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Dar-Odeh N, Bobamuratova DT, Alnazzawi A, Babkair H, Jambi S, Abu-Hammad A, Abu-Hammad O. Jaw-related complications in COVID-19 patients; a systematic review. Cranio 2024; 42:630-637. [PMID: 35083956 DOI: 10.1080/08869634.2022.2031438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The aim of this review was to highlight jaw-related complications in COVID-19 manifestations, their etiology, and prevention methods. METHODS A systematic review of literature was conducted. MEDLINE/PubMed, and Google Scholar were searched for the following keywords: "COVID-19" "Oral manifestations", "Musculoskeletal patients", "Mandible", "Jaw", "Osteonecrosis", "MRONJ", and "dry socket". RESULTS Only nine articles were included in this review. Jaw-related disorders associated with COVID-19 were dry socket, osteonecrosis, and orofacial pain related to temporomandibular joint disorders (TMD) and giant cell arteritis (GCA). CONCLUSION COVID-19 potentially predisposes to osteonecrosis due to thrombotic inflammatory phenomena caused by the disease itself or its therapeutic modalities. All jaw osteonecrosis cases reported so far in relation to COVID-19 affected the upper jaw. Orofacial pain in COVID-19 patients was related to TMD and GCA. Clinical evidence-based studies are required to investigate the actual prevalence and possible correlation between COVID-19 and jaw-related disorders.
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Affiliation(s)
- Najla Dar-Odeh
- College of Dentistry, Taibah University, Al Madinah Al Munawara, Saudi Arabia
- School of Dentistry, University of Jordan, Amman, Jordan
| | | | - Ahmad Alnazzawi
- College of Dentistry, Taibah University, Al Madinah Al Munawara, Saudi Arabia
| | - Hamzah Babkair
- College of Dentistry, Taibah University, Al Madinah Al Munawara, Saudi Arabia
| | - Safa Jambi
- College of Dentistry, Taibah University, Al Madinah Al Munawara, Saudi Arabia
| | | | - Osama Abu-Hammad
- College of Dentistry, Taibah University, Al Madinah Al Munawara, Saudi Arabia
- School of Dentistry, University of Jordan, Amman, Jordan
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Mosmann J, Frutos MC, Origlia JA, Gallo Vaulet ML, García MG, Vilar G, Pérez C, Madariaga MJ, Cuffini C, Cadario ME. Are Mycoplasma pneumoniae coinfections frequent in COVID-19 patients? A systematic review. Rev Argent Microbiol 2024; 56:258-264. [PMID: 38991918 DOI: 10.1016/j.ram.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 02/09/2024] [Accepted: 05/06/2024] [Indexed: 07/13/2024] Open
Abstract
Understanding the proportion of SARS-CoV-2 patients with Mycoplasmapneumoniae coinfection is crucial for treating patients suffering from coronavirus disease (COVID-19), help to ensure responsible use of antibiotics and minimize the negative consequences of overuse. In addition, this knowledge could have an impact on empirical antibiotic management guidelines for patients with COVID-19. This systematic review aimed to identify the prevalence of M. pneumoniae in patients with coronavirus disease 2019 (COVID-19). A bibliographic search of studies published in Spanish or English was conducted using the PubMed search engine. Fourteen articles from different continents (America, Asia and Europe) were included, involving a total of 5855 patients in these studies. The mean age of COVID-19 patients with M. pneumoniae was 48 years old (range 1-107), most of whom were male. The detection of laboratory-confirmed M. pneumoniae infection varied between 0 and 33.3%. Most of patients referred fever, cough, and dyspnea, and received empirical antibiotic treatment. Bacterial coinfection was not associated with increased ICU admission and mortality. The prevalence of coinfection showed extremely dissimilar figures according to the population studied and diagnostic criteria. However, it is important to develop Latin American studies, given the heterogeneity observed in the studies conducted in different countries. Standardized definitions should be developed in order to be able to assess the impact of coinfections in patients with a diagnosis of COVID-19.
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Affiliation(s)
- Jessica Mosmann
- Instituto de Virología, Dr. J.M. Vanella, Facultad de Ciencias Médicas - Universidad Nacional de Córdoba, Córdoba, Argentina.
| | - María Celia Frutos
- Instituto de Virología, Dr. J.M. Vanella, Facultad de Ciencias Médicas - Universidad Nacional de Córdoba, Córdoba, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina
| | - Javier Anibal Origlia
- Cátedra de Patología de Aves y Pilíferos, Facultad de Ciencias Veterinarias, Universidad Nacional de La Plata, La Plata, Argentina
| | - María Lucia Gallo Vaulet
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica, Cátedra de Microbiología Clínica, Buenos Aires, Argentina
| | - Miriam Gabriela García
- Laboratorio de Virología y Biología Molecular, Hospital Interzonal General Agudos Pedro Fiorito, Buenos Aires, Argentina
| | - Gabriela Vilar
- Departamento de Bacteriología, INEI-ANLIS Dr. Carlos G Malbrán, Ciudad Autónoma de Buenos Aires, Argentina
| | - Celeste Pérez
- Departamento de Bacteriología, INEI-ANLIS Dr. Carlos G Malbrán, Ciudad Autónoma de Buenos Aires, Argentina
| | - María Julia Madariaga
- Sección Serología y Pruebas Biológicas, Instituto de Zoonosis Luis Pasteur, Ciudad Autónoma de Buenos Aires, Argentina
| | - Cecilia Cuffini
- Instituto de Virología, Dr. J.M. Vanella, Facultad de Ciencias Médicas - Universidad Nacional de Córdoba, Córdoba, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina
| | - María Estela Cadario
- Departamento de Bacteriología, INEI-ANLIS Dr. Carlos G Malbrán, Ciudad Autónoma de Buenos Aires, Argentina; Departamento de Virología, INEI-ANLIS Dr. Carlos G Malbrán, Ciudad Autónoma de Buenos Aires, Argentina
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Chen M, Zhou Y, Jin S, Bai S, Tang X, Liu Q, Wang L, Ji R, Liu H, Zhong W, Chen Y, Fang D, Zhang J, Hua L. Changing clinical characteristics of pediatric inpatients with pneumonia during COVID-19 pandamic: a retrospective study. Ital J Pediatr 2024; 50:84. [PMID: 38650007 PMCID: PMC11036576 DOI: 10.1186/s13052-024-01651-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 04/07/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic have impacts on the prevalence of other pathogens and people's social lifestyle. This study aimed to compare the pathogen, allergen and micronutrient characteristics of pediatric inpatients with pneumonia prior to and during the COVID-19 pandemic in a large tertiary hospital in Shanghai, China. METHODS Patients with pneumonia admitted to the Department of Pediatric Pulmonology of Xinhua Hospital between March-August 2019 and March-August 2020 were recruited. And clinical characteristics of the patients in 2019 were compared with those in 2020. RESULTS Hospitalizations for pneumonia decreased by 74% after the COVID-19 pandemic. For pathogens, virus, mycoplasma pneumoniae (MP) and mixed infection rates were all much lower in 2020 than those in 2019 (P < 0.01). Regarding allergens, compared with 2019, the positive rates of house dust mite, shrimp and crab were significantly higher in 2020 (P < 0.01). And for micronutrients, the levels of vitamin B2, B6, C and 25-hydroxyvitamin D (25(OH)D) in 2020 were observed to be significantly lower than those in 2019 (P < 0.05). For all the study participants, longer hospital stay (OR = 1.521, P = 0.000), milk allergy (OR = 6.552, P = 0.033) and calcium (Ca) insufficiency (OR = 12.048, P = 0.019) were identified as high-risk factors for severe pneumonia by multivariate analysis. CONCLUSIONS The number of children hospitalized with pneumonia and incidence of common pathogen infections were both reduced, and that allergy and micronutrient status in children were also changed after the outbreak of the COVID-19 pandemic.
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Affiliation(s)
- Mengxue Chen
- Department of Pediatric Pulmonology, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, 200092, Shanghai, China
| | - Yabing Zhou
- Department of Traditional Chinese Medicine, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shengjie Jin
- Department of Mathematics, Statistics and Insurance, Hang Seng University of Hong Kong, Hong Kong, China
| | - Shasha Bai
- Department of Pediatric Pulmonology, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, 200092, Shanghai, China
| | - Xiaoyu Tang
- Department of Pediatric Pulmonology, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, 200092, Shanghai, China
| | - Quanhua Liu
- Department of Pediatric Pulmonology, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, 200092, Shanghai, China
| | - Liwei Wang
- Department of Pediatric Pulmonology, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, 200092, Shanghai, China
| | - Ruoxu Ji
- Department of Pediatric Pulmonology, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, 200092, Shanghai, China
| | - Haipei Liu
- Department of Pediatric Pulmonology, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, 200092, Shanghai, China
| | - Wenwei Zhong
- Department of Pediatric Pulmonology, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, 200092, Shanghai, China
| | - Yi Chen
- Department of Pediatric Pulmonology, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, 200092, Shanghai, China
| | - Dingzhu Fang
- Department of Pediatric Pulmonology, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, 200092, Shanghai, China
| | - Jianhua Zhang
- Department of Pediatric Pulmonology, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, 200092, Shanghai, China.
| | - Li Hua
- Department of Pediatric Pulmonology, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, 200092, Shanghai, China.
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Khan S, Bond SE, Lee-Milner J, Conway BR, Lattyak WJ, Aldeyab MA. Antimicrobial consumption in an acute NHS Trust during the COVID-19 pandemic: intervention time series analysis. JAC Antimicrob Resist 2024; 6:dlae013. [PMID: 38328263 PMCID: PMC10848649 DOI: 10.1093/jacamr/dlae013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 01/11/2024] [Indexed: 02/09/2024] Open
Abstract
Objective To determine the impact of the COVID-19 pandemic on antimicrobial consumption and trends of therapeutic drugs for COVID-19 treatments, including corticosteroids, remdesivir and monoclonal antibodies (tocilizumab) from April 2017 to September 2022 in a secondary care NHS Trust in England. Methods A retrospective intervention time series analysis was conducted for April 2017 to September 2022 at the Mid Yorkshire Teaching NHS Trust. Data were retrieved from the pharmacy dispensing system as defined daily doses (DDDs) monthly and reported per 1000 occupied bed days (OBDs). Antimicrobial consumption and COVID-19 treatment options were measured. DDDs were calculated according to the classification of antimicrobials for systemic use (J01) and for other drugs classification. Trends for antimicrobial consumption and other therapeutic drugs for treating COVID-19 were also determined in each wave in England. Results During the pandemic: total antibiotic consumption decreased from 826.4 to 728.2 DDDs per 1000 OBDs (P = 0.0067); piperacillin/tazobactam use increased (P < 0.0001) and ciprofloxacin use decreased (P < 0.0001); there were no changes in Access, Watch, Reserve antibiotic use, and the proportion of antifungal consumption was consistent throughout the study. The use of total antibiotics (P = 0.024), levofloxacin (P = 0.0007), piperacillin/tazobactam (P = 0.0015) and co-amoxiclav (P = 0.0198) increased during wave one. Consumption of COVID-19 treatment drugs was highest during wave two, with 624.3 DDDs per 1000 OBDs for dexamethasone (P = 0.4441), 6.8 DDDs per 1000 OBDs for remdesivir (P < 0.0001) and 35.01 DDDs per 1000 OBDs for tocilizumab (P = 0.2544). Discussion This study determined the consumption of antimicrobials trends before and during the pandemic. The individual wave antimicrobial consumption indicates maximum consumption in the first wave, advocating for antimicrobial stewardship and preparedness for future pandemics.
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Affiliation(s)
- Sidra Khan
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, HD1 3DH, UK
| | - Stuart E Bond
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, HD1 3DH, UK
- Pharmacy Department, Mid Yorkshire Teaching NHS Trust, Wakefield, WF1 4DG, UK
| | - Jade Lee-Milner
- Pharmacy Department, Mid Yorkshire Teaching NHS Trust, Wakefield, WF1 4DG, UK
| | - Barbara R Conway
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, HD1 3DH, UK
- Institute of Skin Integrity and Infection Prevention, University of Huddersfield, Huddersfield, HD1 3DH, UK
| | - William J Lattyak
- Statistical Consulting Department, Scientific Computing Associates Corp., River Forest, IL 60305, USA
| | - Mamoon A Aldeyab
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, HD1 3DH, UK
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Shin S, Koo S, Yang YJ, Lim HJ. Characteristics of the Mycoplasma pneumoniae Epidemic from 2019 to 2020 in Korea: Macrolide Resistance and Co-Infection Trends. Antibiotics (Basel) 2023; 12:1623. [PMID: 37998825 PMCID: PMC10669541 DOI: 10.3390/antibiotics12111623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/10/2023] [Accepted: 11/12/2023] [Indexed: 11/25/2023] Open
Abstract
Mycoplasma pneumoniae, a major etiological agent of community-acquired pneumonia, exhibits distinct cyclic epidemic patterns recurring every three to five years. Several cases of co-infection with severe acute respiratory syndrome coronavirus 2 have been reported globally, resulting in unfavorable clinical manifestations. This study investigated the epidemiological features of the recent M. pneumoniae outbreak (May 2019-April 2020) using retrospective data from the last five years. Molecular test data for macrolide resistance and co-infection were obtained from the Seegene Medical Foundation. National medical expenditure and hospitalization rates were analyzed using data from The Health Insurance Review and Assessment Service of Korea. The macrolide resistance rate was 69.67%, peaking at 71.30% during the epidemic period, which was considerably higher than the 60.89% rate during non-epidemic periods. The co-infection rate with other respiratory pathogens was 88.49%; macrolide-resistant M. pneumoniae strains showed a 2.33% higher co-infection rate than the susceptible strains. The epidemic period had 15.43% higher hospitalization and 78.27% higher medical budget expenditure per patient than non-epidemic periods. The increased rates of macrolide resistance and co-infection observed in macrolide-resistant M. pneumoniae during the epidemic period highlight the importance of monitoring future outbreaks, especially considering macrolide resistance and the risk of co-infection with other pathogens.
