temperature, precipitation and UV radiation). We have also addressed the role of animals in the transmission of this coronavirus.
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Affiliation(s)
- María Fernández-Raga
- IMARENAB, Applied Chemical and Physics Department, University of León, Spain; Celera Talent Association, Madrid, Spain.
| | | | - Marta García Escolano
- Celera Talent Association, Madrid, Spain; Prospera Biotech. Scientific Park Universitas Miguel Hernández, Elche, Spain
| | - Carlos Bort
- Celera Talent Association, Madrid, Spain; Xplore.ai, Madrid, Spain
| | - Víctor Fanjul
- Celera Talent Association, Madrid, Spain; Data Team, Savana Medica, Madrid, Spain
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24
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Jarvis MC. Aerosol Transmission of SARS-CoV-2: Physical Principles and Implications. Front Public Health 2020; 8:590041. [PMID: 33330334 PMCID: PMC7719704 DOI: 10.3389/fpubh.2020.590041] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 10/30/2020] [Indexed: 12/23/2022] Open
Abstract
Evidence has emerged that SARS-CoV-2, the coronavirus that causes COVID-19, can be transmitted airborne in aerosol particles as well as in larger droplets or by surface deposits. This minireview outlines the underlying aerosol science, making links to aerosol research in other disciplines. SARS-CoV-2 is emitted in aerosol form during normal breathing by both asymptomatic and symptomatic people, remaining viable with a half-life of up to about an hour during which air movement can carry it considerable distances, although it simultaneously disperses. The proportion of the droplet size distribution within the aerosol range depends on the sites of origin within the respiratory tract and on whether the distribution is presented on a number or volume basis. Evaporation and fragmentation reduce the size of the droplets, whereas coalescence increases the mean droplet size. Aerosol particles containing SARS-CoV-2 can also coalesce with pollution particulates, and infection rates correlate with pollution. The operation of ventilation systems in public buildings and transportation can create infection hazards via aerosols, but provides opportunities for reducing the risk of transmission in ways as simple as switching from recirculated to outside air. There are also opportunities to inactivate SARS-CoV-2 in aerosol form with sunlight or UV lamps. The efficiency of masks for blocking aerosol transmission depends strongly on how well they fit. Research areas that urgently need further experimentation include the basis for variation in droplet size distribution and viral load, including droplets emitted by "superspreader" individuals; the evolution of droplet sizes after emission, their interaction with pollutant aerosols and their dispersal by turbulence, which gives a different basis for social distancing.
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25
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Zuber S, Brüssow H. COVID 19: challenges for virologists in the food industry. Microb Biotechnol 2020; 13:1689-1701. [PMID: 32700430 PMCID: PMC7404336 DOI: 10.1111/1751-7915.13638] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 07/08/2020] [Indexed: 12/23/2022] Open
Abstract
The COVID-19 pandemic is not only a challenge for public health and hospitals, but affects many aspects of our societies. This Lilliput minireview deals with problems that the pandemic causes for the food industry, addressing the presence and persistence of SARS-CoV-2 in the food environment, methods of virus inactivation and the protection of the food worker and the consumer. So far food has not been implicated in the transmission of the infection, but social disruptions caused by the pandemic could cause problems with food security.
