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Rabaan AA, Smajlović S, Tombuloglu H, Ćordić S, Hajdarević A, Kudić N, Mutai AA, Turkistani SA, Al-Ahmed SH, Al-Zaki NA, Al Marshood MJ, Alfaraj AH, Alhumaid S, Al-Suhaimi E. SARS-CoV-2 infection and multi-organ system damage: A review. BIOMOLECULES AND BIOMEDICINE 2023; 23:37-52. [PMID: 36124445 PMCID: PMC9901898 DOI: 10.17305/bjbms.2022.7762] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 08/23/2022] [Indexed: 02/03/2023]
Abstract
The SARS-CoV-2 infection causes COVID-19, which has affected approximately six hundred million people globally as of August 2022. Organs and cells harboring angiotensin-converting enzyme 2 (ACE2) surface receptors are the primary targets of the virus. However, once it enters the body through the respiratory system, the virus can spread hematogenously to infect other body organs. Therefore, COVID-19 affects many organs, causing severe and long-term complications, even after the disease has ended, thus worsening the quality of life. Although it is known that the respiratory system is most affected by the SARS-CoV-2 infection, many organs/systems are affected in the short and long term. Since the COVID-19 disease simultaneously affects many organs, redesigning diagnostic and therapy policies to fit the damaged organs is strongly recommended. Even though the pathophysiology of many problems the infection causes is unknown, the frequency of COVID-19 cases rises with age and the existence of preexisting symptoms. This study aims to update our knowledge of SARS-CoV-2 infection and multi-organ dysfunction interaction based on clinical and theoretical evidence. For this purpose, the study comprehensively elucidates the most recent studies on the effects of SARS-CoV-2 infection on multiple organs and systems, including respiratory, cardiovascular, gastrointestinal, renal, nervous, endocrine, reproductive, immune, and parts of the integumentary system. Understanding the range of atypical COVID-19 symptoms could improve disease surveillance, limit transmission, and avoid additional multi-organ-system problems.
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Affiliation(s)
- Ali A Rabaan
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia,College of Medicine, Alfaisal University, Riyadh, Saudi Arabia,Department of Public Health and Nutrition, The University of Haripur, Haripur, Pakistan,Correspondence to Ali A. Rabaan: ; Huseyin Tombuloglu:
| | - Samira Smajlović
- Laboratory Diagnostics Institute Dr. Dedić, Bihać, Bosnia and Herzegovina
| | - Huseyin Tombuloglu
- Department of Genetics Research, Institute for Research and Medical Consultations (IRMC), Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia,Correspondence to Ali A. Rabaan: ; Huseyin Tombuloglu:
| | - Sabahudin Ćordić
- Cantonal Hospital “Dr. Irfan Ljubijankić”, Microbiological Laboratory, Bihać, Bosnia and Herzegovina
| | - Azra Hajdarević
- International Burch University, Faculty of Engineering and Natural Sciences, Department of Genetics and Bioengineering, Ilidža, Bosnia and Herzegovina
| | - Nudžejma Kudić
- University of Sarajevo, Faculty of Agriculture and Food Science, Sarajevo, Bosnia and Herzegovina
| | - Abbas Al Mutai
- Research Center, Almoosa Specialist Hospital, Al Mubarraz, Saudi Arabia,College of Nursing, Princess Norah Bint Abdulrahman University, Riyadh, Saudi Arabia,School of Nursing, Wollongong University, Wollongong, NSW, Australia,Nursing Department, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | | | - Shamsah H Al-Ahmed
- Specialty Pediatric Medicine, Qatif Central Hospital, Qatif, Saudi Arabia
| | - Nisreen A Al-Zaki
- Specialty Pediatric Medicine, Qatif Central Hospital, Qatif, Saudi Arabia
| | - Mona J Al Marshood
- Specialty Pediatric Medicine, Qatif Central Hospital, Qatif, Saudi Arabia
| | - Amal H Alfaraj
- Pediatric Department, Abqaiq General Hospital, First Eastern Health Cluster, Abqaiq, Saudi Arabia
| | - Saad Alhumaid
- Administration of Pharmaceutical Care, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa, Saudi Arabia
| | - Ebtesam Al-Suhaimi
- Biology Department, College of Science and Institute for Research and Medical Consultations (IRMC), Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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2
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Wurth R, Hajdenberg M, Barrera FJ, Shekhar S, Copacino CE, Moreno-Peña PJ, Gharib OAM, Porter F, Hiremath S, Hall JE, Schiffrin EL, Eisenhofer G, Bornstein SR, Brito JP, González-González JG, Stratakis CA, Rodríguez-Gutiérrez R, Hannah-Shmouni F. Scoping review of COVID-19-related systematic reviews and meta-analyses: can we really have confidence in their results? Postgrad Med J 2022; 98:372-379. [PMID: 33637639 PMCID: PMC7918809 DOI: 10.1136/postgradmedj-2020-139392] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 12/12/2020] [Indexed: 12/22/2022]
Abstract
AIM The aim of this study was to systematically appraise the quality of a sample of COVID-19-related systematic reviews (SRs) and discuss internal validity threats affecting the COVID-19 body of evidence. DESIGN We conducted a scoping review of the literature. SRs with or without meta-analysis (MA) that evaluated clinical data, outcomes or treatments for patients with COVID-19 were included. MAIN OUTCOME MEASURES We extracted quality characteristics guided by A Measurement Tool to Assess Systematic Reviews-2 to calculate a qualitative score. Complementary evaluation of the most prominent published limitations affecting the COVID-19 body of evidence was performed. RESULTS A total of 63 SRs were included. The majority were judged as a critically low methodological quality. Most of the studies were not guided by a pre-established protocol (39, 62%). More than half (39, 62%) failed to address risk of bias when interpreting their results. A comprehensive literature search strategy was reported in most SRs (54, 86%). Appropriate use of statistical methods was evident in nearly all SRs with MAs (39, 95%). Only 16 (33%) studies recognised heterogeneity in the definition of severe COVID-19 as a limitation of the study, and 15 (24%) recognised repeated patient populations as a limitation. CONCLUSION The methodological and reporting quality of current COVID-19 SR is far from optimal. In addition, most of the current SRs fail to address relevant threats to their internal validity, including repeated patients and heterogeneity in the definition of severe COVID-19. Adherence to proper study design and peer-review practices must remain to mitigate current limitations.