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Affiliation(s)
- Soyoun Shin
- Daejeon & Chungcheong Reference Lab., Seegene Medical Foundation, Daejeon 35203, Republic of Korea;
| | - Sunhoe Koo
- Daejeon & Chungcheong Reference Lab., Seegene Medical Foundation, Daejeon 35203, Republic of Korea;
| | - Yong-Jin Yang
- Department of Molecular Diagnostics, Seegene Medical Foundation, Seoul 04805, Republic of Korea; (Y.-J.Y.); (H.-J.L.)
| | - Ho-Jae Lim
- Department of Molecular Diagnostics, Seegene Medical Foundation, Seoul 04805, Republic of Korea; (Y.-J.Y.); (H.-J.L.)
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Cruz JP, Balay-Odao EM, Bajet JB, Mesde J, Alotaibi K, Almogairi A, Alquwez N, Alqahtani M, Almansour AM, Alasiry S, Alotaibi JS. Face Mask Use and Social Distancing Attitude of Healthcare Students: A Multi-Disciplinary Study. Healthcare (Basel) 2023; 11:healthcare11060901. [PMID: 36981558 PMCID: PMC10048679 DOI: 10.3390/healthcare11060901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/17/2023] [Accepted: 03/18/2023] [Indexed: 03/30/2023] Open
Abstract
This multi-disciplinary, cross-sectional, and descriptive study investigated health care students' face mask use knowledge, attitude, and practices (KAP) and social distancing attitudes. The study was carried out from October to December 2021 and surveyed 543 health care students selected via convenience sampling from the three Shaqra University campuses in Saudi Arabia. Standard multiple linear regressions were conducted on face mask use KAP and social distancing attitude to identify their significant associated factors. The students in this study had poor knowledge and a neutral attitude towards and modest use practices of face masks during the COVID-19 pandemic. Being female, being a nursing student, and having greater self-reported COVID-19-prevention knowledge were related to higher levels of face mask use knowledge. Having higher face mask use knowledge was linked to better attitude and practice. Knowledge of COVID-19 and its prevention and decreased COVID-19 risk perception were associated with better face mask use practices. The students had more positive than negative attitudes toward social distancing. Having known someone who was infected by the virus, lower risk perception, and better face mask use practices were associated with more positive social distancing attitudes. The findings imply the need to ensure that future health care practitioners are knowledgeable, have a positive attitude and good practices concerning face mask use, and have positive attitudes toward social distancing. The study implications are relevant for health care education in Saudi Arabia and elsewhere.
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Affiliation(s)
- Jonas Preposi Cruz
- Department of Medicine, School of Medicine, Nazarbayev University, Astana 010000, Kazakhstan
| | - Ejercito Mangawa Balay-Odao
- Department of Medicine, School of Medicine, Nazarbayev University, Astana 010000, Kazakhstan
- School of Advanced Studies, Saint Louis University, Baguio 2600, Philippines
| | - Junel Bryan Bajet
- Department of Nursing, College of Applied Medical Sciences, Shaqra University, Al-Dawadmi 11961, Saudi Arabia
| | - Jennifer Mesde
- Department of Nursing, College of Applied Medical Sciences, Shaqra University, Al-Dawadmi 11961, Saudi Arabia
| | - Khalaf Alotaibi
- Department of Nursing, College of Applied Medical Sciences, Shaqra University, Al-Dawadmi 11961, Saudi Arabia
| | - Ahmed Almogairi
- Department of Nursing, College of Applied Medical Sciences, Shaqra University, Al-Dawadmi 11961, Saudi Arabia
| | - Nahed Alquwez
- Department of Nursing, College of Applied Medical Sciences, Shaqra University, Al-Dawadmi 11961, Saudi Arabia
| | - Mohammed Alqahtani
- College of Applied Medical Sciences, Department of Nursing, King Faisal University, Alahsa 31982, Saudi Arabia
| | - Ahmed Mansour Almansour
- Department of Nursing, College of Applied Medical Sciences, Majmaah University, Al-Majmaah 11952, Saudi Arabia
| | - Sharifa Alasiry
- Department of Nursing, College of Applied Medical Sciences, Majmaah University, Al-Majmaah 11952, Saudi Arabia
| | - Jazi Shaydied Alotaibi
- Department of Nursing, College of Applied Medical Sciences, Majmaah University, Al-Majmaah 11952, Saudi Arabia
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Baccari O, Barkallah M, Elleuch J, Ben Ayed N, Chtourou A, Karray-Hakim H, Hammami A, Michaud P, Fendri I, Abdelkafi S. A new TaqMan real-time PCR assay to detect Parachlamydia acanthamoebae and to monitor its co-existence with SARS-COV-2 among COVID-19 patients. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:17564-17572. [PMID: 36195814 PMCID: PMC9532228 DOI: 10.1007/s11356-022-23227-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 09/20/2022] [Indexed: 06/16/2023]
Abstract
Human respiratory infections caused by a large variety of microbial pathogens are the most common diseases responsible for hospitalization, morbidity and mortality. Parachlamydia acanthamoebae, a Chlamydia-related bacterium, has been found to be potentially associated with these diseases. An early and accurate diagnosis of this pathogen could be useful to avoid the potential respiratory complications linked especially to COVID-19 patients and to set suitable outbreak control measures. A TaqMan-PCR assay was developed to detect and quantify Parachlamydia acanthamoebae in environmental and clinical samples from patients of all ages with COVID-19. The selected hydrolysis probe displayed no cross-reaction with the closely related Chlamydia or the other tested pathogens. This q-PCR achieved good reproducibility and repeatability with a detection limit of about 5 DNA copies per reaction. Using this q-PCR assay, Parachlamydia acanthamoebae was detected in 2/78 respiratory specimens and 9/47 water samples. Only one case (1.3%) of Parachlamydia acanthamoebae and SARS-COV-2 co-infection was noticed. To our knowledge, the combination of these two respiratory pathogens has not been described yet. This new TaqMan-PCR assay represents an efficient diagnostic tool to survey Parachlamydia acanthamoebae on a large-scale screening programs and also during outbreaks.
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Affiliation(s)
- Olfa Baccari
- Laboratoire de Génie Enzymatique et Microbiologie, Equipe de Biotechnologie des Algues, Ecole Nationale d'Ingénieurs de Sfax, Université de Sfax, 3038, Sfax, Tunisia
| | - Mohamed Barkallah
- Laboratoire de Génie Enzymatique et Microbiologie, Equipe de Biotechnologie des Algues, Ecole Nationale d'Ingénieurs de Sfax, Université de Sfax, 3038, Sfax, Tunisia
| | - Jihen Elleuch
- Laboratoire de Génie Enzymatique et Microbiologie, Equipe de Biotechnologie des Algues, Ecole Nationale d'Ingénieurs de Sfax, Université de Sfax, 3038, Sfax, Tunisia
| | - Nourelhouda Ben Ayed
- Laboratory of Microbiology, Faculty of Medicine of Sfax, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia
| | - Amel Chtourou
- Laboratory of Microbiology, Faculty of Medicine of Sfax, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia
| | - Héla Karray-Hakim
- Laboratory of Microbiology, Faculty of Medicine of Sfax, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia
| | - Adenene Hammami
- Laboratory of Microbiology, Faculty of Medicine of Sfax, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia
| | - Philippe Michaud
- Institut Pascal, Université Clermont Auvergne, CNRS, Clermont Auvergne INP, 63000, Clermont-Ferrand, France
| | - Imen Fendri
- Laboratoire de Biotechnologie Végétale Appliquée à l'Amélioration des Cultures, Faculté des Sciences de Sfax, Université de Sfax, 3038, Sfax, Tunisia
| | - Slim Abdelkafi
- Laboratoire de Génie Enzymatique et Microbiologie, Equipe de Biotechnologie des Algues, Ecole Nationale d'Ingénieurs de Sfax, Université de Sfax, 3038, Sfax, Tunisia.
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Khan S, Bond SE, Bakhit M, Hasan SS, Sadeq AA, Conway BR, Aldeyab MA. COVID-19 Mixed Impact on Hospital Antimicrobial Stewardship Activities: A Qualitative Study in UK-Based Hospitals. Antibiotics (Basel) 2022; 11:1600. [PMID: 36421244 PMCID: PMC9686587 DOI: 10.3390/antibiotics11111600] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 11/07/2022] [Accepted: 11/08/2022] [Indexed: 03/11/2024] Open
Abstract
Antimicrobial resistance (AMR) is a well-known global threat due to the subsequent increase in antimicrobial usage. Several antimicrobial stewardship (AMS) strategies have been implemented to curb irrational prescribing and reduce the AMR burden. However, since the beginning of the COVID-19 pandemic, it has enormously impacted the healthcare system and jeopardized public health, causing millions of deaths globally. Our semi-structured qualitative study aimed to explore the impact of COVID-19 on AMS activities in the UK hospitals. Seventeen interviews were conducted with health care professionals who were part of AMS teams (consultant medical microbiologists, infectious disease consultants, antimicrobial pharmacists). Interviews were audio-recorded and transcribed. An inductive thematic framework was adopted to analyse and create the themes. After agreement of the hierarchical framework definition, all transcripts were coded accordingly. Four main themes and 15 sub-themes were identified. These main themes were: (1) AMS activities or strategies before and during the pandemic; (2) challenges to implementing AMS activities before and during the pandemic; (3) information from public authorities on AMS during the pandemic; and (4) new AMS activities/strategies adopted during the pandemic. Staff vacancies, redeploying of AMS staff to other duties and meeting the burden related to the COVID-19 and lack of resources were the most frequently identified contributing factors to withheld AMS activities during the pandemic. However, modifications to the hybrid working environment, i.e., remote or flexible working, allowed for resumption of AMS activities including virtual ward rounds, virtual meetings and other activities. Further research needs to assess the impact of the hybrid delivery system on AMS activities.
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Affiliation(s)
- Sidra Khan
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield HD1 3DH, UK
| | - Stuart E. Bond
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield HD1 3DH, UK
- Department of Pharmacy, Mid Yorkshire Hospitals NHS Trust, Wakefield WF1 4DG, UK
| | - Mina Bakhit
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, QLD 4226, Australia
| | - Syed Shahzad Hasan
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield HD1 3DH, UK
| | - Ahmed A. Sadeq
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield HD1 3DH, UK
- Department of Pharmacy, Shaikh Shakhbout Medical City in Partnership with Mayo Clinic, Abu Dhabi P.O. Box 11001, United Arab Emirates
| | - Barbara R. Conway
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield HD1 3DH, UK
- Institute of Skin Integrity and Infection Prevention and Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield HD1 3DH, UK
| | - Mamoon A. Aldeyab
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield HD1 3DH, UK
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Tsed AN, Mushtin NE, Dulaev AK, Shmelev AV. Pathological changes in the osteoarticular system during COVID-19 drug therapy (review of literature). GREKOV'S BULLETIN OF SURGERY 2022. [DOI: 10.24884/0042-4625-2022-181-2-85-91] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
The recommended drugs for the treatment of COVID-19 are, on the one hand, experimental in nature, but at the same time, they have many side effects that cause long-term complications in organs and systems, including osteoarticular. Based on the analysis of modern domestic and foreign literature, to determine the effect of not only the new coronavirus infection COVID-19, but also the drugs used to treat it, on the human osteoarticular system. In the course of the study, a scientific search was made for publications in the electronic databases PubMed, MedLine and e-Library for the period from January 2000 to October 2021 for the main keywords. Due to successive “waves” of the COVID-19 pandemic, the number of patients receiving non-specific therapy, including corticosteroids, will increase in the coming years. Preliminary data on COVID-19 and similar trends during the Sars-COV-1 epidemic of 2003 show that the pathogenesis of Sars- Cov-2 and its treatment with high doses of corticosteroids may increase the risk of osteonercosis in patients, which will inevitably lead to an increase in orthopedic diseases in patients not only the middle age group, but also young patients in the near future. Currently, studies are required aimed at risk stratification, studying the pathogenesis of damage to the musculoskeletal system after COVID-19 and the effectiveness of preventive and therapeutic measures in such patients.