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Affiliation(s)
- Sophie Zuber
- Institute of Food Safety and Analytical ScienceNestlé ResearchLausanne 261000Switzerland
| | - Harald Brüssow
- Department of BiosystemsLaboratory of Gene TechnologyKU LeuvenLeuvenBelgium
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26
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Kanodia A, Srigyan D, Sikka K, Choudhary A, Choudekar A, Mittal S, Bhopale SA, Dar L, Thakar A. Topical lignocaine anaesthesia for oropharyngeal sampling for COVID-19. Eur Arch Otorhinolaryngol 2020; 278:1669-1673. [PMID: 33001294 PMCID: PMC7528153 DOI: 10.1007/s00405-020-06402-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 09/23/2020] [Indexed: 01/20/2023]
Abstract
OBJECTIVES To ascertain if topical lignocaine application in oropharynx prior to swab sampling to test for COVID-19 improves a patient's comfort and to assess its effect on the swab sample taken to conduct the RT-PCR. METHODS Adult patients testing positive on the RT-PCR COVID-19 test were sampled again within 48 h after administering topical oropharyngeal anaesthesia. Patients were asked to rate their discomfort on a visual analog scale (VAS) for both sample A and B. A qualitative real-time RT-PCR for detection of SARS-CoV-2 RNA, was performed, and the cycle threshold value (Ct), used as a surrogate marker for the viral load, was measured for the sample taken without lignocaine (sample A) and the sample taken post-lignocaine application (sample B). The difference in Ct values of both the groups was checked for any statistical significance using paired t-test. Wilcoxon signed rank test was used on VAS scores to determine any significant decrease in discomfort. RESULTS Forty patients were included in the study. Twenty-nine patients (72.5%) reported the procedure to be more comfortable post-lignocaine application. Median (IQR) discomfort on VAS decreased from 7 (1) to 5 (2) after lignocaine use, which was statistically significant (p < 0.05). Mean Ct value for sample A was 17.21 ± 5.25 and for sample B was 18.44 ± 4.8 (p > 0.05), indicating a non-significant effect of lignocaine on SARS-CoV-2 concentration in the sample. CONCLUSION Topical lignocaine, while improving the comfort of the procedure of oropharyngeal sampling for patient did not alter the SARS-CoV-2 viral load that was detected in nasal and oropharyngeal samples taken together.
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Affiliation(s)
- Anupam Kanodia
- Department of Otorhinolaryngology and Head- Neck Surgery, Room No 4057, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, Delhi, 110029, India
| | - Deepankar Srigyan
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Kapil Sikka
- Department of Otorhinolaryngology and Head- Neck Surgery, Room No 4057, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, Delhi, 110029, India.
| | - Aashish Choudhary
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Avinash Choudekar
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Saurabh Mittal
- Department of Pulmonary, Critical and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Shweta Arun Bhopale
- Department of Oncoanesthesia and Palliative Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Lalit Dar
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Alok Thakar
- Department of Otorhinolaryngology and Head- Neck Surgery, Room No 4057, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, Delhi, 110029, India
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27
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Ruiz‐Hitzky E, Darder M, Wicklein B, Ruiz‐Garcia C, Martín‐Sampedro R, del Real G, Aranda P. Nanotechnology Responses to COVID-19. Adv Healthc Mater 2020; 9:e2000979. [PMID: 32885616 DOI: 10.1002/adhm.202000979] [Citation(s) in RCA: 87] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/24/2020] [Indexed: 12/12/2022]
Abstract
Researchers, engineers, and medical doctors are made aware of the severity of the COVID-19 infection and act quickly against the coronavirus SARS-CoV-2 using a large variety of tools. In this review, a panoply of nanoscience and nanotechnology approaches show how these disciplines can help the medical, technical, and scientific communities to fight the pandemic, highlighting the development of nanomaterials for detection, sanitation, therapies, and vaccines. SARS-CoV-2, which can be regarded as a functional core-shell nanoparticle (NP), can interact with diverse materials in its vicinity and remains attached for variable times while preserving its bioactivity. These studies are critical for the appropriate use of controlled disinfection systems. Other nanotechnological approaches are also decisive for the development of improved novel testing and diagnosis kits of coronavirus that are urgently required. Therapeutics are based on nanotechnology strategies as well and focus on antiviral drug design and on new nanoarchitectured vaccines. A brief overview on patented work is presented that emphasizes nanotechnology applied to coronaviruses. Finally, some comments are made on patents of the initial technological responses to COVID-19 that have already been put in practice.