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Affiliation(s)
- Rachel Wurth
- NICHD, National Institutes of Health, Bethesda, Maryland, USA
| | - Michelle Hajdenberg
- College of Arts and Sciences, Washington University in St Louis, St Louis, Missouri, USA
| | - Francisco J Barrera
- Endocrinology Division, Department of Internal Medicine, University Hospital "Dr. Jose E. González", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
- Knowledge and Evaluation Research, Mayo Clinic, Rochester, Minnesota, USA
- Plataforma INVEST-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
| | - Skand Shekhar
- NICHD, National Institutes of Health, Bethesda, Maryland, USA
- Clinical Research Branch, NIEHS, National Institutes of Health, Bethesda, Maryland, USA
| | | | - Pablo J Moreno-Peña
- Plataforma INVEST-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
| | - Omar A M Gharib
- NICHD, National Institutes of Health, Bethesda, Maryland, USA
| | - Forbes Porter
- NICHD, National Institutes of Health, Bethesda, Maryland, USA
| | - Swapnil Hiremath
- University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
| | - Janet E Hall
- Clinical Research Branch, NIEHS, National Institutes of Health, Bethesda, Maryland, USA
| | | | - Graeme Eisenhofer
- Institute of Clinical Chemistry and Laboratory Medicine, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Stefan R Bornstein
- Department of Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Juan P Brito
- Knowledge and Evaluation Research, Mayo Clinic, Rochester, Minnesota, USA
| | - José Gerardo González-González
- Endocrinology Division, Department of Internal Medicine, University Hospital "Dr. Jose E. González", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
- Plataforma INVEST-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
| | | | - René Rodríguez-Gutiérrez
- Endocrinology Division, Department of Internal Medicine, University Hospital "Dr. Jose E. González", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
- Knowledge and Evaluation Research, Mayo Clinic, Rochester, Minnesota, USA
- Plataforma INVEST-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
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3
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Ghaznavi H, Shirvaliloo M, Sargazi S, Mohammadghasemipour Z, Shams Z, Hesari Z, Shahraki O, Nazarlou Z, Sheervalilou R, Shirvalilou S. SARS-CoV-2 and Influenza Viruses: Strategies to Cope with Co-infection and Bioinformatics Perspective. Cell Biol Int 2022; 46:1009-1020. [PMID: 35322909 PMCID: PMC9083817 DOI: 10.1002/cbin.11800] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 03/18/2022] [Accepted: 03/20/2022] [Indexed: 12/15/2022]
Abstract
Almost a century after the devastating pandemic of the Spanish flu, humankind is facing the relatively comparable global outbreak of COVID‐19. COVID‐19 is an infectious disease caused by SARS‐CoV‐2 with an unprecedented transmission pattern. In the face of the recent repercussions of COVID‐19, many have argued that the clinical experience with influenza through the last century may have tremendous implications in the containment of this newly emerged viral disease. During the last 2 years, from the emergence of COVID‐19, tremendous advances have been made in diagnosing and treating coinfections. Several approved vaccines are available now for the primary prevention of COVID‐19 and specific treatments exist to alleviate symptoms. The present review article aims to discuss the pathophysiology, diagnosis, and treatment of SARS‐CoV‐2 and influenza A virus coinfection while delivering a bioinformatics‐based insight into this subject matter.
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Affiliation(s)
- Habib Ghaznavi
- Pharmacology Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Milad Shirvaliloo
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saman Sargazi
- Cellular and Molecular Research Center, Research Institute of Cellular and Molecular Sciences in Infectious Diseases, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Zahra Mohammadghasemipour
- Department of Infectious Disease, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Zinat Shams
- Department of Biological Science, Kharazmi University, Tehran, Iran
| | - Zahra Hesari
- Laboratory Sciences Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Omolbanin Shahraki
- Pharmacology Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.,Cellular and Molecular Research Center, Research Institute of Cellular and Molecular Sciences in Infectious Diseases, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Ziba Nazarlou
- Material Engineering Department, College of Science Koç University, Istanbul, 34450, Turkey
| | - Roghayeh Sheervalilou
- Pharmacology Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.,Cellular and Molecular Research Center, Research Institute of Cellular and Molecular Sciences in Infectious Diseases, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Sakine Shirvalilou
- Finetech in Medicine Research Center, Iran University of Medical Sciences, Tehran, Iran
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4
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Baldeón ME, Maldonado A, Ochoa-Andrade M, Largo C, Pesantez M, Herdoiza M, Granja G, Bonifaz M, Espejo H, Mora F, Abril-López P, Armijo LKR, Pacheco V, Salazar R, Reinthaller S, Zertuche F, Fornasini M. Effect of convalescent plasma as complementary treatment in patients with moderate COVID-19 infection. Transfus Med 2022; 32:153-161. [PMID: 35001439 DOI: 10.1111/tme.12851] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 12/13/2021] [Accepted: 12/30/2021] [Indexed: 01/17/2023]
Abstract
INTRODUCTION South America is one of the regions most affected by the COVID-19 pandemic. Specific and affordable treatments are needed to treat SARS-CoV-2 infection. Evidence regarding the use of convalescent plasma in COVID-19 patients is still limited. We compared the safety and efficacy of COVID-19-convalescent plasma administration as a complement to standard treatment in the early management of patients with moderate SARS-CoV-2 infection. METHODS We carried out a random double blinded, placebo-controlled trial that compared standard treatment plus convalescent plasma (CP) or plus non-convalescent plasma in the management of COVID-19 patients. The main outcome was survival and secondary endpoints included: length of hospitalisation (LOH), days from treatment to discharge, time to clinical improvement or death within a 28-day period, and adverse reactions to treatment. RESULTS Administration of CP with antibodies against SARS-CoV-2 did not affect patient survival, RR = 1.003, 95% CI (0.3938, 2.555). These results led to terminate the RCT prematurely. However, early treatment of COVID-19 patients with CP tended to decrease the LOH while the delay in CP treatment was associated with longer hospitalisation. In addition, delay in CP treatment negatively affected the recovery of the respiratory rate. CONCLUSION Use of CP for the treatment of COVID-19 patients is safe and its early use can decrease the LOH and improve respiratory function. Early administration of antibody-rich CP could contribute to decrease the negative impact of COVID-19 pandemic in patients with impaired immune response.