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Khan MA, Bin Islam S, Rakib MU, Alam D, Hossen MM, Tania M, Asad A. Major Drugs Used in COVID-19 Treatment: Molecular Mechanisms, Validation
and Current Progress in Trials. CORONAVIRUSES 2022; 3. [DOI: 10.2174/2666796701999201204122819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 11/16/2020] [Accepted: 11/11/2020] [Indexed: 07/28/2024]
Abstract
Background:
Currently, the present world is facing a new deadly challenge against a pandemic disease called
COVID-19, which is caused by a coronavirus, named SARS-CoV-2. To date, there is no drug or vaccine that can treat
COVID-19 completely, but some drugs have been used primarily, and they are in different stages of clinical trials. This
review article discussed and compared those drugs which are running ahead in COVID-19 treatments.
Methods:
We have explored PUBMED, SCOPUS, WEB OF SCIENCE, as well as press release of WHO, NIH and FDA for
articles about COVID-19, and reviewed them.
Results:
Drugs like favipiravir, remdesivir, lopinavir/ritonavir, hydroxychloroquine, azithromycin, ivermectin,
corticosteroids and interferons have been found effective in some extents, and partially approved by FDA and WHO to treat
COVID-19 at different phases of pandemic. However, some of these drugs have been disapproved later, although clinical
trials are going on. In parallel, plasma therapy has been found fruitful in some extents too, and a number of vaccine trails are
going on.
Conclusions:
This review article discussed the epidemiologic and mechanistic characteristics of SARS-CoV-2, and how
drugs could act on this virus with the comparative discussion on progress and backwards of major drugs used till date,
which might be beneficial for choosing therapies against COVID-19 in different countries.
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Affiliation(s)
- Md. Asaduzzaman Khan
- The Key Laboratory of Epigenetics and Oncology, The Research Center for Preclinical Medicine, Southwest Medical
University, Luzhou, Sichuan 646000, China
| | - Shad Bin Islam
- Bachelor in Medicine and Surgery Program, Affiliated hospital of Southwest
Medical University, Luzhou, Sichuan 646000, China
| | - Mejbah Uddin Rakib
- Bachelor in Medicine and Surgery Program, Affiliated hospital of Southwest
Medical University, Luzhou, Sichuan 646000, China
| | - Didarul Alam
- Bachelor in Medicine and Surgery Program, Affiliated hospital of Southwest
Medical University, Luzhou, Sichuan 646000, China
| | - Md. Munnaf Hossen
- Department of Immunology, Health Science Center, Shenzhen,
University, Shenzhen, Guangdong 518060, China
| | - Mousumi Tania
- Division of Molecular Cancer, Red Green Research Center,
Dhaka, Bangladesh
| | - Asaduzzaman Asad
- Department of Biochemistry and Molecular Biology, Jahangirnagar University; and International
Center for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
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11
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Khan S, Hasan SS, Bond SE, Conway BR, Aldeyab MA. Antimicrobial consumption in patients with COVID-19: a systematic review and meta-analysis. Expert Rev Anti Infect Ther 2021; 20:749-772. [PMID: 34895002 DOI: 10.1080/14787210.2022.2011719] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Since the onset of the pandemic, prescribing antimicrobials has become a common practice to treat patients infected with COVID-19. AREAS COVERED A systematic literature search was performed in the electronic databases MEDLINE, CINAHL, WHO COVID-19 database, including EMBASE, Scopus, WHO-COVID, LILACS, and Google Scholar to identify original articles published up to 31 July 2021. A random-effects model was used to estimate the pooled prevalence or proportion of antimicrobial consumption among COVID-19 patients. EXPERT OPINION We identified 43 original articles, 33 studies from high-income countries, six from upper-middle-income countries, and four from lower-middle-income countries. Most of the studies presented data from hospital or secondary health-care settings (n = 34). Included studies measured antimicrobial consumption as Daily Defined Doses (DDD) or day of therapy (DOT) or percentage. A total of 19 studies measured antimicrobial consumption as DDDs or DOT. Meta-analysis revealed an overall high antimicrobial consumption of 68% (95% CI: 60% to 75%). The subgroup analysis found a lower consumption in high-income countries (58%, 95% CI: 48% to 67%), compared with lower and middle-income countries (89%, 95% CI: 82% to 94%). High antimicrobial consumption found in COVID-19 patients demands implementation of appropriate antimicrobial stewardship interventions.
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Affiliation(s)
- Sidra Khan
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, UK
| | - Syed Shahzad Hasan
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, UK
| | - Stuart E Bond
- Pharmacy Department, Mid Yorkshire Hospitals NHS Trust, Wakefield, UK
| | - Barbara R Conway
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, UK.,Institute of Skin Integrity and Infection Prevention, University of Huddersfield, Huddersfield, UK
| | - Mamoon A Aldeyab
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, UK
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12
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Al-Hadidi SH, Alhussain H, Abdel Hadi H, Johar A, Yassine HM, Al Thani AA, Eltai NO. The Spectrum of Antibiotic Prescribing During COVID-19 Pandemic: A Systematic Literature Review. Microb Drug Resist 2021; 27:1705-1725. [PMID: 34077290 PMCID: PMC8713256 DOI: 10.1089/mdr.2020.0619] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Objectives: Over the last decades, there has been a significant increase in antimicrobial prescribing and consumption associated with the development of patients' adverse events and antimicrobial resistance (AMR) to the point of becoming a global priority. This study aims at evaluating antibiotic prescribing during COVID-19 pandemic from November 2019 to December 2020. Materials and Methods: A systematic review was conducted primarily through the NCBI database, using PRISMA guidelines to identify relevant literature for the period between November 1, 2019 and December 19, 2020, using the keywords: COVID-19 OR SARS-Cov-2 AND antibiotics restricted to the English language excluding nonclinical articles. Five hundred twenty-seven titles were identified; all articles fulfilling the study criteria were included, 133 through the NCBI, and 8 through Google Scholar with a combined total of 141 studies. The patient's spectrum included all ages from neonates to elderly with all associated comorbidities, including immune suppression. Results: Of 28,093 patients included in the combined studies, 58.7% received antibiotics (16,490/28,093), ranging from 1.3% to 100% coverage. Antibiotics coverage was less in children (57%) than in adults with comorbidities (75%). Broad-spectrum antibiotics were prescribed presumptively without pathogen identifications, which might contribute to adverse outcomes. Conclusions: During the COVID-19 pandemic, there has been a significant and wide range of antibiotic prescribing in patients affected by the disease, particularly in adults with underlying comorbidities, despite the paucity of evidence of associated bacterial infections. The current practice might increase patients' immediate and long-term risks of adverse events, susceptibility to secondary infections as well as aggravating AMR.
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Affiliation(s)
| | | | - Hamad Abdel Hadi
- Infectious Disease Division, Communicable Diseases Centre, Hamad Medical Corporation, Doha, Qatar
| | | | | | | | - Nahla O. Eltai
- Biomedical Research Center, Qatar University, Doha, Qatar
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13
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Chaudhry R, Sreenath K, Batra P, Vinayaraj EV, Rathor N, Saikiran K, Aravindan A, Singh V, Brijwal M, Soneja M, Verma N, Subramanium R, Singh UB, Guleria R. Atypical bacterial co-infections among patients with COVID-19: A study from India. J Med Virol 2021; 94:303-309. [PMID: 34491594 PMCID: PMC8661859 DOI: 10.1002/jmv.27324] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 09/04/2021] [Indexed: 01/17/2023]
Abstract
Emerging evidence shows co‐infection with atypical bacteria in coronavirus disease 2019 (COVID‐19) patients. Respiratory illness caused by atypical bacteria such as Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella pneumophila may show overlapping manifestations and imaging features with COVID‐19 causing clinical and laboratory diagnostic issues. We conducted a prospective study to identify co‐infections with SARS‐CoV‐2 and atypical bacteria in an Indian tertiary hospital. From June 2020 to January 2021, a total of 194 patients with laboratory‐confirmed COVID‐19 were also tested for atypical bacterial pathogens. For diagnosing M. pneumoniae, a real‐time polymerase chain reaction (PCR) assay and serology (IgM ELISA) were performed. C. pneumoniae diagnosis was made based on IgM serology. L. pneumophila diagnosis was based on PCR or urinary antigen testing. Clinical and epidemiological features of SARS‐CoV‐2 and atypical bacteria‐positive and ‐negative patient groups were compared. Of the 194 patients admitted with COVID‐19, 17 (8.8%) were also diagnosed with M. pneumoniae (n = 10) or C. pneumoniae infection (n = 7). Confusion, headache, and bilateral infiltrate were found more frequently in the SARS CoV‐2 and atypical bacteria co‐infection group. Patients in the M. pneumoniae or C. pneumoniae co‐infection group were more likely to develop ARDS, required ventilatory support, had a longer hospital length of stay, and higher fatality rate compared to patients with only SARS‐CoV‐2. Our report highlights co‐infection with bacteria causing atypical pneumonia should be considered in patients with SARS‐CoV‐2 depending on the clinical context. Timely identification of co‐existing pathogens can provide pathogen‐targeted treatment and prevent fatal outcomes of patients infected with SARS‐CoV‐2 during the current pandemic.
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Affiliation(s)
- Rama Chaudhry
- Department of Microbiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - K Sreenath
- Department of Microbiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Priyam Batra
- Department of Microbiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - E V Vinayaraj
- Department of Microbiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Nisha Rathor
- Department of Microbiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Kvp Saikiran
- Department of Microbiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Ajisha Aravindan
- Department of Anesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Vishwajeet Singh
- Department of Geriatric Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Megha Brijwal
- Department of Microbiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Manish Soneja
- Department of Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Nishant Verma
- Department of Microbiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Rajeshwari Subramanium
- Department of Anesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Urvashi B Singh
- Department of Microbiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Randeep Guleria
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
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14
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Agca H, Akalin H, Saglik I, Hacimustafaoglu M, Celebi S, Ener B. Changing epidemiology of influenza and other respiratory viruses in the first year of COVID-19 pandemic. J Infect Public Health 2021; 14:1186-1190. [PMID: 34399190 DOI: 10.1016/j.jiph.2021.08.004] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 07/15/2021] [Accepted: 08/03/2021] [Indexed: 10/20/2022] Open
Abstract
INTRODUCTION We aimed to determine the epidemiological change in influenza and other respiratory tract viruses isolated from patients with nasopharyngeal swab samples in our hospital during the COVID-19 period. METHODS We investigated nasopharyngeal swabs for respiratory viruses between March 2020 and February 2021 during the first year of pandemic in Turkey. We used QIAStat Dx Respiratory panel (Qiagen, Germany) in QIAStat Dx (Qiagen, Germany) for detection of respiratory viruses between March 2020 and February 2021. Respiratory panel kit included influenza A, B, influenza A H1N1, rhinovirus/enterovirus, parainfluenza (PIV) 1,2,3,4, coronaviruses (CoVs) NL 63, 229E, OC43 and HKU1, human metapneumovirus (MPV) A/B, bocavirus, respiratory syncytial virus (RSV) A/B and adenovirus. RESULTS We retrospectively analyzed the results of 319 nasopharyngeal swab samples. The average age of 199 (62.4%) male and 120 (37.6%) female patients between the ages of 0-92 was 16 years. We found that 101 (31.7%) samples were positive for viruses. Rhino/enteroviruses were the most common viruses in all age groups. Influenza positivity rate during the first year of pandemic declined to 2.3% from 17.3% among the previous year. MPV infection activity did not change during the pandemic. DISCUSSION According to our findings we argue that epidemiology of respiratory viruses has changed during the pandemic period. Despite the current clinical focus on the COVID-19 pandemic, clinicians should keep in mind that rhino/enterovirus and MPV infections may mimic COVID-19 and respiratory infections should be differentially diagnosed with rapid multiplex kits containing SARS-CoV-2, rhino/enterovirus and MPV.