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Affiliation(s)
- Eduardo Ruiz‐Hitzky
- Materials Science Institute of Madrid ICMM‐CSIC c/ Sor Juana Inés de la Cruz 3 Madrid 28049 Spain
| | - Margarita Darder
- Materials Science Institute of Madrid ICMM‐CSIC c/ Sor Juana Inés de la Cruz 3 Madrid 28049 Spain
| | - Bernd Wicklein
- Materials Science Institute of Madrid ICMM‐CSIC c/ Sor Juana Inés de la Cruz 3 Madrid 28049 Spain
| | | | - Raquel Martín‐Sampedro
- Materials Science Institute of Madrid ICMM‐CSIC c/ Sor Juana Inés de la Cruz 3 Madrid 28049 Spain
- National Institute of Agricultural and Food Research INIA Ctra. de la Coruña Km 7.5 Madrid 28040 Spain
| | - Gustavo del Real
- National Institute of Agricultural and Food Research INIA Ctra. de la Coruña Km 7.5 Madrid 28040 Spain
| | - Pilar Aranda
- Materials Science Institute of Madrid ICMM‐CSIC c/ Sor Juana Inés de la Cruz 3 Madrid 28049 Spain
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28
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Agarwal A, Basmaji J, Muttalib F, Granton D, Chaudhuri D, Chetan D, Hu M, Fernando SM, Honarmand K, Bakaa L, Brar S, Rochwerg B, Adhikari NK, Lamontagne F, Murthy S, Hui DSC, Gomersall C, Mubareka S, Diaz JV, Burns KEA, Couban R, Ibrahim Q, Guyatt GH, Vandvik PO. High-flow nasal cannula for acute hypoxemic respiratory failure in patients with COVID-19: systematic reviews of effectiveness and its risks of aerosolization, dispersion, and infection transmission. Can J Anaesth 2020; 67:1217-1248. [PMID: 32542464 PMCID: PMC7294988 DOI: 10.1007/s12630-020-01740-2] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 05/20/2020] [Accepted: 05/20/2020] [Indexed: 01/03/2023] Open
Abstract
PURPOSE We conducted two World Health Organization-commissioned reviews to inform use of high-flow nasal cannula (HFNC) in patients with coronavirus disease (COVID-19). We synthesized the evidence regarding efficacy and safety (review 1), as well as risks of droplet dispersion, aerosol generation, and associated transmission (review 2) of viral products. SOURCE Literature searches were performed in Ovid MEDLINE, Embase, Web of Science, Chinese databases, and medRxiv. Review 1: we synthesized results from randomized-controlled trials (RCTs) comparing HFNC to conventional oxygen therapy (COT) in critically ill patients with acute hypoxemic respiratory failure. Review 2: we narratively summarized findings from studies evaluating droplet dispersion, aerosol generation, or infection transmission associated with HFNC. For both reviews, paired reviewers independently conducted screening, data extraction, and risk of bias assessment. We evaluated certainty of evidence using GRADE methodology. PRINCIPAL FINDINGS No eligible studies included COVID-19 patients. Review 1: 12 RCTs (n = 1,989 patients) provided low-certainty evidence that HFNC may reduce invasive ventilation (relative risk [RR], 0.85; 95% confidence interval [CI], 0.74 to 0.99) and escalation of oxygen therapy (RR, 0.71; 95% CI, 0.51 to 0.98) in patients with respiratory failure. Results provided no support for differences in mortality (moderate certainty), or in-hospital or intensive care length of stay (moderate and low certainty, respectively). Review 2: four studies evaluating droplet dispersion and three evaluating aerosol generation and dispersion provided very low certainty evidence. Two simulation studies and a crossover study showed mixed findings regarding the effect of HFNC on droplet dispersion. Although two simulation studies reported no associated increase in aerosol dispersion, one reported that higher flow rates were associated with increased regions of aerosol density. CONCLUSIONS High-flow nasal cannula may reduce the need for invasive ventilation and escalation of therapy compared with COT in COVID-19 patients with acute hypoxemic respiratory failure. This benefit must be balanced against the unknown risk of airborne transmission.