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Affiliation(s)
- Manuel E Baldeón
- Escuela de Medicina, Facultad de Ciencias Médicas, de la Salud y de la Vida, Universidad Internacional del Ecuador, Quito, Ecuador
| | - Augusto Maldonado
- Escuela de Medicina, Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Quito, Ecuador.,Ministerio de Salud Pública, Coordinación Zonal 9, Hospital General Docente de Calderón, Quito, Ecuador
| | - Miguel Ochoa-Andrade
- Instituto Ecuatoriano de Seguridad Social, Hospital General Quito Sur - IESS, Quito, Ecuador
| | - Carolina Largo
- Ministerio de Salud Pública, Coordinación Zonal 9, Hospital General Docente de Calderón, Quito, Ecuador
| | | | | | - Gerardo Granja
- Instituto Ecuatoriano de Seguridad Social, Hospital General Quito Sur - IESS, Quito, Ecuador
| | - Marco Bonifaz
- Instituto Ecuatoriano de Seguridad Social, Hospital General Quito Sur - IESS, Quito, Ecuador
| | - Hugo Espejo
- Instituto Ecuatoriano de Seguridad Social, Hospital General Quito Sur - IESS, Quito, Ecuador
| | - Francisco Mora
- Instituto Ecuatoriano de Seguridad Social, Hospital General Quito Sur - IESS, Quito, Ecuador
| | - Patricio Abril-López
- Ministerio de Salud Pública, Coordinación Zonal 9, Hospital General Docente de Calderón, Quito, Ecuador
| | | | - Verónica Pacheco
- Ministerio de Salud Pública, Coordinación Zonal 9, Hospital Pablo Arturo Suarez, Quito, Ecuador
| | - Rafael Salazar
- Ministerio de Salud Pública, Coordinación Zonal 9, Hospital Pablo Arturo Suarez, Quito, Ecuador
| | - Steffy Reinthaller
- Ministerio de Salud Pública, Coordinación Zonal 9, Hospital Pablo Arturo Suarez, Quito, Ecuador
| | - Federico Zertuche
- Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
| | - Marco Fornasini
- Escuela de Medicina, Facultad de Ciencias Médicas, de la Salud y de la Vida, Universidad Internacional del Ecuador, Quito, Ecuador
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5
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YILMAZ ZK, ŞENCAN N. An Examination of the Factors Affecting Community Pharmacists' Knowledge, Attitudes, and Impressions About the COVID-19 Pandemic. Turk J Pharm Sci 2021; 18:530-540. [PMID: 34708643 PMCID: PMC8562124 DOI: 10.4274/tjps.galenos.2020.01212] [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: 10/31/2020] [Accepted: 12/07/2020] [Indexed: 12/01/2022]
Abstract
Objectives Coronavirus disease-2019 (COVID-19)-related cases and deaths are ongoing throughout the world, but there is still no effective drug in its treatment, and the vaccine supply is not adequate for the global population. It is important that pharmacists have sufficient knowledge and awareness to prevent and control the disease. COVID-19 has been widely covered in the media, which has been a source widely used by healthcare professionals. This study aimed to assess the knowledge, attitudes, and impressions of community pharmacists about COVID-19 and the factors affecting them. Materials and Methods The questions in this survey were formed using the guideline created by the World Health Organization, a guide composed by the Turkish COVID-19 Scholarly Commission, and data disclosed to the public on the website of the Ministry of Health. The questionnaire was designed with Google forms and then applied to community pharmacists all over Turkey by sharing the survey link. Results Analyses of 393 questionnaires showed that Ministry of Health/government statements, the internet (scientific sources), and the media were the preferred sources of information (96.7%, 89.6%, and 84%, respectively). “Ways to avoid COVID-19” was the most searched title (96.9%). It was determined that the names of the two drugs most frequently mentioned by the participants to be used in the treatment of COVID-19 in Turkey were hydroxychloroquine and azithromycin (57.5%; 50.1%, respectively). Participants who received information from the media gave less education to patients/customers on personal protection measures against COVID-19 (83.3%) and symptoms of COVID-19 (78.8%); however, their behavior regarding the training of pharmacy personnel was found to be the opposite. It has been determined that about half of the participants (46.6%) mostly trust the Ministry of Health regarding the COVID-19 pandemic. Conclusion Media and other sources influence the knowledge, behavior and impressions of pharmacists’. Having a high level of knowledge positively affects people’s behavior. It is important for pharmacists to have accurate information about COVID-19 and to transfer their knowledge to the community to provide patient education and to prevent/control the spread of COVID-19.
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Affiliation(s)
- Zekiye Kübra YILMAZ
- Acıbadem Mehmet Ali Aydınlar University Faculty of Pharmacy, Department of Clinical Pharmacy, İstanbul, Turkey
| | - Nazlı ŞENCAN
- Acıbadem Mehmet Ali Aydınlar University Faculty of Pharmacy, Department of Pharmacy Management, İstanbul, Turkey
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6
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Machluf Y, Rosenfeld S, Ben Shlomo I, Chaiter Y, Dekel Y. The Misattributed and Silent Causes of Poor COVID-19 Outcomes Among Pregnant Women. Front Med (Lausanne) 2021; 8:745797. [PMID: 34765620 PMCID: PMC8575767 DOI: 10.3389/fmed.2021.745797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 09/23/2021] [Indexed: 01/08/2023] Open
Abstract
Abundant evidence strongly suggests that the condition of pregnancy makes women and their fetuses highly vulnerable to severe Corona-virus 2019 (COVID-19) complications. Here, two novel hypoxia-related conditions are proposed to play a pivotal role in better understanding the relationship between COVID-19, pregnancy and poor health outcomes. The first condition, "misattributed dyspnea (shortness of breath)" refers to respiratory symptoms common to both advanced pregnancy and COVID-19, which are mistakenly perceived as related to the former rather than to the latter; as a result, pregnant women with this condition receive no medical attention until the disease is in an advanced stage. The second condition, "silent hypoxia", refers to abnormally low blood oxygen saturation levels in COVID-19 patients, which occur in the absence of typical respiratory distress symptoms, such as dyspnea, thereby also leading to delayed diagnosis and treatment. The delay in diagnosis and referral to treatment, due to either "misattributed dypsnea" or "silent hypoxia", may lead to rapid deterioration and poor health outcome to both the mothers and their fetuses. This is particularly valid among women during advanced stages of pregnancy as the altered respiratory features make the consequences of the disease more challenging to cope with. Studies have demonstrated the importance of monitoring blood oxygen saturation by pulse oximetry as a reliable predictor of disease severity and outcome among COVID-19 patients. We propose the use of home pulse oximetry during pregnancy as a diagnostic measure that, together with proper medical guidance, may allow early diagnosis of hypoxia and better health outcomes.