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Affiliation(s)
- Harun Agca
- Department of Medical Microbiology, Faculty of Medicine, Bursa Uludag University, Turkey.
| | - Halis Akalin
- Department of Infectıous Diseases and Clinical Microbiology, Faculty of Medicine, Bursa Uludag University, Turkey
| | - Imran Saglik
- Department of Medical Microbiology, Faculty of Medicine, Bursa Uludag University, Turkey
| | - Mustafa Hacimustafaoglu
- Department of Pediatrics, Infectious Diseases Subunit, Faculty of Medicine, Bursa Uludag University, Turkey
| | - Solmaz Celebi
- Department of Pediatrics, Infectious Diseases Subunit, Faculty of Medicine, Bursa Uludag University, Turkey
| | - Beyza Ener
- Department of Medical Microbiology, Faculty of Medicine, Bursa Uludag University, Turkey
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15
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Yassin A, Nawaiseh M, Shaban A, Alsherbini K, El-Salem K, Soudah O, Abu-Rub M. Neurological manifestations and complications of coronavirus disease 2019 (COVID-19): a systematic review and meta-analysis. BMC Neurol 2021; 21:138. [PMID: 33784985 PMCID: PMC8007661 DOI: 10.1186/s12883-021-02161-4] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 03/17/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The spectrum of neurological involvement in COVID-19 is not thoroughly understood. To the best of our knowledge, no systematic review with meta-analysis and a sub-group comparison between severe and non-severe cases has been published. The aim of this study is to assess the frequency of neurological manifestations and complications, identify the neurodiagnostic findings, and compare these aspects between severe and non-severe COVID-19 cases. METHODS A systematic search of PubMed, Scopus, EBSCO, Web of Science, and Google Scholar databases was conducted for studies published between the 1st of January 2020 and 22nd of April 2020. In addition, we scanned the bibliography of included studies to identify other potentially eligible studies. The criteria for eligibility included studies published in English language (or translated to English), those involving patients with COVID-19 of all age groups, and reporting neurological findings. Data were extracted from eligible studies. Meta-analyses were conducted using comprehensive meta-analysis software. Random-effects model was used to calculate the pooled percentages and means with their 95% confidence intervals (CIs). Sensitivity analysis was performed to assess the effect of individual studies on the summary estimate. A subgroup analysis was conducted according to severity. The main outcomes of the study were to identify the frequency and nature of neurological manifestations and complications, and the neuro-diagnostic findings in COVID-19 patients. RESULTS 44 articles were included with a pooled sample size of 13,480 patients. The mean age was 50.3 years and 53% were males. The most common neurological manifestations were: Myalgia (22.2, 95% CI, 17.2 to 28.1%), taste impairment (19.6, 95% CI, 3.8 to 60.1%), smell impairment (18.3, 95% CI, 15.4 to 76.2%), headache (12.1, 95% CI, 9.1 to 15.8%), dizziness (11.3, 95% CI, 8.5 to 15.0%), and encephalopathy (9.4, 95% CI, 2.8 to 26.6%). Nearly 2.5% (95% CI, 1 to 6.1%) of patients had acute cerebrovascular diseases (CVD). Myalgia, elevated CK and LDH, and acute CVD were significantly more common in severe cases. Moreover, 20 case reports were assessed qualitatively, and their data presented separately. CONCLUSIONS Neurological involvement is common in COVID-19 patients. Early recognition and vigilance of such involvement might impact their overall outcomes.
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Affiliation(s)
- Ahmed Yassin
- Division of Neurology, Department of Neurosciences, Faculty of Medicine, Jordan University of Science and Technology, P.O.Box 630001, Irbid, 22110, Jordan.
| | - Mohammed Nawaiseh
- Graduate of The University of Jordan, Amman, Jordan
- Intern at Jordanian Royal Medical Services, Amman, Jordan
| | - Ala Shaban
- Graduate of The University of Jordan, Amman, Jordan
- Researcher, King Hussein Cancer Center, Amman, Jordan
| | - Khalid Alsherbini
- Department of Neurology, University of Tennessee Health Science Center, Methodist University Hospital, Memphis, TN, USA
| | - Khalid El-Salem
- Division of Neurology, Department of Neurosciences, Faculty of Medicine, Jordan University of Science and Technology, P.O.Box 630001, Irbid, 22110, Jordan
| | - Ola Soudah
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Mohammad Abu-Rub
- Department of Neurology, The George Washington University, Washington, DC, USA
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16
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Chaudhry R, Sreenath K, Vinayaraj EV, Sahoo B, Vishnu Narayanan MR, Kiran KVPS, Batra P, Rathor N, Singh S, Mohan A, Bhatnagar S. Mycoplasma pneumoniae co-infection with SARS-CoV-2: A case report. Access Microbiol 2021; 3:000212. [PMID: 34151164 PMCID: PMC8209699 DOI: 10.1099/acmi.0.000212] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 02/02/2021] [Indexed: 12/22/2022] Open
Abstract
We report co-infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and Mycoplasma pneumoniae in a patient with pneumonia in India. Atypical bacterial pathogens causing community-acquired pneumonia may share similar clinical presentations and radiographic features with SARS-CoV-2 making a thorough differential diagnosis essential. The co-infection of SARS-CoV-2 and M. pneumoniae is infrequently reported in the literature. Broader testing for common respiratory pathogens should be performed in severe COVID-19 cases to rule out other concurrent infections. Early identification of co-existing respiratory pathogens could provide pathogen-directed therapy, and can save patient lives during the ongoing COVID-19 outbreak.
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Affiliation(s)
- Rama Chaudhry
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - K Sreenath
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - E V Vinayaraj
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Biswajeet Sahoo
- Department of Laboratory Oncology, National Cancer Institute, Jhajjar, Hayana, India
| | - M R Vishnu Narayanan
- Department of Anaesthesiology, All India Institute of Medical Sciences, New Delhi, India
| | - K V P Sai Kiran
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Priyam Batra
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Nisha Rathor
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Sheetal Singh
- Department of Hospital Administration, National Cancer Institute, Jhajjar, Hayana, India
| | - Anant Mohan
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sushma Bhatnagar
- Department of Onco-Anaesthesia and Palliative Medicine, All India Institute of Medical Sciences, New Delhi, India
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17
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Zhao F, Han Z, Wang R, Luo Y. Neurological Manifestations of COVID-19: Causality or Coincidence? Aging Dis 2021; 12:27-35. [PMID: 33532124 PMCID: PMC7801278 DOI: 10.14336/ad.2020.0917] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 09/21/2020] [Indexed: 12/22/2022] Open
Abstract
The COVID-19 pandemic that swept the world at the beginning of 2020 is still raging. It is well established that in addition to respiratory symptoms, COVID-19 can also have neurological manifestations that may result from direct or indirect neurological damage. But are these neurological manifestations coincidental or causal? From a neurological perspective, these symptoms could be the result of neurological damage following SARS-CoV-2 infection, or they could be coincidental, from causes such as secondary systemic complications or side effects of drug treatment. The aim of this review is to raise clinician's awareness to the development of neurological impairment in SARS-CoV-2 infected patients in the current normative prevention and control.
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Affiliation(s)
- Fangfang Zhao
- Institute of Cerebrovascular Disease Research and Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China.
| | - Ziping Han
- Institute of Cerebrovascular Disease Research and Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China.
- Beijing Geriatric Medical Research Center and Beijing Key Laboratory of Translational Medicine for Cerebrovascular Diseases, Beijing, China.
| | - Rongliang Wang
- Institute of Cerebrovascular Disease Research and Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China.
- Beijing Geriatric Medical Research Center and Beijing Key Laboratory of Translational Medicine for Cerebrovascular Diseases, Beijing, China.
| | - Yumin Luo
- Institute of Cerebrovascular Disease Research and Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China.
- Beijing Geriatric Medical Research Center and Beijing Key Laboratory of Translational Medicine for Cerebrovascular Diseases, Beijing, China.
- Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China.
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18
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Israfil SMH, Sarker MMR, Rashid PT, Talukder AA, Kawsar KA, Khan F, Akhter S, Poh CL, Mohamed IN, Ming LC. Clinical Characteristics and Diagnostic Challenges of COVID-19: An Update From the Global Perspective. Front Public Health 2021; 8:567395. [PMID: 33505949 PMCID: PMC7831046 DOI: 10.3389/fpubh.2020.567395] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 11/27/2020] [Indexed: 12/15/2022] Open
Abstract
Clinical characteristics are essential for the correct diagnosis of diseases. The current review aimed to summarize the global clinical characteristics of the COVID-19 patients systematically and identify their diagnostic challenges to help the medical practitioners properly diagnose and for better management of COVID-19 patients. We conducted a systematic search in PubMed, Web of Science, Scopus, Science Direct, and Google Scholar databases for original articles containing clinical information of COVID-19 published up to 7th May 2020. Two researchers independently searched the databases to extract eligible articles. A total of 34 studies from 8 different countries with 10889 case-patients were included for clinical characteristics. The most common clinical symptoms were cough 59.6, fever 46.9, fatigue 27.8, and dyspnea 20.23%. The prominent laboratory findings were lymphocytopenia 55.9, elevated levels of CRP 61.9, aspartate aminotransferase 53.3, LDH 40.8, ESR 72.99, serum ferritin 63, IL-6 52, and prothrombin time 35.47%, and decreased levels of platelets 17.26, eosinophils 59.0, hemoglobin 29, and albumin 38.4%. CT scan of the chest showed an abnormality in 93.50% cases with bilateral lungs 71.1%, ground-glass opacity 48%, lesion in lungs 78.3%, and enlargement of lymph node 50.7%. Common comorbidities were hypertension, diabetes, obesity, and cardiovascular diseases. The estimated median incubation period was 5.36 days, and the overall case fatality rate was 16.9% (Global case fatality outside China was 22.24%: USA 21.24%, Italy 25.61%, and others 0%; whereas the case fatality inside the Hubei Province of China was found to be 11.71%). Global features on the clinical characteristics of COVID-19 obtained from laboratory tests and CT scan results will provide useful information to the physicians to diagnose the disease and for better management of the patients as well as to address the diagnostic challenges to control the infection.
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Affiliation(s)
| | - Md. Moklesur Rahman Sarker
- Department of Pharmacy, State University of Bangladesh, Dhaka, Bangladesh
- Pharmacology and Toxicology Research Division, Health Med Science Research Limited, Dhaka, Bangladesh
| | | | - Ali Azam Talukder
- Department of Microbiology, Jahangirnagar University, Savar, Bangladesh
| | | | - Farzana Khan
- Pharmacology and Toxicology Research Division, Health Med Science Research Limited, Dhaka, Bangladesh
| | - Selina Akhter
- Department of Public Health, Daffodil International University, Dhaka, Bangladesh
| | - Chit Laa Poh
- Centre for Virus and Vaccine Research, School of Science and Technology, Sunway University, Petaling Jaya, Malaysia
| | - Isa Naina Mohamed
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia (The National University of Malaysia), Cheras, Malaysia
| | - Long Chiau Ming
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Bandar Seri Begawan, Brunei
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19
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Centeno‐Tablante E, Medina‐Rivera M, Finkelstein JL, Rayco‐Solon P, Garcia‐Casal MN, Rogers L, Ghezzi‐Kopel K, Ridwan P, Peña‐Rosas JP, Mehta S. Transmission of SARS-CoV-2 through breast milk and breastfeeding: a living systematic review. Ann N Y Acad Sci 2021; 1484:32-54. [PMID: 32860259 PMCID: PMC7970667 DOI: 10.1111/nyas.14477] [Citation(s) in RCA: 98] [Impact Index Per Article: 32.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 07/30/2020] [Accepted: 08/03/2020] [Indexed: 01/08/2023]
Abstract
The pandemic of coronavirus disease 2019 (COVID-19) is caused by infection with a novel coronavirus strain, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). At present, there is limited information on potential transmission of the infection from mother to child, particularly through breast milk and breastfeeding. Here, we provide a living systematic review to capture information that might necessitate changes in the guidance on breast milk and breastfeeding given the uncertainty in this area. Our search retrieved 19,414 total records; 605 were considered for full-text eligibility and no ongoing trials were identified. Our review includes 340 records, 37 with breast milk samples and 303 without. The 37 articles with analyzed breast milk samples reported on 77 mothers who were breastfeeding their children; among them, 19 of 77 children were confirmed COVID-19 cases based on RT-PCR assays, including 14 neonates and five older infants. Nine of the 68 analyzed breast milk samples from mothers with COVID-19 were positive for SARS-CoV-2 RNA; of the exposed infants, four were positive and two were negative for COVID-19. Currently, there is no evidence of SARS-CoV-2 transmission through breast milk. Studies are needed with longer follow-up periods that collect data on infant feeding practices and on viral presence in breast milk.
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Affiliation(s)
| | | | | | - Pura Rayco‐Solon
- Department of Maternal, Newborn,
Child and Adolescent Health and AgeingWorld Health OrganizationGenevaSwitzerland
| | | | - Lisa Rogers
- Department of Nutrition and Food
SafetyWorld Health OrganizationGenevaSwitzerland
| | | | - Pratiwi Ridwan
- Division of Nutritional
SciencesCornell UniversityIthacaNew York
| | | | - Saurabh Mehta
- Division of Nutritional
SciencesCornell UniversityIthacaNew York
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20
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Dong ZY, Xiang BJ, Jiang M, Sun MJ, Dai C. The Prevalence of Gastrointestinal Symptoms, Abnormal Liver Function, Digestive System Disease and Liver Disease in COVID-19 Infection: A Systematic Review and Meta-Analysis. J Clin Gastroenterol 2021; 55:67-76. [PMID: 33116063 PMCID: PMC7713642 DOI: 10.1097/mcg.0000000000001424] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND The worldwide outbreak of COVID-19 infected millions of people. Some patients had gastrointestinal (GI) symptoms, abnormal liver function, digestive system disease and liver disease. AIM To investigate the prevalence of GI symptoms, abnormal liver function, digestive system disease and liver disease in patients with COVID-19 by a systematic review and meta-analysis. METHODS We searched PubMed, Ovid Embase, Medline, and 2 Chinese databases. Primary outcomes were the prevalence of GI symptoms, abnormal liver function, digestive system disease, and liver disease. Different studies were included in different subset analysis. These outcomes were estimated with proportions, odds ratio, 95% confidence interval (CI) and P-value by Stata SE 15.1. RESULTS Thirty-one studies involving 4682 patients were included. The most significant GI symptoms were diarrhea (0.08, 95% CI: 0.06-0.11) and anorexia (0.17, 95% CI: 0.06-0.27). The most significant abnormal liver function was increased alanine aminotransferase (ALT) (0.25, 95% CI: 0.16-0.33). A total of 5% of the patients had digestive system disease (95% CI: 0.02-0.08). A total of 3% of the patients had liver disease (95% CI: 0.02-0.05). The prevalence of nausea and vomiting, diarrhea, abnormal liver function, digestive system disease, and liver disease was higher in Wuhan group. The prevalence of diarrhea was higher in non-China group. Patients in severe/intensive care unit group were more likely to have diarrhea, anorexia, abdominal pain increased aspartate aminotransferase, and increased ALT. CONCLUSION The most significant GI symptoms were anorexia and diarrhea. The most significant abnormal liver function was increased ALT. Severe patients were more likely to have GI symptoms and abnormal liver function.