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Affiliation(s)
- Arnav Agarwal
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - John Basmaji
- Division of Critical Care, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Fiona Muttalib
- Centre for Global Child Health, Hospital for Sick Children, Toronto, ON, Canada
| | - David Granton
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | | | - Devin Chetan
- Department of Pediatrics, University of Toronto, Toronto, ON, Canada
- Division of Cardiology, Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, ON, Canada
| | - Malini Hu
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | - Shannon M Fernando
- Division of Critical Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada
- Department of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Kimia Honarmand
- Division of Critical Care, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Schulich School of Medicine and Dentistry, Department of Medicine, Western University, London, ON, Canada
| | - Layla Bakaa
- Honours Life Sciences Program, Faculty of Science, McMaster University, Hamilton, ON, Canada
| | - Sonia Brar
- School of Medicine and Biomedical Sciences, University of Buffalo, Buffalo, NY, USA
| | - Bram Rochwerg
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
- Department of Medicine, McMaster University, Hamilton, ON, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Neill K Adhikari
- Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada
| | - Francois Lamontagne
- Université de Sherbrooke, Sherbrooke, Canada
- Centre de recherche du CHU de Sherbrooke, Sherbrooke, QC, Canada
| | - Srinivas Murthy
- BC Children's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - David S C Hui
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong, SAR, China
- Stanley Ho, Center for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong, SAR, China
| | - Charles Gomersall
- Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Samira Mubareka
- Division of Infectious Diseases, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Janet V Diaz
- Pacific Medical Center, San Francisco, CA, USA
- World Health Organization, Geneva, Switzerland
| | - Karen E A Burns
- Unity Health Toronto - St. Michael's Hospital, Toronto, ON, Canada
- University of Toronto, Toronto, ON, Canada
- Li Ka Shing Knowledge Institute, Toronto, ON, Canada
| | - Rachel Couban
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
- Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, ON, Canada
| | - Quazi Ibrahim
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Gordon H Guyatt
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
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Machhi J, Herskovitz J, Senan AM, Dutta D, Nath B, Oleynikov MD, Blomberg WR, Meigs DD, Hasan M, Patel M, Kline P, Chang RCC, Chang L, Gendelman HE, Kevadiya BD. The Natural History, Pathobiology, and Clinical Manifestations of SARS-CoV-2 Infections. J Neuroimmune Pharmacol 2020; 15:359-386. [PMID: 32696264 PMCID: PMC7373339 DOI: 10.1007/s11481-020-09944-5] [Citation(s) in RCA: 319] [Impact Index Per Article: 79.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 07/08/2020] [Indexed: 02/06/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the etiological agent of coronavirus disease 2019 (COVID-19). SARS-CoV-2, is a positive-sense single-stranded RNA virus with epithelial cell and respiratory system proclivity. Like its predecessor, SARS-CoV, COVID-19 can lead to life-threatening disease. Due to wide geographic impact affecting an extremely high proportion of the world population it was defined by the World Health Organization as a global public health pandemic. The infection is known to readily spread from person-to-person. This occurs through liquid droplets by cough, sneeze, hand-to-mouth-to-eye contact and through contaminated hard surfaces. Close human proximity accelerates SARS-CoV-2 spread. COVID-19 is a systemic disease that can move beyond the lungs by blood-based dissemination to affect multiple organs. These organs include the kidney, liver, muscles, nervous system, and spleen. The primary cause of SARS-CoV-2 mortality is acute respiratory distress syndrome initiated by epithelial infection and alveolar macrophage activation in the lungs. The early cell-based portal for viral entry is through the angiotensin-converting enzyme 2 receptor. Viral origins are zoonotic with genomic linkages to the bat coronaviruses but without an identifiable intermediate animal reservoir. There are currently few therapeutic options, and while many are being tested, although none are effective in curtailing the death rates. There is no available vaccine yet. Intense global efforts have targeted research into a better understanding of the epidemiology, molecular biology, pharmacology, and pathobiology of SARS-CoV-2. These fields of study will provide the insights directed to curtailing this disease outbreak with intense international impact. Graphical Abstract.
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Affiliation(s)
- Jatin Machhi
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, Omaha, NE, 68198-5880, USA
| | - Jonathan Herskovitz
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, Omaha, NE, 68198-5880, USA
- Department of Pathology and Microbiology, College of Medicine, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Ahmed M Senan
- Glycomics and Glycan Bioengineering Research Center (GGBRC), College of Food Science and Technology, Nanjing Agricultural University, Nanjing, 20095, China
| | - Debashis Dutta
- Department of Immunology and Microbiology, The Scripps Research Institute, Jupiter, FL, 33458, USA
| | - Barnali Nath
- Viral Immunology Lab, Indian Institute of Technology Guwahati, Guwahati, Assam, 781039, India
| | - Maxim D Oleynikov
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, Omaha, NE, 68198-5880, USA
| | - Wilson R Blomberg
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, Omaha, NE, 68198-5880, USA
| | - Douglas D Meigs
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, Omaha, NE, 68198-5880, USA
| | - Mahmudul Hasan
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Milankumar Patel
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, Omaha, NE, 68198-5880, USA
| | - Peter Kline
- SARS-CoV-2 Patient Survivor, Chicago, IL, 60204, USA
| | - Raymond Chuen-Chung Chang
- Laboratory of Neurodegenerative Diseases, School of Biomedical Sciences, LKS Faculty of Medicine, and State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, SAR, China
| | - Linda Chang
- University of Maryland, School of Medicine, Baltimore, MD, 21201, USA
| | - Howard E Gendelman
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, Omaha, NE, 68198-5880, USA.