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Affiliation(s)
- Yossy Machluf
- Unit of Agrigenomics, Shamir Research Institute, Haifa University, Kazerin, Israel
| | - Sherman Rosenfeld
- The Department of Science Teaching, Weizmann Institute of Science, Rehovot, Israel
| | - Izhar Ben Shlomo
- Emergency Medicine Program, Zefat Academic College, Safed, Israel
| | - Yoram Chaiter
- The Israeli Center for Emerging Technologies in Hospitals and Hospital-Based Health Technology Assessment, Shamir (Assaf Harofeh) Medical Center, Zerifin, Israel
| | - Yaron Dekel
- Unit of Agrigenomics, Shamir Research Institute, Haifa University, Kazerin, Israel
- Department of Medical Laboratory Sciences, Zefat Academic College, Safed, Israel
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7
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Early reports of epidemiological parameters of the COVID-19 pandemic. Western Pac Surveill Response J 2021; 12:65-81. [PMID: 34540315 PMCID: PMC8421745 DOI: 10.5365/wpsar.2020.11.3.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background The emergence of a new pathogen requires a rapid assessment of its transmissibility, to inform appropriate public health interventions. Methods The peer-reviewed literature published between 1 January and 30 April 2020 on COVID-19 in PubMed was searched. Estimates of the incubation period, serial interval and reproduction number for COVID-19 were obtained and compared. Results A total of 86 studies met the inclusion criteria. Of these, 33 estimated the mean incubation period (4–7 days) and 15 included estimates of the serial interval (mean 4–8 days; median length 4–5 days). Fifty-two studies estimated the reproduction number. Although reproduction number estimates ranged from 0.3 to 14.8, in 33 studies (63%), they fell between 2 and 3. Discussion Studies calculating the incubation period and effective reproduction number were published from the beginning of the pandemic until the end of the study period (30 April 2020); however, most of the studies calculating the serial interval were published in April 2020. The calculated incubation period was similar over the study period and in different settings, whereas estimates of the serial interval and effective reproduction number were setting-specific. Estimates of the serial interval were shorter at the end of the study period as increasing evidence of pre-symptomatic transmission was documented and as jurisdictions enacted outbreak control measures. Estimates of the effective reproduction number varied with the setting and the underlying model assumptions. Early analysis of epidemic parameters provides vital information to inform the outbreak response.
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8
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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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9
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Gao X, Liu Y, Zou S, Liu P, Zhao J, Yang C, Liang M, Yang J. Genome-wide screening of SARS-CoV-2 infection-related genes based on the blood leukocytes sequencing data set of patients with COVID-19. J Med Virol 2021; 93:5544-5554. [PMID: 34009691 PMCID: PMC8242610 DOI: 10.1002/jmv.27093] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/23/2021] [Accepted: 05/15/2021] [Indexed: 12/14/2022]
Abstract
Coronavirus disease 2019 (COVID‐19) is a global epidemic disease caused by a novel virus, severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), causing serious adverse effects on human health. In this study, we obtained a blood leukocytes sequencing data set of COVID‐19 patients from the GEO database and obtained differentially expressed genes (DEGs). We further analyzed these DEGs by protein–protein interaction analysis and Gene Ontology enrichment analysis and identified the DEGs closely related to SARS‐CoV‐2 infection. Then, we constructed a six‐gene model (comprising IFIT3, OASL, USP18, XAF1, IFI27, and EPSTI1) by logistic regression analysis and calculated the area under the ROC curve (AUC) for the diagnosis of COVID‐19. The AUC values of the training group, testing group, and entire group were 0.930, 0.914, and 0.921, respectively. The six genes were highly expressed in patients with COVID‐19 and positively correlated with the expression of SARS‐CoV‐2 invasion‐related genes (ACE2, TMPRSS2, CTSB, and CTSL). The risk score calculated by this model was also positively correlated with the expression of TMPRSS2, CTSB, and CTSL, indicating that the six genes were closely related to SARS‐CoV‐2 infection. In conclusion, we comprehensively analyzed the functions of DEGs in the blood leukocytes of patients with COVID‐19 and constructed a six‐gene model that may contribute to the development of new diagnostic and therapeutic ideas for COVID‐19. Moreover, these six genes may be therapeutic targets for COVID‐19. COVID‐19 is a global epidemic and poses a serious risk to human health. The differentially expressed genes related to SARS‐CoV‐2 infection in leukocytes of patients with COVD‐19 were screened. A 6‐gene model for COVID‐19 diagnosis and treatment was constructed by logistic regression analysis. The role and mechanism of these six genes (IFIT3, OASL, USP18, XAF1, IFI27, and EPSTI1) in COVID‐19 were preliminarily analyzed.
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Affiliation(s)
- Xin Gao
- Clinical Laboratory, The First People's Hospital of Huaihua, Huaihua, Hunan, China.,Clinical Laboratory, The Fourth Affiliated Hospital of Jishou University, Huaihua, Hunan, China
| | - Yuan Liu
- Clinical Laboratory, The First People's Hospital of Huaihua, Huaihua, Hunan, China.,Clinical Laboratory, The Fourth Affiliated Hospital of Jishou University, Huaihua, Hunan, China
| | - Shaohui Zou
- Clinical Laboratory, The First People's Hospital of Huaihua, Huaihua, Hunan, China.,Clinical Laboratory, The Fourth Affiliated Hospital of Jishou University, Huaihua, Hunan, China
| | - Pengqin Liu
- Department of Nuclear Medicine, The First People's Hospital of Huaihua, Huaihua, Hunan, China.,Department of Nuclear Medicine, The Fourth Affiliated Hospital of Jishou University, Huaihua, Hunan, China
| | - Jing Zhao
- Clinical Laboratory, The First People's Hospital of Huaihua, Huaihua, Hunan, China.,Clinical Laboratory, The Fourth Affiliated Hospital of Jishou University, Huaihua, Hunan, China
| | - Changshun Yang
- Clinical Laboratory, The First People's Hospital of Huaihua, Huaihua, Hunan, China.,Clinical Laboratory, The Fourth Affiliated Hospital of Jishou University, Huaihua, Hunan, China
| | - Mingxing Liang
- Clinical Laboratory, The First People's Hospital of Huaihua, Huaihua, Hunan, China.,Clinical Laboratory, The Fourth Affiliated Hospital of Jishou University, Huaihua, Hunan, China
| | - Jinlian Yang
- Clinical Laboratory, The First People's Hospital of Huaihua, Huaihua, Hunan, China.,Clinical Laboratory, The Fourth Affiliated Hospital of Jishou University, Huaihua, Hunan, China
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10
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Balla M, Merugu G, Nesheiwat Z, Patel M, Sheikh T, Fatima R, Kotturi VK, Bommana V, Pulagam G, Kaminski B. Epidemiological and Clinical Characteristics of 217 COVID-19 Patients in Northwest Ohio, United States. Cureus 2021; 13:e14308. [PMID: 34079643 PMCID: PMC8162051 DOI: 10.7759/cureus.14308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background There is limited data on the clinical characteristics and predictors of mortality of coronavirus disease-2019 (COVID-19) in North West Ohio. We performed a retrospective review of patients hospitalized with COVID-19 in the ProMedica Health System in Northwest Ohio from March 25 to June 16, 2020. The study aims to identify epidemiological, clinical characteristics, and predictors of Mortality of COVID-19 patients in Northwest Ohio. Methods This study was conducted on 217 COVID-19 patients admitted to ProMedica Health System Hospitals in Northwest Ohio from March 25 to June 16, 2020. We collected data, including clinical signs, symptoms, and outcomes of the COVID-19 patients. We compared clinical signs and symptoms along with comorbidities of survivors and non-survivors. Results Of the 217 patients included in the study, the mean age of the population was 63.13 (SD 17.8), of which 194 (89.4%, mean age 61.7 years) survived while 23 (10.6%, mean age 74.6 years) died. Among them, 53% were females and 47% male. Common presenting symptoms were chest pain (91.71%), shortness of breath (79.7%), cough (71%), and fever (64%). Mortality was associated with age greater than 63 (p-value 0.0052) and hypertension (p-value: 0.0058) with marginal significance with gender (p-value: 0.0642), chest pain (p-value: 0.0944), and history of cancer (p-value: 0.0944). Conclusions Advanced age and hypertension (HTN) are independent predictors for increased mortality. History of cancer and chest pain are associated with increased mortality with marginal significance. Awareness among physicians about predictors of mortality is essential in dealing with COVID-19 patients. It is essential to educate the public about preventative strategies such as wearing masks to decrease mortality and morbidity from this pandemic.