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Affiliation(s)
- Zi-Yuan Dong
- Department of Gastroenterology, First Affiliated Hospital, China Medical University, Shenyang City, Liaoning Province, China
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21
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Shaban RZ, Li C, O'Sullivan MVN, Gerrard J, Stuart RL, Teh J, Gilroy N, Sorrell TC, White E, Bag S, Hackett K, Chen SCA, Kok J, Dwyer DE, Iredell JR, Maddocks S, Ferguson P, Varshney K, Carter I, Barratt R, Robertson M, Baskar SR, Friend C, Robosa RS, Sotomayor‐Castillo C, Nahidi S, Macbeth DA, Alcorn KAD, Wattiaux A, Moore F, McMahon J, Naughton W, Korman TM, Catton M, Kanapathipillai R, Romanes F, Rowe E, Catford J, Kennedy B, Qiao M, Shaw D. COVID-19 in Australia: our national response to the first cases of SARS-CoV-2 infection during the early biocontainment phase. Intern Med J 2021; 51:42-51. [PMID: 33196128 PMCID: PMC7753759 DOI: 10.1111/imj.15105] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/27/2020] [Accepted: 08/27/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND On 31 December 2019, the World Health Organization recognised clusters of pneumonia-like cases due to a novel coronavirus disease (COVID-19). COVID-19 became a pandemic 71 days later. AIM To report the clinical and epidemiological features, laboratory data and outcomes of the first group of 11 returned travellers with COVID-19 in Australia. METHODS This is a retrospective, multi-centre case series. All patients with confirmed COVID-19 infection were admitted to tertiary referral hospitals in New South Wales, Queensland, Victoria and South Australia. RESULTS The median age of the patient cohort was 42 years (interquartile range (IQR), 24-53 years) with six men and five women. Eight (72.7%) patients had returned from Wuhan, one from Shenzhen, one from Japan and one from Europe. Possible human-to-human transmission from close family contacts in gatherings overseas occurred in two cases. Symptoms on admission were fever, cough and sore throat (n = 9, 81.8%). Co-morbidities included hypertension (n = 3, 27.3%) and hypercholesterolaemia (n = 2, 18.2%). No patients developed severe acute respiratory distress nor required intensive care unit admission or mechanical ventilation. After a median hospital stay of 14.5 days (IQR, 6.75-21), all patients were discharged. CONCLUSIONS This is a historical record of the first COVID-19 cases in Australia during the early biocontainment phase of the national response. These findings were invaluable for establishing early inpatient and outpatient COVID-19 models of care and informing the management of COVID-19 over time as the outbreak evolved. Future research should extend this Australian case series to examine global epidemiological variation of this novel infection.
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Affiliation(s)
- Ramon Z. Shaban
- Faculty of Medicine and HealthUniversity of SydneySydneyNew South WalesAustralia
- Infectious Diseases and Sexual Health ServicesWestmead HospitalSydneyNew South WalesAustralia
- Marie Bashir Institute for Infectious Diseases and BiosecurityThe University of SydneySydneyNew South WalesAustralia
- Westmead HospitalWestern Sydney Local Health DistrictSydneyNew South WalesAustralia
| | - Cecilia Li
- Faculty of Medicine and HealthUniversity of SydneySydneyNew South WalesAustralia
| | - Matthew V. N. O'Sullivan
- Faculty of Medicine and HealthUniversity of SydneySydneyNew South WalesAustralia
- Centre for Infectious Diseases and Microbiology Laboratory ServicesInstitute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead HospitalSydneyNew South WalesAustralia
| | - John Gerrard
- Department of Infectious Diseases and ImmunologyGold Coast University HospitalGold CoastQueenslandAustralia
| | - Rhonda L. Stuart
- Monash Infectious DiseasesMonash HealthMelbourneVictoriaAustralia
- Centre for Inflammatory Diseases, Department of MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Joanne Teh
- Infectious Diseases UnitRoyal Adelaide HospitalAdelaideSouth AustraliaAustralia
| | - Nicole Gilroy
- Centre for Infectious Diseases and Microbiology Laboratory ServicesInstitute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead HospitalSydneyNew South WalesAustralia
| | - Tania C. Sorrell
- Infectious Diseases and Sexual Health ServicesWestmead HospitalSydneyNew South WalesAustralia
- Marie Bashir Institute for Infectious Diseases and BiosecurityThe University of SydneySydneyNew South WalesAustralia
| | - Elizabeth White
- Westmead HospitalWestern Sydney Local Health DistrictSydneyNew South WalesAustralia
| | - Shopna Bag
- Centre for Population HealthWestern Sydney Public Health UnitSydneyNew South WalesAustralia
- Faculty of Medicine and Health, Westmead Clinical SchoolThe University of SydneySydneyNew South WalesAustralia
| | - Kate Hackett
- Westmead HospitalWestern Sydney Local Health DistrictSydneyNew South WalesAustralia
| | - Sharon C. A. Chen
- Centre for Infectious Diseases and Microbiology Laboratory ServicesInstitute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead HospitalSydneyNew South WalesAustralia
- Marie Bashir Institute for Infectious Diseases and BiosecurityThe University of SydneySydneyNew South WalesAustralia
| | - Jen Kok
- Centre for Infectious Diseases and Microbiology Laboratory ServicesInstitute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead HospitalSydneyNew South WalesAustralia
- Marie Bashir Institute for Infectious Diseases and BiosecurityThe University of SydneySydneyNew South WalesAustralia
| | - Dominic E. Dwyer
- Centre for Infectious Diseases and Microbiology Laboratory ServicesInstitute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead HospitalSydneyNew South WalesAustralia
- Marie Bashir Institute for Infectious Diseases and BiosecurityThe University of SydneySydneyNew South WalesAustralia
| | - Jonathan R. Iredell
- Marie Bashir Institute for Infectious Diseases and BiosecurityThe University of SydneySydneyNew South WalesAustralia
- Centre for Infectious Diseases and MicrobiologyWestmead Institute for Medical ResearchSydneyNew South WalesAustralia
| | - Susan Maddocks
- Centre for Infectious Diseases and Microbiology Laboratory ServicesInstitute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead HospitalSydneyNew South WalesAustralia
| | - Patricia Ferguson
- Faculty of Medicine and HealthUniversity of SydneySydneyNew South WalesAustralia
- Centre for Infectious Diseases and Microbiology Laboratory ServicesInstitute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead HospitalSydneyNew South WalesAustralia
| | - Kavita Varshney
- Faculty of Medicine and HealthUniversity of SydneySydneyNew South WalesAustralia
- Emergency Department Westmead HospitalWestern Sydney Local Health DistrictSydneyNew South WalesAustralia
| | - Ian Carter
- Centre for Infectious Diseases and Microbiology Laboratory ServicesInstitute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead HospitalSydneyNew South WalesAustralia
| | - Ruth Barratt
- Faculty of Medicine and HealthUniversity of SydneySydneyNew South WalesAustralia
- Infectious Diseases and Sexual Health ServicesWestmead HospitalSydneyNew South WalesAustralia
| | - Mark Robertson
- Centre for Infectious Diseases and Microbiology Laboratory ServicesInstitute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead HospitalSydneyNew South WalesAustralia
- Department of Microbiology and Infectious Diseases, NSW Health PathologyGosford HospitalCentral CoastNew South WalesAustralia
| | - Sai R. Baskar
- Centre for Infectious Diseases and Microbiology Laboratory ServicesInstitute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead HospitalSydneyNew South WalesAustralia
- Department of Microbiology and Infectious DiseasesNSW Health Pathology, Concord Repatriation General HospitalSydneyNew South WalesAustralia
| | - Caren Friend
- Counter Disaster UnitWestern Sydney Local Health DistrictSydneyNew South WalesAustralia
| | - Roselle S. Robosa
- Centre for Infectious Diseases and Microbiology Laboratory ServicesInstitute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead HospitalSydneyNew South WalesAustralia
| | | | - Shizar Nahidi
- Faculty of Medicine and HealthUniversity of SydneySydneyNew South WalesAustralia
| | - Deborough A. Macbeth
- Department of Infectious Diseases and ImmunologyGold Coast University HospitalGold CoastQueenslandAustralia
| | - Kylie A. D. Alcorn
- Department of Infectious Diseases and ImmunologyGold Coast University HospitalGold CoastQueenslandAustralia
| | - Andre Wattiaux
- Gold Coast Public Health UnitGold CoastQueenslandAustralia
| | - Frederick Moore
- Public Health Virology LaboratoryForensic and Scientific ServicesBrisbaneQueenslandAustralia
| | - Jamie McMahon
- Public Health Virology LaboratoryForensic and Scientific ServicesBrisbaneQueenslandAustralia
- Child Health Research CentreThe University of QueenslandBrisbaneQueenslandAustralia
| | - William Naughton
- Monash Infectious DiseasesMonash HealthMelbourneVictoriaAustralia
| | - Tony M. Korman
- Monash Infectious DiseasesMonash HealthMelbourneVictoriaAustralia
- Centre for Inflammatory Diseases, Department of MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Mike Catton
- Victorian Infectious Diseases Reference LaboratoryRoyal Melbourne Hospital, Peter Doherty Institute for Infections and ImmunityMelbourneVictoriaAustralia
| | | | - Finn Romanes
- Department of Health and Human ServicesState Government VictoriaMelbourneVictoriaAustralia
| | - Emily Rowe
- Infectious Diseases UnitRoyal Adelaide HospitalAdelaideSouth AustraliaAustralia
- Faculty of Health and Medical SciencesUniversity of AdelaideAdelaideSouth AustraliaAustralia
| | - Jennifer Catford
- Infectious Diseases UnitRoyal Adelaide HospitalAdelaideSouth AustraliaAustralia
| | - Brendan Kennedy
- Infectious Diseases UnitRoyal Adelaide HospitalAdelaideSouth AustraliaAustralia
- Communicable Disease Control BranchSA HealthAdelaideSouth AustraliaAustralia
| | - Ming Qiao
- Directorate of Microbiology and Infectious DiseasesSouth Australia PathologyAdelaideSouth AustraliaAustralia
| | - David Shaw
- Infectious Diseases UnitRoyal Adelaide HospitalAdelaideSouth AustraliaAustralia
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22
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Salamanna F, Maglio M, Landini MP, Fini M. Body Localization of ACE-2: On the Trail of the Keyhole of SARS-CoV-2. Front Med (Lausanne) 2020; 7:594495. [PMID: 33344479 PMCID: PMC7744810 DOI: 10.3389/fmed.2020.594495] [Citation(s) in RCA: 136] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 11/16/2020] [Indexed: 01/08/2023] Open
Abstract
The explosion of the new coronavirus (SARS-CoV-2) pandemic has brought the role of the angiotensin converting enzyme 2 (ACE2) back into the scientific limelight. Since SARS-CoV-2 must bind the ACE2 for entering the host cells in humans, its expression and body localization are critical to track the potential target organ of this infection and to outline disease progression and clinical outcomes. Here, we mapped the physiological body distribution, expression, and activities of ACE2 and discussed its potential correlations and mutal interactions with the disparate symptoms present in SARS-CoV-2 patients at the level of different organs. We highlighted that despite during SARS-CoV-2 infection ACE2-expressing organs may become direct targets, leading to severe pathological manifestations, and subsequent multiple organ failures, the exact mechanism and the potential interactions through which ACE2 acts in these organs is still heavily debated. Further scientific efforts, also considering a personalized approach aimed to consider specific patient differences in the mutual interactions ACE2-SARS-CoV-2 and the long-term health effects associated with COVID-19 are currently mandatory.