- Department of Pathology and Microbiology, College of Medicine, University of Nebraska Medical Center, Omaha, NE, 68198, USA.
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, Omaha, NE, 68198, USA.
| | - Bhavesh D Kevadiya
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, Omaha, NE, 68198-5880, USA.
- Interventional Regenerative Medicine and Imaging Laboratory, Department of Radiology, Stanford University, Palo Alto, CA, 94304, USA.
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30
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Licina A, Silvers A, Stuart RL. Use of powered air-purifying respirator (PAPR) by healthcare workers for preventing highly infectious viral diseases-a systematic review of evidence. Syst Rev 2020; 9:173. [PMID: 32771035 PMCID: PMC7414632 DOI: 10.1186/s13643-020-01431-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 07/23/2020] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Healthcare workers (HCWs) are at particular risk during pandemics and epidemics of highly virulent diseases with significant morbidity and case fatality rate. These diseases include severe acute respiratory syndrome coronaviruses, SARS-CoV-1 and SARS-CoV-2, Middle Eastern Respiratory Syndrome (MERS), and Ebola. With the current (SARS-CoV-2) global pandemic, it is critical to delineate appropriate contextual respiratory protection for HCWs. The aim of this systematic review was to evaluate the effect of powered air-purifying respirators (PAPRs) as part of respiratory protection versus another device (egN95/FFP2) on HCW infection rates and contamination. METHODS Our primary outcomes included HCW infection rates with SARS-CoV-2, SARS-CoV-1, Ebola, or MERS when utilizing PAPR. We included randomized controlled trials, non-randomized controlled trials, and observational studies. We searched the following databases: MEDLINE, EMBASE, and Cochrane Library (Cochrane Database of Systematic Reviews and CENTRAL). Two reviewers independently screened all citations, full-text articles, and abstracted data. Due to clinical and methodological heterogeneity, we did not conduct a meta-analysis. Where applicable, we constructed evidence profile (EP) tables for each individual outcome. Confidence in cumulative evidence for each outcome was classified according to the GRADE system. RESULTS We identified 689 studies during literature searches. We included 10 full-text studies. A narrative synthesis was provided. Two on-field studies reported no difference in the rates of healthcare workers performing airway procedures during the care of critical patients with SARS-CoV-2. A single simulation trial reported a lower level of cross-contamination of participants using PAPR compared to alternative respiratory protection. There is moderate quality evidence that PAPR use is associated with greater heat tolerance but lower scores for mobility and communication ability. We identified a trend towards greater self-reported wearer comfort with PAPR technology in low-quality observational simulation studies. CONCLUSION Field observational studies do not indicate a difference in healthcare worker infection utilizing PAPR devices versus other compliant respiratory equipment. Greater heat tolerance accompanied by lower scores of mobility and audibility in PAPR was identified. Further pragmatic studies are needed in order to delineate actual effectiveness and provider satisfaction with PAPR technology. SYSTEMATIC REVIEW REGISTRATION The protocol for this review was prospectively registered with the International Register of Systematic Reviews identification number CRD42020184724 .