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Affiliation(s)
- Mamtha Balla
- Internal Medicine, ProMedica Toledo Hospital, Toledo, USA.,Internal Medicine, The University of Toledo Medical Center, Toledo, USA
| | - Ganesh Merugu
- Geriatrics, The University of Toledo Medical Center, Toledo, USA
| | - Zeid Nesheiwat
- Internal Medicine, The University of Toledo Medical Center, Toledo, USA
| | - Mitra Patel
- Internal Medicine, The University of Toledo College of Medicine, Toledo, USA
| | - Taha Sheikh
- Internal Medicine, The University of Toledo Medical Center, Toledo, USA
| | - Rawish Fatima
- Internal Medicine, The University of Toledo Medical Center, Toledo, USA
| | - Vinay K Kotturi
- Family Medicine, The University of Toledo Medical Center, Toledo, USA
| | | | - Gautham Pulagam
- Internal Medicine, Medical University of the Americas, Charlestown, KNA
| | - Brian Kaminski
- Emergency Medicine, ProMedica Toledo Hospital, Toledo, USA
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11
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Merugu GP, Nesheiwat Z, Balla M, Patel M, Fatima R, Sheikh T, Kotturi V, Bommana V, Pulagam G, Kaminski B. Predictors of mortality in 217 COVID-19 patients in Northwest Ohio, United States: A retrospective study. J Med Virol 2021; 93:2875-2882. [PMID: 33350488 DOI: 10.1002/jmv.26750] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 12/17/2020] [Accepted: 12/20/2020] [Indexed: 01/06/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic continues to cause significant morbidity and mortality worldwide. This study aims to identify specific lab markers, complications, and treatments that may be associated with increased mortality in COVID-19 patients. This study is retrospective in nature; it included 217 COVID-19 positive patients who were admitted to a ProMedica Health System hospital in Northwest Ohio, United States, between March 25 and June 16, 2020. We collected various laboratory values, complications, and treatment courses. T test and χ2 analyses were used to predict mortality. COVID-19 test was confirmed via polymerase chain reaction. Of 217 patients included in the study, the mean age of the population was 63.13 (SD, 17.8), of which 194 (89.4%, mean age 61.7 years) survived while 23 (10.6%, mean age 74.6 years) died. Among them, 53% were females and 47% male. Laboratory values that were associated with mortality were low hemoglobin (p = .0046), elevated INR (p = .0005), low platelets (p = .0246) and elevated procalcitonin (p = .0472). Marginally significant laboratory values included elevated troponin (p = .0661), and elevated creatinine (p = .0741). Treatment with either antibiotic, antifungals, antivirals, blood transfusion, steroids, and intubation were all statistically significant for mortality. COVID-19 related complications with either ARDS, myocarditis, elevated INR, septic shock, or age greater than 63 were significant predictors of mortality. Low hemoglobin, elevated INR, Low platelet, elevated procalcitonin, treated with either antibiotic, antifungal, antiviral, blood transfusion, steroids, and intubation are associated with high mortality related to COVID-19 infection. Healthcare professionals must be aware of these predictors.
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Affiliation(s)
- Ganesh Prasad Merugu
- Division of Geriatric Medicine, Department of Family Medicine, University of Toledo-Health Sciences, Toledo, Ohio, USA
| | - Zeid Nesheiwat
- Department of Internal Medicine, University of Toledo-Health Sciences, Toledo, Ohio, USA
| | - Mamtha Balla
- Department of Internal Medicine, Promedica Toledo Hospital, University of Toledo, Toledo, Ohio, USA
| | - Mitra Patel
- Department of Internal Medicine, University of Toledo-Health Sciences, Toledo, Ohio, USA
| | - Rawish Fatima
- Department of Internal Medicine, University of Toledo-Health Sciences, Toledo, Ohio, USA
| | - Taha Sheikh
- Department of Internal Medicine, University of Toledo-Health Sciences, Toledo, Ohio, USA
| | - Vinay Kotturi
- Department of Internal Medicine, University of Toledo-Health Sciences, Toledo, Ohio, USA
| | - Venugopala Bommana
- Department of Internal Medicine, Promedica Toledo Hospital, University of Toledo, Toledo, Ohio, USA
| | - Gautham Pulagam
- Department of Internal Medicine, Medical University of the Americas, Charlestown, Massachusetts, USA
| | - Brian Kaminski
- Department of Emergency Medicine, Promedica Toledo Hospital, University of Toledo-Health Sciences, Toledo, Ohio, USA
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12
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Checchi V, Bellini P, Bencivenni D, Consolo U. COVID-19 Dentistry-Related Aspects: A Literature Overview. Int Dent J 2021; 71:21-26. [PMID: 33616049 PMCID: PMC7361251 DOI: 10.1111/idj.12601] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
A new coronavirus (Sars-CoV-2) was detected in China at the end of 2019 and has since caused a worldwide pandemic. This virus is responsible for an acute respiratory syndrome (COVID-19), distinguished by a potentially lethal interstitial bilateral pneumonia. Because Sars-CoV-2 is highly infective through airborne contamination, the high infection risk in the dental environment is a serious problem for both professional practitioners and patients. This literature overview provides a description of the clinical aspects of COVID-19 and its transmission, while supplying valuable information regarding protection and prevention measures.