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Affiliation(s)
- Francesca Salamanna
- Surgical Sciences and Technologies, Istituto di Ricovero e Cura a Carattere Scientifico Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Melania Maglio
- Surgical Sciences and Technologies, Istituto di Ricovero e Cura a Carattere Scientifico Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Maria Paola Landini
- Scientific Direction, Istituto di Ricovero e Cura a Carattere Scientifico Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Milena Fini
- Surgical Sciences and Technologies, Istituto di Ricovero e Cura a Carattere Scientifico Istituto Ortopedico Rizzoli, Bologna, Italy
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23
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Oliva A, Siccardi G, Migliarini A, Cancelli F, Carnevalini M, D'Andria M, Attilia I, Danese VC, Cecchetti V, Romiti R, Ceccarelli G, Mastroianni CM, Palange P, Venditti M. Co-infection of SARS-CoV-2 with Chlamydia or Mycoplasma pneumoniae: a case series and review of the literature. Infection 2020; 48:871-877. [PMID: 32725598 PMCID: PMC7386385 DOI: 10.1007/s15010-020-01483-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 07/15/2020] [Indexed: 12/13/2022]
Abstract
INTRODUCTION The novel coronavirus SARS-CoV-2 has spread all over the world causing a global pandemic and representing a great medical challenge. Nowadays, there is limited knowledge on the rate of co-infections with other respiratory pathogens, with viral co-infection being the most representative agents. Co-infection with Mycoplasma pneumoniae has been described both in adults and pediatrics whereas only two cases of Chlamydia pneumoniae have been reported in a large US study so far. METHODS In the present report, we describe a series of seven patients where co-infection with C. pneumoniae (n = 5) or M. pneumoniae (n = 2) and SARS-CoV-2 was detected in a large teaching hospital in Rome. RESULTS AND CONCLUSION An extensive review of the updated literature regarding the co-infection between SARS-CoV-2 and these atypical pathogens is also performed.
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Affiliation(s)
- Alessandra Oliva
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy.
| | - G Siccardi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - A Migliarini
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - F Cancelli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - M Carnevalini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - M D'Andria
- Department of Clinical, Internal, Anestesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - I Attilia
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - V C Danese
- Department of Clinical, Internal, Anestesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - V Cecchetti
- Department of Clinical, Internal, Anestesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - R Romiti
- Department of Clinical, Internal, Anestesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - G Ceccarelli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - C M Mastroianni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - P Palange
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - M Venditti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy
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24
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Karcıoğlu O, Yüksel A, Baha A, Er AB, Esendağlı D, Gülhan PY, Karaoğlanoğlu S, Erçelik M, Şerifoğlu İ, Yıldız E, Köktürk N. Covid-19: The Biggest Threat of the 21 st Century: In Respectful Memory of the Warriors All Over the World. Turk Thorac J 2020; 21:409-418. [PMID: 33352097 PMCID: PMC7752102 DOI: 10.5152/turkthoracj.2020.20069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 07/06/2020] [Indexed: 01/08/2023]
Abstract
Since the first case was diagnosed in China, the new coronavirus infection (COVID-19) has become the number one issue in the world and it seems to remain trend-topic for a long time. Until 17 April, it affected 210 countries, infected over 2 million people and caused approximately 150000 deaths. Although the course of the disease ranges from asymptomatic state to severe ARDS; the majority of patients reveal only mild symptoms. Though adults are the most commonly affected group; it can also be seen in newborns and elderly patients. Unfortunately, elderly patients are the most vulnerable group with higher mortality. Elderly patients, smokers and patients with comorbid conditions are most affected by the disease. In certain diagnostical tool is the real-time reverse transcription-polymerase chain reaction (real-time RT-PCR) test. However, it can be resulted in false-negative results and in this case the computed thorax tomography (CT) is one of the most important tools with high sensitivity. Besides the supportive treatment, most commonly used agents are immunomodulatory drugs such as plaquenil and azitromycin, and anti-virals including oseltamivir, ritonavir-lopinavir, favipiravir. Until a vaccine or a specific therapy invented, the most important intervention to control the disease is to fight against transmission. This is a real war and the doctors are the soldiers.
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Affiliation(s)
- Oğuz Karcıoğlu
- Clinic of Chest Diseases, Çubuk Halil Şıvgın State Hospital, Ankara, Turkey
| | - Aycan Yüksel
- Department of Chest Diseases, Ufuk University School of Medicine, Ankara, Turkey
| | - Ayşe Baha
- Department of Chest Diseases, Near East University School of Medicine, Mersin, Turkey
| | - Aslıhan Banu Er
- Clinic of Chest Diseases, Denizli State Hospital, Denizli, Turkey
| | - Dorina Esendağlı
- Department of Chest Diseases, Başkent University School of Medicine, Ankara Turkey
| | - Pınar Yıldız Gülhan
- Department of Chest Diseases, Düzce University School of Medicine, Düzce, Turkey
| | - Selen Karaoğlanoğlu
- Department of Chest Diseases, Ordu University School of Medicine, Ordu, Turkey
| | - Merve Erçelik
- Department of Chest Diseases, Düzce University School of Medicine, Düzce, Turkey
| | - İrem Şerifoğlu
- Clinic of Chest Diseases, Kırıkhan State Hospital, Hatay, Turkey
| | - Ethem Yıldız
- Clinic of Chest Diseases, Bingöl State Hospital, Bingöl, Turkey
| | - Nurdan Köktürk
- Department of Chest Diseases, Gazi University School of Medicine, Ankara, Turkey
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25
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Abate BB, Kassie AM, Kassaw MW, Aragie TG, Masresha SA. Sex difference in coronavirus disease (COVID-19): a systematic review and meta-analysis. BMJ Open 2020; 10:e040129. [PMID: 33028563 PMCID: PMC7539579 DOI: 10.1136/bmjopen-2020-040129] [Citation(s) in RCA: 150] [Impact Index Per Article: 37.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 08/10/2020] [Accepted: 08/11/2020] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To assess the sex difference in the prevalence of COVID-19 confirmed cases. DESIGN Systematic review and meta-analysis. SETTING PubMed, Cochrane Library and Google Scholar were searched for related information. The authors developed a data extraction form on an Excel sheet and the following data from eligible studies were extracted: author, country, sample size, number of female patients and number of male patients. Using STATA V.14 for analysis, the authors pooled the overall prevalence of men and/or women using a random-effect meta-analysis model. The authors examined the heterogeneity in effect size using Q statistics and I2 statistics. Subgroup and sensitivity analyses were performed. Publication bias was also checked. PARTICIPANTS Studies on COVID-19 confirmed cases were included. INTERVENTION Sex (male/female) of COVID-19 confirmed cases was considered. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was prevalence of COVID-19 among men and women. RESULTS A total of 57 studies with 221 195 participants were used in the analysis. The pooled prevalence of COVID-19 among men was found to be 55.00 (51.43-56.58, I2=99.5%, p<0.001). Sensitivity analysis showed the findings were not dependent on a single study. Moreover, a funnel plot showed symmetrical distribution. Egger's regression test p value was not significant, which indicates absence of publication bias in both outcomes. CONCLUSIONS The prevalence of symptomatic COVID-19 was found to be higher in men than in women. The high prevalence of smoking and alcohol consumption contributed to the high prevalence of COVID-19 among men. Additional studies on the discrepancies in severity and mortality rate due to COVID-19 among men and women and the associated factors are recommended.
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Affiliation(s)
| | | | | | | | - Setamlak Adane Masresha
- College of Health Sciences, Department of Public Health, Woldia University, Woldia, Amhara, Ethiopia
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26
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Amin D, McKitish K, Shah PS. Association of mortality and recent Mycoplasma pneumoniae infection in COVID-19 patients. J Med Virol 2020; 93:1180-1183. [PMID: 32852080 PMCID: PMC7461379 DOI: 10.1002/jmv.26467] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 08/22/2020] [Accepted: 08/24/2020] [Indexed: 12/27/2022]
Abstract
To compare characteristics and outcomes of patients who had COVID‐19 with Mycoplasma pneumoniae immunoglobulin M (IgM) antibodies to those without M. pneumoniae antibodies. We retrospectively reviewed cases admitted over a 4‐week period between 17 March 2020 and 14 April 2020 to the Hoboken University Medical Center, NJ, USA. We compared the outcomes of COVID‐19 patients who were positive for M. pneumoniae IgM with those who were negative for M. pneumoniae IgM. The primary outcome was mortality. The adjusted odds ratio was calculated after controlling for baseline differences. Of 139 patients admitted with COVID‐19, 79 were positive for M. pneumoniae IgM. The mortality among those who were M. pneumoniae IgM positive was significantly higher (adjusted odds ratio: 2.28, 95% confidence interval: 1.03 to 5.03) compared with those who were M. pneumoniae IgM negative. Patients with coinfection (COVID‐19 and mycoplasma) have higher mortality compared with patients with just COVID‐19 disease.
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Affiliation(s)
- Deepak Amin
- Department of Medicine, Hoboken University Medical Center, Hoboken, New Jersey, USA
| | - Kristin McKitish
- Department of Medicine, Hoboken University Medical Center, Hoboken, New Jersey, USA
| | - Prakesh S Shah
- Department of Pediatrics, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
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27
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Pimentel MAF, Redfern OC, Hatch R, Young JD, Tarassenko L, Watkinson PJ. Trajectories of vital signs in patients with COVID-19. Resuscitation 2020; 156:99-106. [PMID: 32918984 PMCID: PMC7481128 DOI: 10.1016/j.resuscitation.2020.09.002] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 08/04/2020] [Accepted: 09/01/2020] [Indexed: 12/23/2022]
Abstract
Background The global pandemic of coronavirus disease 2019 (COVID-19) has placed a huge strain on UK hospitals. Early studies suggest that patients can deteriorate quickly after admission to hospital. The aim of this study was to model changes in vital signs for patients hospitalised with COVID-19. Methods This was a retrospective observational study of adult patients with COVID-19 admitted to one acute hospital trust in the UK (CV) and a cohort of patients admitted to the same hospital between 2013-2017 with viral pneumonia (VI). The primary outcome was the start of continuous positive airway pressure/non-invasive positive pressure ventilation, ICU admission or death in hospital. We used non-linear mixed-effects models to compare changes in vital sign observations prior to the primary outcome. Using observations and FiO2 measured at discharge in the VI cohort as the model of normality, we also combined individual vital signs into a single novelty score. Results There were 497 cases of COVID-19, of whom 373 had been discharged from hospital. 135 (36.2%) of patients experienced the primary outcome, of whom 99 died in hospital. In-hospital mortality was over 4-times higher in the CV than the VI cohort (26.5% vs 6%). For those patients who experienced the primary outcome, CV patients became increasingly hypoxaemic, with a median estimated FiO2 (0.75) higher than that of the VI cohort (estimated FiO2 of 0.35). Prior to the primary outcome, blood pressure remained within normal range, and there was only a small rise in heart rate. The novelty score showed that patients with COVID-19 deteriorated more rapidly that patients with viral pneumonia. Conclusions Patients with COVID-19 who deteriorate in hospital experience rapidly-worsening respiratory failure, with low SpO2 and high FiO2, but only minor abnormalities in other vital signs. This has potential implications for the ability of early warning scores to identify deteriorating patients.
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Affiliation(s)
- Marco A F Pimentel
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UK
| | - Oliver C Redfern
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Robert Hatch
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
| | - J Duncan Young
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Lionel Tarassenko
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UK
| | - Peter J Watkinson
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
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28
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Smyk W, Janik MK, Portincasa P, Milkiewicz P, Lammert F, Krawczyk M. COVID-19: Focus on the lungs but do not forget the gastrointestinal tract. Eur J Clin Invest 2020; 50:e13276. [PMID: 32406522 PMCID: PMC7261996 DOI: 10.1111/eci.13276] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 05/01/2020] [Accepted: 05/09/2020] [Indexed: 01/08/2023]
Abstract
The coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 was declared in the last weeks as global pandemic. Currently affecting more than 5 000 000 individuals worldwide, COVID-19 is most commonly associated with symptoms caused by the acute respiratory distress syndrome (ARDS). As the number of infected individuals increases, we are learning that not only lungs, but also other organs can be affected by the virus. The gastrointestinal symptoms, for example diarrhoea, vomiting, nausea or abdominal pain, are frequent in patients with COVID-19. Moreover, alimentary tract symptoms may precede the respiratory presentation of SARS-CoV-2 infection. This can lead to delayed diagnosis and inappropriate management of infected patients. In addition, SARS-CoV-2 nucleic acid can be detected in faeces of infected patients and rectal swabs are even reported to remain positive for a longer period of time than nasopharyngeal swabs. Here, we aim to provide an update on the gastrointestinal involvement of COVID-19 presenting the symptoms that can be encountered in infected patients. We address the role of angiotensin-converting enzyme 2 (ACE2), as a functional receptor for SARS-CoV-2, which also was found in the gastrointestinal tract. Finally, we briefly discuss faecal shedding of SARS-CoV-2 and its potential role in the pathogenesis of the disease.