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Affiliation(s)
| | - Andrew Silvers
- Monash Medical Centre, Clayton, Australia
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria Australia
| | - Rhonda L. Stuart
- Infection Prevention & Epidemiology, Monash Health, Clayton, Victoria Australia
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31
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Ha JF. The COVID-19 pandemic and face shields. Br J Surg 2020; 107:e398. [PMID: 32735688 PMCID: PMC7929265 DOI: 10.1002/bjs.11842] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 06/03/2020] [Indexed: 11/23/2022]
Affiliation(s)
- J F Ha
- Department of Paediatrics Otolaryngology Head & Neck Surgery, Perth Children's Hospital, 15 Hospital Avenue, Nedlands, 6009, Western Australia, Australia.,Murdoch ENT, Wexford Medical Center, Suite 17-18, Level 1, 3 Barry Marshall Parade, Murdoch, 6150, Western Australia, Australia.,Department of Surgery, University of Western Australia, Stirling Highway, Nedlands, 6009, Western Australia, Australia
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Tsilingiris D, Papatheodoridi M, Kapelios CJ. Providing evidence on the ongoing health care workers' mask debate. Intern Emerg Med 2020; 15:773-777. [PMID: 32468509 PMCID: PMC7255970 DOI: 10.1007/s11739-020-02382-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 05/18/2020] [Indexed: 01/20/2023]
Abstract
The scarcity of facemasks, particularly N95 respirators, combined with the lack of solid data to address the suitability of each mask type for adequate health care worker (HCW) protection have caused turmoil among HCWs. Current recommendations suggest mask usage solely during HCW contact with Covid-19 patients, namely plain medical mask for low-risk contacts and N95 for aerosol generating procedures. The distinction regarding the escalation of mask complexity depending on contact type is nevertheless based on plausible theoretical assumptions rather than hard evidence of a clear benefit. Conversely, we suggest that at least a plain mask should be used during all HCWs' contacts in healthcare facilities which constitute a highly probable but often overlooked means of SARS-CoV-2 transmission among HCWs.
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Affiliation(s)
- Dimitrios Tsilingiris
- First Department of Propaedeutic Internal Medicine, Laiko General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Margarita Papatheodoridi
- Institute of Liver and Digestive Health, School of Life and Medical Sciences, Royal Free Hospital, University College London, London, UK
| | - Chris J Kapelios
- Cardiology Department, Laiko General Hospital, 17 Agiou Thoma Street, 11 527, Athens, Greece.
- Department of Health Policy, The London School of Economics and Political Science, London, UK.
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D’Marco L, Puchades MJ, Romero-Parra M, Gimenez-Civera E, Soler MJ, Ortiz A, Gorriz JL. Coronavirus disease 2019 in chronic kidney disease. Clin Kidney J 2020; 13:297-306. [PMID: 32699615 PMCID: PMC7367105 DOI: 10.1093/ckj/sfaa104] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Indexed: 01/04/2023] Open
Abstract
The clinical spectrum of coronavirus disease 2019 (COVID-19) infection ranges from asymptomatic infection to severe pneumonia with respiratory failure and even death. More severe cases with higher mortality have been reported in older patients and in those with chronic illness such as hypertension, diabetes or cardiovascular diseases. In this regard, patients with chronic kidney disease (CKD) have a higher rate of all-type infections and cardiovascular disease than the general population. A markedly altered immune system and immunosuppressed state may predispose CKD patients to infectious complications. Likewise, they have a state of chronic systemic inflammation that may increase their morbidity and mortality. In this review we discuss the chronic immunologic changes observed in CKD patients, the risk of COVID-19 infections and the clinical implications for and specific COVID-19 therapy in CKD patients. Indeed, the risk for severe COVID-19 is 3-fold higher in CKD than in non-CKD patients; CKD is 12-fold more frequent in intensive care unit than in non-hospitalized COVID-19 patients, and this ratio is higher than for diabetes or cardiovascular disease; and acute COVID-19 mortality is 15-25% for haemodialysis patients even when not developing pneumonia.