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Affiliation(s)
- Vittorio Checchi
- Unit of Dentistry and Oral-Maxillo-Facial Surgery, Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, Modena, Italy
| | - Pierantonio Bellini
- Unit of Dentistry and Oral-Maxillo-Facial Surgery, Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, Modena, Italy.
| | - Davide Bencivenni
- Unit of Dentistry and Oral-Maxillo-Facial Surgery, Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, Modena, Italy
| | - Ugo Consolo
- Unit of Dentistry and Oral-Maxillo-Facial Surgery, Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, Modena, Italy
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13
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Hatmi ZN. A Systematic Review of Systematic Reviews on the COVID-19 Pandemic. SN COMPREHENSIVE CLINICAL MEDICINE 2021; 3:419-436. [PMID: 33521564 PMCID: PMC7835449 DOI: 10.1007/s42399-021-00749-y] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/10/2021] [Indexed: 01/31/2023]
Abstract
COVID-19 a systemic inflammation involving multiple organs, affecting all age groups, with high mortality rate, severe adverse outcomes, and high economic burden need to be described. A systematic review of systematic reviews conducted. We searched PubMed, OVID Medline, Cochrane library, COVID-19 resource centers of N Engl. J Med, AHA, and LITCOVID. Certainty of evidences was evaluated by GRADE approach. Meta-analysis according to random effects model was conducted. Seventy-one eligible systematic reviews are included in the study. A total of 86.5% of them had high quality, and 13.5% had medium quality. Meta-analysis results are presented in tabular format, and the remaining results are presented in narration fashion. COVID-19 involves blood vessels, lung, heart, nervous system, liver, gastrointestinal system, kidney, eyes, and other organs and infects adult and children, neonates, pregnant women, and elderly, transmitted via air born and droplet. Comorbidities associated with COVID-19 are HTN 20.7%, CVD 9.6%, DM 9.55%, respiratory diseases 7%, and 9% of cigarette smoking. Prognostic factors for mortality among COVID-19 cases are acute cardiac injury, diagnosed CVD, DM, respiratory disease, and HTN. Prognostic factors for disease severity are CVD and HTN. Prognostic factors for disease progression were fever, shortness of breath, and smoking. There is no specific antiviral treatment. Preventive measures including physical distancing of 2 m and more, using PPE, avoiding social gatherings, quarantine, and isolation have been recommended. Encouraging telemedicine, online training, and homeschooling are highly recommended. Vaccine is approaching, and concerns exist about vaccine with a high efficacy. Modification of CVD and cardiometabolic risk became the cornerstone for sustainable control of pandemic.
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Affiliation(s)
- Zinat Nadia Hatmi
- Department of preventive medicine, Medical school, Tehran University of Medical Sciences, Purcina Ave, Medical Faculty, Building No 4, Second floor, Tehran, Iran ,Department of Epidemiology, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria
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14
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Das S, Rasul MG, Hossain MS, Khan AR, Alam MA, Ahmed T, Clemens JD. Acute food insecurity and short-term coping strategies of urban and rural households of Bangladesh during the lockdown period of COVID-19 pandemic of 2020: report of a cross-sectional survey. BMJ Open 2020; 10:e043365. [PMID: 33310813 PMCID: PMC7735103 DOI: 10.1136/bmjopen-2020-043365] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION We conducted a cross-sectional survey to assess the extent and to identify the determinants of food insecurity and coping strategies in urban and rural households of Bangladesh during the month-long, COVID-19 lockdown period. SETTING Selected urban and rural areas of Bangladesh. PARTICIPANTS 106 urban and 106 rural households. OUTCOME VARIABLES AND METHOD Household food insecurity status and the types of coping strategies were the outcome variables for the analyses. Multinomial logistic regression analyses were done to identify the determinants. RESULTS We found that around 90% of the households were suffering from different grades of food insecurity. Severe food insecurity was higher in urban (42%) than rural (15%) households. The rural households with mild/moderate food insecurity adopted either financial (27%) or both financial and food compromised (32%) coping strategies, but 61% of urban mild/moderate food insecure households applied both forms of coping strategies. Similarly, nearly 90% of severely food insecure households implemented both types of coping strategies. Living in poorest households was significantly associated (p value <0.05) with mild/moderate (regression coefficient, β: 15.13, 95% CI 14.43 to 15.82), and severe food insecurity (β: 16.28, 95% CI 15.58 to 16.97). The statistically significant (p <0.05) determinants of both food compromised and financial coping strategies were living in urban areas (β: 1.8, 95% CI 0.44 to 3.09), living in poorest (β: 2.7, 95% CI 1 to 4.45), poorer (β: 2.6, 95% CI 0.75 to 4.4) and even in the richer (β: 1.6, 95% CI 0.2 to 2.9) households and age of the respondent (β: 0.1, 95% CI 0.02 to 0.21). CONCLUSION Both urban and rural households suffered from moderate to severe food insecurity during the month-long lockdown period in Bangladesh. But, poorest, poorer and even the richer households adopted different coping strategies that might result in long-term economic and nutritional consequences.
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Affiliation(s)
- Subhasish Das
- Nutrition and Clinical Services Division, icddr,b, Dhaka, Bangladesh
| | - Md Golam Rasul
- Nutrition and Clinical Services Division, icddr,b, Dhaka, Bangladesh
| | - Md Shabab Hossain
- Nutrition and Clinical Services Division, icddr,b, Dhaka, Bangladesh
| | - Ar-Rafi Khan
- Nutrition and Clinical Services Division, icddr,b, Dhaka, Bangladesh
| | - Md Ashraful Alam
- Nutrition and Clinical Services Division, icddr,b, Dhaka, Bangladesh
| | - Tahmeed Ahmed
- Nutrition and Clinical Services Division, icddr,b, Dhaka, Bangladesh
| | - John D Clemens
- Infectious Diseases Division, icddr,b, Dhaka, Bangladesh
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15
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Ashraf UM, Abokor AA, Edwards JM, Waigi EW, Royfman RS, Hasan SAM, Smedlund KB, Hardy AMG, Chakravarti R, Koch LG. SARS-CoV-2, ACE2 expression, and systemic organ invasion. Physiol Genomics 2020; 53:51-60. [PMID: 33275540 DOI: 10.1152/physiolgenomics.00087.2020] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
A novel coronavirus disease, COVID-19, has created a global pandemic in 2020, posing an enormous challenge to healthcare systems and affected communities. COVID-19 is caused by severe acute respiratory syndrome (SARS)-coronavirus-2 (CoV-2) that manifests as bronchitis, pneumonia, or a severe respiratory illness. SARS-CoV-2 infects human cells via binding a "spike" protein on its surface to angiotensin-converting enzyme 2 (ACE2) within the host. ACE2 is crucial for maintaining tissue homeostasis and negatively regulates the renin-angiotensin-aldosterone system (RAAS) in humans. The RAAS is paramount for normal function in multiple organ systems including the lungs, heart, kidney, and vasculature. Given that SARS-CoV-2 internalizes via ACE2, the resultant disruption in ACE2 expression can lead to altered tissue function and exacerbate chronic diseases. The widespread distribution and expression of ACE2 across multiple organs is critical to our understanding of the varied clinical outcomes of COVID-19. This perspective review based on the current literature was prompted to show how disruption of ACE2 by SARS-CoV-2 can affect different organ systems.