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Affiliation(s)
- Wiktor Smyk
- Liver and Internal Medicine Unit, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Maciej K Janik
- Liver and Internal Medicine Unit, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Piero Portincasa
- Clinica Medica "A. Murri", Department of Biomedical Sciences and Human Oncology, "Aldo Moro" University Medical School, Bari, Italy
| | - Piotr Milkiewicz
- Liver and Internal Medicine Unit, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Frank Lammert
- Department of Medicine II, Saarland University Medical Center, Saarland University, Homburg, Germany
| | - Marcin Krawczyk
- Department of Medicine II, Saarland University Medical Center, Saarland University, Homburg, Germany.,Laboratory of Metabolic Liver Diseases, Department of General, Transplant and Liver Surgery, Centre for Preclinical Research, Medical University of Warsaw, Warsaw, Poland
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Chiu NC, Chi H, Tai YL, Peng CC, Tseng CY, Chen CC, Tan BF, Lin CY. Impact of Wearing Masks, Hand Hygiene, and Social Distancing on Influenza, Enterovirus, and All-Cause Pneumonia During the Coronavirus Pandemic: Retrospective National Epidemiological Surveillance Study. J Med Internet Res 2020; 22:e21257. [PMID: 32750008 PMCID: PMC7471891 DOI: 10.2196/21257] [Citation(s) in RCA: 158] [Impact Index Per Article: 39.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 07/29/2020] [Accepted: 08/01/2020] [Indexed: 01/12/2023] Open
Abstract
Background The coronavirus disease (COVID-19) pandemic is an important health crisis worldwide. Several strategies were implemented to combat COVID-19, including wearing masks, hand hygiene, and social distancing. The impact of these strategies on COVID-19 and other viral infections remains largely unclear. Objective We aim to investigate the impact of implemented infectious control strategies on the incidences of influenza, enterovirus infection, and all-cause pneumonia during the COVID-19 pandemic. Methods We utilized the electronic database of the Taiwan National Infectious Disease Statistics System and extracted incidences of COVID-19, influenza virus, enterovirus, and all-cause pneumonia. We compared the incidences of these diseases from week 45 of 2016 to week 21 of 2020 and performed linear regression analyses. Results The first case of COVID-19 in Taiwan was reported in late January 2020 (week 4). Infectious control strategies have been promoted since late January. The influenza virus usually peaks in winter and decreases around week 14. However, a significant decrease in influenza was observed after week 6 of 2020. Regression analyses produced the following results: 2017, R2=0.037; 2018, R2=0.021; 2019, R2=0.046; and 2020, R2=0.599. A dramatic decrease in all-cause pneumonia was also reported (R2 values for 2017-2020 were 0.435, 0.098, 0.352, and 0.82, respectively). Enterovirus had increased by week 18 in 2017-2019, but this was not observed in 2020. Conclusions Using this national epidemiological database, we found a significant decrease in cases of influenza, enterovirus, and all-cause pneumonia during the COVID-19 pandemic. Wearing masks, hand hygiene, and social distancing may contribute not only to the prevention of COVID-19 but also to the decline of other respiratory infectious diseases. Further studies are warranted to elucidate the causal relationship.
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Affiliation(s)
- Nan-Chang Chiu
- MacKay Children's Hospital, Taipei, Taiwan.,Department of Medicine, MacKay Medical College, New Taipei, Taiwan
| | - Hsin Chi
- MacKay Children's Hospital, Taipei, Taiwan.,Department of Medicine, MacKay Medical College, New Taipei, Taiwan
| | - Yu-Lin Tai
- Hsinchu MacKay Memorial Hospital, Hsinchu, Taiwan
| | - Chun-Chih Peng
- MacKay Children's Hospital, Taipei, Taiwan.,Department of Medicine, MacKay Medical College, New Taipei, Taiwan
| | | | - Chung-Chu Chen
- Hsinchu MacKay Memorial Hospital, Hsinchu, Taiwan.,Teaching Center of Natural Science, Minghsin University of Science and Technology, Hsinchu, Taiwan
| | - Boon Fatt Tan
- National Taiwan University, Hsinchu Branch, Hsinchu, Taiwan
| | - Chien-Yu Lin
- Department of Medicine, MacKay Medical College, New Taipei, Taiwan.,Hsinchu MacKay Memorial Hospital, Hsinchu, Taiwan
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30
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Manohar P, Loh B, Nachimuthu R, Hua X, Welburn SC, Leptihn S. Secondary Bacterial Infections in Patients With Viral Pneumonia. Front Med (Lausanne) 2020; 7:420. [PMID: 32850912 PMCID: PMC7419580 DOI: 10.3389/fmed.2020.00420] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 06/30/2020] [Indexed: 01/08/2023] Open
Abstract
Pulmonary diseases of viral origin are often followed by the manifestation of secondary infections, leading to further clinical complications and negative disease outcomes. Thus, research on secondary infections is essential. Here, we review clinical data of secondary bacterial infections developed after the onset of pulmonary viral infections. We review the most recent clinical data and current knowledge of secondary bacterial infections and their treatment in SARS-CoV-2 positive patients; case reports from SARS-CoV, MERS-CoV, SARS-CoV2 and the best-studied respiratory virus, influenza, are described. We outline treatments used or prophylactic measures employed for secondary bacterial infections. This evaluation includes recent clinical reports of pulmonary viral infections, including those by COVID-19, that reference secondary infections. Where data was provided for COVID-19 patients, a mortality rate of 15.2% due to secondary bacterial infections was observed for patients with pneumonia (41 of 268). Most clinicians treated patients with SARS-CoV-2 infections with prophylactic antibiotics (63.7%, n = 1,901), compared to 73.5% (n = 3,072) in all clinical reports of viral pneumonia included in this review. For all cases of viral pneumonia, a mortality rate of 10.9% due to secondary infections was observed (53 of 482). Most commonly, quinolones, cephalosporins and macrolides were administered, but also the glycopeptide vancomycin. Several bacterial pathogens appear to be prevalent as causative agents of secondary infections, including antibiotic-resistant strains of Staphylococcus aureus and Klebsiella pneumoniae.
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Affiliation(s)
- Prasanth Manohar
- Zhejiang University-University of Edinburgh (ZJU-UoE) Institute, Zhejiang University, Haining, China.,School of Medicine, The Second Affiliated Hospital Zhejiang University (SAHZU), Hangzhou, China
| | - Belinda Loh
- Zhejiang University-University of Edinburgh (ZJU-UoE) Institute, Zhejiang University, Haining, China
| | - Ramesh Nachimuthu
- Antibiotic Resistance and Phage Therapy Laboratory, School of Bio Sciences and Technology, Vellore Institute of Technology (VIT), Vellore, India
| | - Xiaoting Hua
- Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China
| | - Susan C Welburn
- Zhejiang University-University of Edinburgh (ZJU-UoE) Institute, Zhejiang University, Haining, China.,Infection Medicine, Biomedical Sciences, Edinburgh Medical School, College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, United Kingdom
| | - Sebastian Leptihn
- Zhejiang University-University of Edinburgh (ZJU-UoE) Institute, Zhejiang University, Haining, China.,Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Infection Medicine, Biomedical Sciences, Edinburgh Medical School, College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, United Kingdom
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31
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Kulkarni AV, Kumar P, Tevethia HV, Premkumar M, Arab JP, Candia R, Talukdar R, Sharma M, Qi X, Rao PN, Reddy DN. Systematic review with meta-analysis: liver manifestations and outcomes in COVID-19. Aliment Pharmacol Ther 2020; 52:584-599. [PMID: 32638436 PMCID: PMC7361465 DOI: 10.1111/apt.15916] [Citation(s) in RCA: 165] [Impact Index Per Article: 41.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 05/22/2020] [Accepted: 06/04/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND The incidence of elevated liver chemistries and the presence of pre-existing chronic liver disease (CLD) have been variably reported in COVID-19. AIMS To assess the prevalence of CLD, the incidence of elevated liver chemistries and the outcomes of patients with and without underlying CLD/elevated liver chemistries in COVID-19. METHODS A comprehensive search of electronic databases from 1 December 2019 to 24 April 2020 was done. We included studies reporting underlying CLD or elevated liver chemistries and patient outcomes in COVID-19. RESULTS 107 articles (n = 20 874 patients) were included for the systematic review. The pooled prevalence of underlying CLD was 3.6% (95% CI, 2.5-5.1) among the 15 407 COVID-19 patients. The pooled incidence of elevated liver chemistries in COVID-19 was 23.1% (19.3-27.3) at initial presentation. Additionally, 24.4% (13.5-40) developed elevated liver chemistries during the illness. The pooled incidence of drug-induced liver injury was 25.4% (14.2-41.4). The pooled prevalence of CLD among 1587 severely infected patients was 3.9% (3%-5.2%). The odds of developing severe COVID-19 in CLD patients was 0.81 (0.31-2.09; P = 0.67) compared to non-CLD patients. COVID-19 patients with elevated liver chemistries had increased risk of mortality (OR-3.46 [2.42-4.95, P < 0.001]) and severe disease (OR-2.87 [95% CI, 2.29-3.6, P < 0.001]) compared to patients without elevated liver chemistries. CONCLUSIONS Elevated liver chemistries are common at presentation and during COVID-19. The severity of elevated liver chemistries correlates with the outcome of COVID-19. The presence of CLD does not alter the outcome of COVID-19. Further studies are needed to analyse the outcomes of compensated and decompensated liver disease.
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Affiliation(s)
- Anand V. Kulkarni
- Department of HepatologyAsian Institute of GastroenterologyHyderabadIndia
| | - Pramod Kumar
- Department of HepatologyAsian Institute of GastroenterologyHyderabadIndia
| | | | | | - Juan Pablo Arab
- Departamento de GastroenterologiaEscuela de MedicinaPontificia Universidad Catolica de ChileSantiagoChile
| | - Roberto Candia
- Departamento de GastroenterologiaEscuela de MedicinaPontificia Universidad Catolica de ChileSantiagoChile
| | - Rupjyoti Talukdar
- Department of GastroenterologyAsian Institute of GastroenterologyHyderabadIndia
| | - Mithun Sharma
- Department of HepatologyAsian Institute of GastroenterologyHyderabadIndia
| | - Xiaolong Qi
- CHESS CenterInstitute of Portal HypertensionThe First Hospital of Lanzhou UniversityLanzhouChina
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32
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Packwood R, Galletta G, Tennyson J. An Unusual Case Report of COVID-19 Presenting with Meningitis Symptoms and Shingles. Clin Pract Cases Emerg Med 2020; 4:316-320. [PMID: 32926675 PMCID: PMC7434230 DOI: 10.5811/cpcem.2020.4.47557] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 04/17/2020] [Accepted: 04/17/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION As severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spreads across the globe, physicians face the challenges of a contagious pandemic including which patients to isolate, how to conserve personal protective equipment, and who to test. The current protocol at our hospital is to place anyone with new cough, dyspnea, or fever into airborne and contact precautions and consider them for testing. Unfortunately, the symptomatic presentations of coronavirus disease 2019 (COVID-19) are proving more variable than previously thought. CASE REPORT Our case of COVID-19 presented with headache and then progressed to a meningitis-like illness with co-existing shingles rash. CONCLUSION COVID-19 can have a variety of initial presentations that are not the classic respiratory symptoms and fever. These presenting symptoms of COVID-19 can include a meningitis-like illness, as our case report indicates. The wide variety of presentations of COVID-19 may warrant widespread testing to identify cases, protect healthcare workers, and prevent the spread of this pandemic.
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Affiliation(s)
- Rebecca Packwood
- University of Massachusetts, Department of Emergency Medicine, Worcester, Massachusetts
| | - Gayle Galletta
- University of Massachusetts, Department of Emergency Medicine, Worcester, Massachusetts
| | - Joseph Tennyson
- University of Massachusetts, Department of Emergency Medicine, Worcester, Massachusetts
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33
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Galbadage T, Peterson BM, Awada J, Buck AS, Ramirez DA, Wilson J, Gunasekera RS. Systematic Review and Meta-Analysis of Sex-Specific COVID-19 Clinical Outcomes. Front Med (Lausanne) 2020; 7:348. [PMID: 32671082 PMCID: PMC7331754 DOI: 10.3389/fmed.2020.00348] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 06/10/2020] [Indexed: 01/08/2023] Open
Abstract
To successfully mitigate the extraordinary devastation caused by the Coronavirus disease 2019 (COVID-19) pandemic, it is crucial to identify important risk factors for this disease. One such neglected health determinant is the sex of the patient. This is an essential clinical characteristic, as it can factor into a patient's clinical management and preventative measures. Some clinical studies have shown disparities in the proportion between males and females that have more severe clinical outcomes or, subsequently, die from this disease. However, this association has not been unequivocally established. Thus, the purpose of this investigation was to examine the association between male sex and COVID-19 severity. We systematically reviewed the literature, identified studies that matched predetermined selection criteria, and performed a meta-analysis to evaluate the proportion of males among four disease severity categories. Appropriate assessment strategies were implemented to assess and minimize potential biases. The results of this meta-analysis indicated that males constituted a significantly higher proportion of those who had adverse clinical outcomes and died from COVID-19. As the coronavirus spread from the East to the West, male sex remained a consistent risk factor. Our results support the establishment of the male sex as an important risk factor for this disease. Early identification and appropriate medical care for males with lab-confirmed COVID-19 may substantially change the course of clinical prognosis, resulting in greater numbers of lives saved.