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Affiliation(s)
- Luis D’Marco
- Nephrology Department, Hospital Clínico Universitario, INCLIVA, Universidad de Valencia, Valencia, Spain
| | - María Jesús Puchades
- Nephrology Department, Hospital Clínico Universitario, INCLIVA, Universidad de Valencia, Valencia, Spain
| | - María Romero-Parra
- Nephrology Department, Hospital Clínico Universitario, INCLIVA, Universidad de Valencia, Valencia, Spain
| | - Elena Gimenez-Civera
- Nephrology Department, Hospital Clínico Universitario, INCLIVA, Universidad de Valencia, Valencia, Spain
| | - María José Soler
- Nephrology Department, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Alberto Ortiz
- IIS-Fundación Jiménez Diaz UAM and School of Medicine, Universidad Autonoma de Madrid, Madrid, Spain
| | - José Luis Gorriz
- Nephrology Department, Hospital Clínico Universitario, INCLIVA, Universidad de Valencia, Valencia, Spain
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The risk of COVID-19 transmission by laparoscopic smoke may be lower than for laparotomy: a narrative review. Surg Endosc 2020; 34:3298-3305. [PMID: 32458289 PMCID: PMC7250491 DOI: 10.1007/s00464-020-07652-y] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 05/13/2020] [Indexed: 12/15/2022]
Abstract
Background Surgical smoke is a well-recognized hazard in the operating room. At the beginning of the COVID-19 pandemic, surgical societies quickly published guidelines recommending avoiding laparoscopy or to consider open surgery because of the fear of transmission of SARS-CoV-2 through surgical smoke or aerosol. This narrative review of the literature aimed to determine whether there are any differences in the creation of surgical smoke/aerosol between laparoscopy and laparotomy and if laparoscopy may be safer than laparotomy. Methods A literature search was performed using the Pubmed, Embase and Google scholar search engines, as well as manual search of the major journals with specific COVID-19 sections for ahead-of-print publications. Results Of 1098 identified articles, we critically appraised 50. Surgical smoke created by electrosurgical and ultrasonic devices has the same composition both in laparoscopy and laparotomy. SARS-CoV-2 has never been found in surgical smoke and there is currently no data to support its virulence if ever it could be transmitted through surgical smoke/aerosol. Conclusion If laparoscopy is performed in a closed cavity enabling containment of surgical smoke/aerosol, and proper evacuation of smoke with simple measures is respected, and as long as laparoscopy is not contraindicated, we believe that this surgical approach may be safer for the operating team while the patient has the benefits of minimally invasive surgery. Evidence-based research in this field is needed for definitive determination of safety.
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Personal protective equipment (PPE) for both anesthesiologists and other airway managers: principles and practice during the COVID-19 pandemic. Can J Anaesth 2020; 67:1005-1015. [PMID: 32329014 PMCID: PMC7178924 DOI: 10.1007/s12630-020-01673-w] [Citation(s) in RCA: 110] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 04/09/2020] [Accepted: 04/12/2020] [Indexed: 01/25/2023] Open
Abstract
Healthcare providers are facing a coronavirus disease pandemic. This pandemic may last for many months, stressing the Canadian healthcare system in a way that has not previously been seen. Keeping healthcare providers safe, healthy, and available to work throughout this pandemic is critical. The consistent use of appropriate personal protective equipment (PPE) will help assure its availability and healthcare provider safety. The purpose of this communique is to give both anesthesiologists and other front-line healthcare providers a framework from which to understand the principles and practices surrounding PPE decision-making. We propose three types of PPE including: 1) PPE for droplet and contact precautions, 2) PPE for general airborne, droplet, and contact precautions, and 3) PPE for those performing or assisting with high-risk aerosol-generating medical procedures.
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Asenjo JF. Safer intubation and extubation of patients with COVID-19. Can J Anaesth 2020; 67:1276-1278. [PMID: 32323101 PMCID: PMC7175818 DOI: 10.1007/s12630-020-01666-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 04/07/2020] [Accepted: 04/13/2020] [Indexed: 12/11/2022] Open
Affiliation(s)
- Juan Francisco Asenjo
- Department of Anesthesia, The Montreal General Hospital, McGill University, Montreal, QC, Canada.
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37
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Matava CT, Yu J, Denning S. Clear plastic drapes may be effective at limiting aerosolization and droplet spray during extubation: implications for COVID-19. Can J Anaesth 2020; 67:902-904. [PMID: 32246431 PMCID: PMC7124129 DOI: 10.1007/s12630-020-01649-w] [Citation(s) in RCA: 86] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 03/25/2020] [Accepted: 03/25/2020] [Indexed: 11/01/2022] Open
Affiliation(s)
- Clyde T Matava
- Department of Anesthesia and Pain Medicine, Department of Anesthesia, Faculty of Medicine, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
| | - Julie Yu
- Department of Anesthesia and Pain Medicine, Department of Anesthesia, Faculty of Medicine, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Simon Denning
- Department of Anesthesia and Pain Medicine, Department of Anesthesia, Faculty of Medicine, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
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