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Affiliation(s)
- Usman M Ashraf
- Department of Physiology and Pharmacology, The University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Ahmed A Abokor
- Department of Physiology and Pharmacology, The University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Jonnelle M Edwards
- Department of Physiology and Pharmacology, The University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Emily W Waigi
- Department of Physiology and Pharmacology, The University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Rachel S Royfman
- Department of Physiology and Pharmacology, The University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Syed Abdul-Moiz Hasan
- Department of Physiology and Pharmacology, The University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Kathryn B Smedlund
- Department of Physiology and Pharmacology, The University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Ana Maria Gregio Hardy
- Department of Physiology and Pharmacology, The University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Ritu Chakravarti
- Department of Physiology and Pharmacology, The University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Lauren Gerard Koch
- Department of Physiology and Pharmacology, The University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
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16
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Omoronyia O, Ekpenyong N, Ukweh I, Mpama E. Knowledge and practice of COVID-19 prevention among community health workers in rural Cross River State, Nigeria: implications for disease control in Africa. Pan Afr Med J 2020; 37:50. [PMID: 33209177 PMCID: PMC7648466 DOI: 10.11604/pamj.2020.37.50.24307] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 09/02/2020] [Indexed: 11/11/2022] Open
Abstract
Introduction in developing countries, community health workers (CHWs) are essential, for provision of behaviour change communication towards prevention of coronavirus 2019 (COVID-19) infection at rural grassroots level. We aimed at assessing their level of knowledge and practice of preventive measures in a developing country setting. Methods total enumeration of all CHWs in a rural local government area in southern Nigeria was carried out, using cross-sectional descriptive study design. Pretested self-administered 15-item questionnaire was used to assess knowledge of COVID-19 including basic epidemiology, virology, preventive measures and use of personal protective equipment (PPE). Practice of preventive measures was also assessed. Each correct response to knowledge question contributed one unit to the total score which was converted to percentage. Total knowledge score of 50% or greater was considered satisfactory. Results complete data was obtained from eighty-six (86) respondents with mean age of 36.3±8.9 years (18-54 years). Mean total knowledge score was 28.14±12.8% (6.7 to 53.3%), and 9.3% (n=8) had score of at least 50%. Correct responses to appropriate sequence of putting on and removing personal protective equipment (PPE) were 5.8% (n=5) and 8.1% (n=7), respectively. Regular practice of use of face masks, goggles, gloves, and hand hygiene was found to be 50% (n=43), 12.8% (n=11), 30.2% (n=26), and 56.4% (n=48), respectively. Conclusion community health workers are grossly underprepared for provision of health education on COVID-19, due to their poor level of knowledge. Their capacity building through workshops and effective continuing education program are urgently needed.
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Affiliation(s)
- Ogban Omoronyia
- Department of Community Medicine, University of Calabar, Calabar, Nigeria
| | - Nnette Ekpenyong
- Department of Community Medicine, University of Calabar, Calabar, Nigeria
| | - Ikechukwu Ukweh
- Department of Community Medicine, University of Calabar, Calabar, Nigeria
| | - Enagu Mpama
- Department of Community Medicine, University of Calabar, Calabar, Nigeria
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17
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Barash A, Machluf Y, Ariel I, Dekel Y. The Pursuit of COVID-19 Biomarkers: Putting the Spotlight on ACE2 and TMPRSS2 Regulatory Sequences. Front Med (Lausanne) 2020; 7:582793. [PMID: 33195331 PMCID: PMC7661736 DOI: 10.3389/fmed.2020.582793] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 09/23/2020] [Indexed: 12/15/2022] Open
Abstract
Diverse populations worldwide are differentially affected by coronavirus disease 2019 (COVID-19). While socioeconomic background has been studied extensively, little is known about the genetic variation underlying this phenomenon. This study is aimed at examining the genetic basis behind the great discrepancies among diverse ethnic groups in terms of COVID-19 susceptibility for viral infection, disease prognosis, and mortality. To this end, in silico analysis of single-nucleotide polymorphisms (SNPs) within regulatory sequences of the human angiotensin-converting enzyme 2 (ACE2) and transmembrane protease serine 2 (TMPRSS2)-the virus's gateway to host cells-and their plausible implications on expression levels was conducted. We provide indication that the variation in the human ACE2 and TMPRSS2 regulatory sequences is likely to be involved in and contribute to this phenomenon. SNPs that are abundant in the more susceptible populations introduce binding sites (BSs) for transcription factors or they may invalidate BSs for transcription repressor-both may enhance target gene (ACE2 or TMPRSS2) expression in the relevant target tissues. SNPs that are abundant in the more resistant populations may invalidate BSs for a transcriptional repressor or they may introduce BSs for a transcriptional repressor or initiator of mRNA degradation, which may reduce target gene expression levels. This aspect, when added to the socioeconomic factors, can be a cause for the divergent prevalence of the disease and the different mortality rates within diverse populations. This demonstration may call for a shift in the paradigm of searching for COVID-19 biomarkers, such that SNPs within regulatory sequences should be of high importance.