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Affiliation(s)
- Thushara Galbadage
- Department of Kinesiology and Health Science, Biola University, La Mirada, CA, United States
| | - Brent M Peterson
- Department of Kinesiology and Health Science, Biola University, La Mirada, CA, United States
| | - Joseph Awada
- Department of Chemistry, Physics, and Engineering, Biola University, La Mirada, CA, United States
| | - Alison S Buck
- Department of Chemistry, Physics, and Engineering, Biola University, La Mirada, CA, United States
| | - Danny A Ramirez
- Department of Chemistry, Physics, and Engineering, Biola University, La Mirada, CA, United States
| | - Jason Wilson
- Department of Mathematics and Computer Science, Biola University, La Mirada, CA, United States
| | - Richard S Gunasekera
- Department of Chemistry, Physics, and Engineering, Biola University, La Mirada, CA, United States
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34
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Wang J, Tang Y, Ma Y, Zhou Q, Li W, Baskota M, Yang Y, Wang X, Li Q, Luo X, Fukuoka T, Ahn HS, Lee MS, Luo Z, Liu E, Chen Y. Efficacy and safety of antibiotic agents in children with COVID-19: a rapid review. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:619. [PMID: 32566556 PMCID: PMC7290645 DOI: 10.21037/atm-20-3300] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 04/26/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND The aim of this review was to evaluate the efficacy and safety of antibiotic agents in children with COVID-19, as well as to introduce the present situation of antibiotics use and bacterial coinfections in COVID-19 patients. METHODS We searched Cochrane library, Medline, Embase, Web of Science, CBM, Wanfang Data and CNKI from their inception to March 31, 2020. In addition, we searched related studies on COVID-19 published before March 31, 2020 through Google Scholar. We evaluated the risk of bias of included studies, and synthesized the results using a qualitative synthesis. RESULTS Six studies met our inclusion criteria. Five studies on SARS showed an overall risk of death of 7.2% to 20.0%. One study of SARS patients who used macrolides, quinolones or beta lactamases showed that the mean duration of hospital stay was 14.2, 13.8 and 16.2 days, respectively, and their average duration of fever was 14.3, 14.0 and 16.2 days, respectively. One cohort study on MERS indicated that macrolide therapy was not associated with a significant reduction in 90-day mortality (adjusted OR 0.84, 95% CI: 0.47-1.51, P=0.56) and improvement in MERS-CoV RNA clearance (adjusted HR 0.88, 95% CI: 0.47-1.64, P=0.68). According to the findings of 33 studies, the proportion of antibiotics use ranged from 19.4% to 100.0% in children and 13.2% to 100.0% in adults, despite the lack of etiological evidence. The most commonly used antibiotics in adults were quinolones, cephalosporins and macrolides and in children meropenem and linezolid. CONCLUSIONS The benefits of antibiotic agents for adults with SARS or MERS were questionable in the absence of bacterial coinfections. There is no evidence to support the use of antibiotic agents for children with COVID-19 in the absence of bacterial coinfection.
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Affiliation(s)
- Jianjian Wang
- School of Public Health, Lanzhou University, Lanzhou 730000, China
- Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
| | - Yuyi Tang
- Department of Respiratory Medicine, Children’s Hospital of Chongqing Medical University, Chongqing 400014, China
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children’s Hospital of Chongqing Medical University, Chongqing 400014, China
- Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - Yanfang Ma
- Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
| | - Qi Zhou
- Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
- The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, China
| | - Weiguo Li
- Department of Respiratory Medicine, Children’s Hospital of Chongqing Medical University, Chongqing 400014, China
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children’s Hospital of Chongqing Medical University, Chongqing 400014, China
- Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - Muna Baskota
- Department of Respiratory Medicine, Children’s Hospital of Chongqing Medical University, Chongqing 400014, China
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children’s Hospital of Chongqing Medical University, Chongqing 400014, China
- Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - Yinmei Yang
- Department of Respiratory Medicine, Children’s Hospital of Chongqing Medical University, Chongqing 400014, China
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children’s Hospital of Chongqing Medical University, Chongqing 400014, China
- Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - Xingmei Wang
- Department of Respiratory Medicine, Children’s Hospital of Chongqing Medical University, Chongqing 400014, China
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children’s Hospital of Chongqing Medical University, Chongqing 400014, China
- Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - Qingyuan Li
- Department of Respiratory Medicine, Children’s Hospital of Chongqing Medical University, Chongqing 400014, China
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children’s Hospital of Chongqing Medical University, Chongqing 400014, China
- Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - Xufei Luo
- School of Public Health, Lanzhou University, Lanzhou 730000, China
- Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
| | - Toshio Fukuoka
- Emergency and Critical Care Center, the Department of General Medicine, Department of Research and Medical Education at Kurashiki Central Hospital, Kurashiki, Japan
- Advisory Committee in Cochrane Japan, Tokyo, Japan
| | - Hyeong Sik Ahn
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
- Korea Cochrane Centre, Seoul, Korea
| | - Myeong Soo Lee
- Korea Institute of Oriental Medicine, Daejeon, Korea
- University of Science and Technology, Daejeon, Korea
| | - Zhengxiu Luo
- Department of Respiratory Medicine, Children’s Hospital of Chongqing Medical University, Chongqing 400014, China
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children’s Hospital of Chongqing Medical University, Chongqing 400014, China
- Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - Enmei Liu
- Department of Respiratory Medicine, Children’s Hospital of Chongqing Medical University, Chongqing 400014, China
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children’s Hospital of Chongqing Medical University, Chongqing 400014, China
- Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - Yaolong Chen
- School of Public Health, Lanzhou University, Lanzhou 730000, China
- Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
- Lanzhou University, an Affiliate of the Cochrane China Network, Lanzhou 730000, China
- Chinese GRADE Center, Lanzhou 730000, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou University, Lanzhou 730000, China
| | - on behalf of COVID-19 Evidence and Recommendations Working Group
- School of Public Health, Lanzhou University, Lanzhou 730000, China
- Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
- Department of Respiratory Medicine, Children’s Hospital of Chongqing Medical University, Chongqing 400014, China
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children’s Hospital of Chongqing Medical University, Chongqing 400014, China
- Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
- The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, China
- Emergency and Critical Care Center, the Department of General Medicine, Department of Research and Medical Education at Kurashiki Central Hospital, Kurashiki, Japan
- Advisory Committee in Cochrane Japan, Tokyo, Japan
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
- Korea Cochrane Centre, Seoul, Korea
- Korea Institute of Oriental Medicine, Daejeon, Korea
- University of Science and Technology, Daejeon, Korea
- Lanzhou University, an Affiliate of the Cochrane China Network, Lanzhou 730000, China
- Chinese GRADE Center, Lanzhou 730000, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou University, Lanzhou 730000, China
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35
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Giorgi PD, Villa F, Gallazzi E, Debernardi A, Schirò GR, Crisà FM, Talamonti G, D'Aliberti G. The management of emergency spinal surgery during the COVID-19 pandemic in Italy. Bone Joint J 2020; 102-B:671-676. [PMID: 32323563 DOI: 10.1302/0301-620x.102b6.bjj-2020-0537] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
AIMS The current pandemic caused by COVID-19 is the biggest challenge for national health systems for a century. While most medical resources are allocated to treat COVID-19 patients, several non-COVID-19 medical emergencies still need to be treated, including vertebral fractures and spinal cord compression. The aim of this paper is to report the early experience and an organizational protocol for emergency spinal surgery currently being used in a large metropolitan area by an integrated team of orthopaedic surgeons and neurosurgeons. METHODS An organizational model is presented based on case centralization in hub hospitals and early management of surgical cases to reduce hospital stay. Data from all the patients admitted for emergency spinal surgery from the beginning of the outbreak were prospectively collected and compared to data from patients admitted for the same reason in the same time span in the previous year, and treated by the same integrated team. RESULTS A total of 19 patients (11 males and eight females, with a mean age of 49.9 years (14 to 83)) were admitted either for vertebral fracture or spinal cord compression in a 19-day period, compared to the ten admitted in the previous year. No COVID-19 patients were treated. The mean time between admission and surgery was 1.7 days, significantly lower than 6.8 days the previous year (p < 0.001). CONCLUSION The structural organization and the management protocol we describe allowed us to reduce the time to surgery and ultimately hospital stay, thereby maximizing the already stretched medical resources available. We hope that our early experience can be of value to the medical communities that will soon be in the same emergency situation. Cite this article: Bone Joint J 2020;102-B(6):671-676.
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Affiliation(s)
- P D Giorgi
- Orthopedics and Traumatology Unit, Emergency and Urgency Department, A.S.S.T. Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - F Villa
- Neurosurgery Unit, Emergency and Urgency Department, A.S.S.T. Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - E Gallazzi
- Orthopedics and Traumatology Unit, Emergency and Urgency Department, A.S.S.T. Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - A Debernardi
- Neurosurgery Unit, Emergency and Urgency Department, A.S.S.T. Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - G R Schirò
- Orthopedics and Traumatology Unit, Emergency and Urgency Department, A.S.S.T. Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - F M Crisà
- Neurosurgery Unit, Emergency and Urgency Department, A.S.S.T. Grande Ospedale Metropolitano Niguarda, Milan, Italy.,Università Degli Studi di Milano, Milan, Italy
| | - G Talamonti
- Neurosurgery Unit, Emergency and Urgency Department, A.S.S.T. Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - G D'Aliberti
- Neurosurgery Unit, Emergency and Urgency Department, A.S.S.T. Grande Ospedale Metropolitano Niguarda, Milan, Italy
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36
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Easom N, Moss P, Barlow G, Samson A, Taynton T, Adams K, Ivan M, Burns P, Gajee K, Eastick K, Lillie PJ. Sixty-eight consecutive patients assessed for COVID-19 infection: Experience from a UK Regional infectious diseases Unit. Influenza Other Respir Viruses 2020; 14:374-379. [PMID: 32223012 PMCID: PMC7228236 DOI: 10.1111/irv.12739] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 03/13/2020] [Indexed: 01/05/2023] Open
Abstract
Background Assessment of possible infection with SARS‐CoV‐2, the novel coronavirus responsible for COVID‐19 illness, has been a major activity of infection services since the first reports of cases in December 2019. Objectives We report a series of 68 patients assessed at a Regional Infection Unit in the UK. Methods Between 29 January 2020 and 24 February 2020, demographic, clinical, epidemiological and laboratory data were collected. We compared clinical features between patients not requiring admission for clinical reasons or antimicrobials with those assessed as needing either admission or antimicrobial treatment. Results Patients assessed were aged from 0 to 76 years; 36/68 were female. Peaks of clinical assessments coincided with updates to the case definition for suspected COVID‐19. Microbiological diagnoses included SARS‐CoV‐2, mycoplasma pneumonia, influenza A, non‐SARS/MERS coronaviruses and rhinovirus/enterovirus. Nine of sixty‐eight received antimicrobials, 15/68 were admitted, 5 due to inability to self‐isolate. Patients requiring admission on clinical grounds or antimicrobials (14/68) were more likely to have fever or raised respiratory rate compared to those not requiring admission or antimicrobials. Conclusions The majority of patients had mild illness, which did not require clinical intervention. This finding supports a community testing approach, supported by clinicians able to review more unwell patients. Extensions of the epidemiological criteria for the case definition of suspected COVID‐19 lead to increased screening intensity; strategies must be in place to accommodate this in time for forthcoming changes as the epidemic develops.
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Affiliation(s)
- Nicholas Easom
- Department of Infection, Hull University Teaching Hospitals NHS Trust, Castle Hill Hospital, Hull, UK
| | - Peter Moss
- Department of Infection, Hull University Teaching Hospitals NHS Trust, Castle Hill Hospital, Hull, UK
| | - Gavin Barlow
- Department of Infection, Hull University Teaching Hospitals NHS Trust, Castle Hill Hospital, Hull, UK
| | - Anda Samson
- Department of Infection, Hull University Teaching Hospitals NHS Trust, Castle Hill Hospital, Hull, UK
| | - Thomas Taynton
- Department of Infection, Hull University Teaching Hospitals NHS Trust, Castle Hill Hospital, Hull, UK
| | - Kate Adams
- Department of Infection, Hull University Teaching Hospitals NHS Trust, Castle Hill Hospital, Hull, UK
| | - Monica Ivan
- Department of Infection, Hull University Teaching Hospitals NHS Trust, Castle Hill Hospital, Hull, UK
| | - Phillipa Burns
- Department of Infection, Hull University Teaching Hospitals NHS Trust, Castle Hill Hospital, Hull, UK
| | - Kavitha Gajee
- Department of Infection, Hull University Teaching Hospitals NHS Trust, Castle Hill Hospital, Hull, UK
| | - Kirstine Eastick
- Department of Infection, Hull University Teaching Hospitals NHS Trust, Castle Hill Hospital, Hull, UK
| | - Patrick J Lillie
- Department of Infection, Hull University Teaching Hospitals NHS Trust, Castle Hill Hospital, Hull, UK
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