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Affiliation(s)
- Ayelet Barash
- Unit of Agrigenomics, Shamir Research Institute, Haifa University, Kazerin, Israel
- School of Zoology and the Steinhardt Museum of Natural History, Tel Aviv University, Tel Aviv, Israel
| | - Yossy Machluf
- Unit of Agrigenomics, Shamir Research Institute, Haifa University, Kazerin, Israel
| | - Ilana Ariel
- Department of Pathology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Yaron Dekel
- Unit of Agrigenomics, Shamir Research Institute, Haifa University, Kazerin, Israel
- Department of Medical Laboratory Sciences, Zefat Academic College, Zefat, Israel
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18
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Balla M, Merugu GP, Konala VM, Sangani V, Kondakindi H, Pokal M, Gayam V, Adapa S, Naramala S, Malayala SV. Back to basics: review on vitamin D and respiratory viral infections including COVID-19. J Community Hosp Intern Med Perspect 2020; 10:529-536. [PMID: 33194123 PMCID: PMC7599018 DOI: 10.1080/20009666.2020.1811074] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 08/13/2020] [Indexed: 12/19/2022] Open
Abstract
IMPORTANCE As the scientific community is in a marathon in finding out the cure for COVID-19, in this crisis, it is essential for the physicians not to forget about the basics. Due to the pandemic crisis, in many nursing homes and hospitals, there established new policies on decreasing unnecessary medications to minimize cross-contamination. Sometimes these policies are making providers avoid essential drugs such as Vitamins, including Vitamin D. In this paper, we try to emphasize the importance of Vitamin D in COVID-19 and respiratory viral patients. RELEVANCE Vitamin D helps in decreasing the 'pro-inflammatory cytokines' in the lungs and acts in immunomodulatory function, and 'also it will increase the anti-inflammatory, antiviral responses of the respiratory epithelial cells during infection.' CONCLUSION Due to the highly contagious nature of COVID-19 and the increased morbidity and mortality with no appropriate therapy and vaccine, one must be cautious and do everything to help COVID-19 patients. In hospitals and other health care settings to decrease cross-contamination, holding other non-essential medications is taking place. Discontinuing Vitamins could increase the mortality and morbidity of those affected, especially in deficient/insufficient individuals. Obtaining serum 25 (OH) D levels in all patients with viral respiratory infections, especially COVID-19, could help in the detection and treatment of Vitamin D deficiency and potentially decrease recovery time and improve outcome. Even though evidence suggests that vitamin D has the anti-inflammatory, antiviral properties, randomized double-blinded controlled trials are needed to verify this further, and to understand Vitamin D and COVID-19 better. ABBREVIATIONS Vitamin D receptor-VDR; 25(OH)D- 25 hydroxyvitamin D; 1,25 (OH)D-1,25 dihydroxy Vitamin D; 1α,25-dihydroxy Vitamin D-1,25[OH]2 D or calcitriol; IU- International Units; Interferons stimulated genes- ISG; ARI- acute respiratory infection; RSV- respiratory syncytial virus; RTI- Respiratory tract infections; COPD-Chronic obstructive pulmonary disease; BMI-Basal metabolic index; USA-USA.
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Affiliation(s)
- Mamtha Balla
- Department of Internal Medicine, University of Toledo and Promedica Toledo Hospital, Toledo, OH, USA
| | - Ganesh Prasad Merugu
- Division of Geriatric Medicine, Department of Family Medicine, University of Toledo- Health Sciences, Toledo, OH, USA
| | - Venu Madhav Konala
- Department of Internal Medicine, Division of Medical Oncology, Ashland Bellefonte Cancer Center, Ashland, KY, USA
| | - Vikram Sangani
- Department of Internal Medicine, Medical Center of Central Georgia, Macon, GA, USA
| | - Hema Kondakindi
- Gynecologist, Depart of Obgyn, Durgabhai Deshmukh Hospital and Research Center, India
| | - Mytri Pokal
- Department of Internal Medicine, University of Toledo and Promedica Toledo Hospital, Toledo, OH, USA
- Division of Geriatric Medicine, Department of Family Medicine, University of Toledo- Health Sciences, Toledo, OH, USA
- Department of Internal Medicine, Division of Medical Oncology, Ashland Bellefonte Cancer Center, Ashland, KY, USA
- Department of Internal Medicine, Medical Center of Central Georgia, Macon, GA, USA
- Gynecologist, Depart of Obgyn, Durgabhai Deshmukh Hospital and Research Center, India
- Department of Internal Medicine, Medical Center of Central Georgia, GA, USA
- Department of Medicine, Interfaith Medical Center, Brooklyn, NY, USA
- Department of Internal Medicine, Division of Nephrology, Adventist Medical Center, Hanford, CA, USA
- Department of Internal Medicine, Division of Rheumatology, Adventist Medical Center, Hanford, CA, USA
- Department of Internal Medicine, Jeanes Campus, Temple University, Philadelphia, PA, USA
| | - Vijay Gayam
- Department of Internal Medicine, Medical Center of Central Georgia, GA, USA
- Department of Internal Medicine, Jeanes Campus, Temple University, Philadelphia, PA, USA
| | - Sreedhar Adapa
- Department of Medicine, Interfaith Medical Center, Brooklyn, NY, USA
| | - Srikanth Naramala
- Department of Internal Medicine, Division of Nephrology, Adventist Medical Center, Hanford, CA, USA
| | - Srikrishna V Malayala
- Department of Internal Medicine, Division of Rheumatology, Adventist Medical Center, Hanford, CA, USA
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19
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González-Calatayud DM, Vargas-Ábrego DB, Gutiérrez-Uvalle DGE, López-Romero DSC, González-Pérez DLG, Carranco-Martínez DJA, Raful-Zacarías-Ezzat DJ, Gracida-Mancilla DNI. Observational study of the suspected or confirmed cases of sars COV-2 infection needing emergency surgical intervention during the first months of the pandemic in a third level hospital: Case series. Ann Med Surg (Lond) 2020; 60:149-154. [PMID: 33133593 PMCID: PMC7584489 DOI: 10.1016/j.amsu.2020.10.038] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 10/17/2020] [Indexed: 12/14/2022] Open
Abstract
Approximately 28, 404, 603 surgical events have been suspended in the 12 peak weeks of the COVID-19 pandemic. The aim of this study was to report all the surgically intervened patients with suspected or confirmed SARS CoV-2 infection from April 1 to July 31, 2020, and to estimate their prognosis in the Surgical Therapy Department of a third level hospital in Mexico. Method We conducted an observational study of patients undergoing surgical intervention in the operating room assigned as COVID, where we considered age, sex, treating department, type of intervention, and initial biomarkers (first five days of hospitalization), days of hospital stay, days in the Intensive Care Unit and reason for discharge. Results 42 patients have been surgically intervened, with a total of 49 surgeries. For Otolaringology and General Surgery, there were more deceased cases than alive cases; while for Thoracic Surgery, and Obstetrics and Gynecology, there were more alive cases than deceased ones (36% and 0% deceased, respectively), with statistically significant differences (p = 0.014). With regard to mortality for each group of surgical procedure, patients who underwent C-section or pleurostomy had a mortality rate of 0%; the mortality rate for patients who underwent tracheostomy was 52%; patients who underwent laparotomy had a mortality rate of 54%; for those who underwent debridement, the mortality rate was 100%; which show significant differences, with a p value of 0.03. Discussion we identified an overall mortality rate of 42.8%, with a significant difference between treating departments and type of surgical procedure. This can be explained because many of the General Surgery patients, in addition to their infectious process by COVID-19, had another complication, like sepsis, In the same way, we can say that pregnant patients are healthy and have a physiological condition. Finally, patients undergoing an open tracheostomy had solely pulmonary complications. Conclusion There is no doubt that we face an unknown condition for which we have been learning tests along the way. This sample of cases undergoing surgery at the beginning of the COVID-19 pandemic can provide clues on relevant results that we must consider for future cases. There is a relation between patients undergoing emergency surgery with SARS-Cov-2 infection and higher mortality rate. The SARS CoV2 Infection had an important impact in the surgical productivity with a decrease of 85%. The overall mortality rate for patients with SARS CoV2 infection that were intervened for emergency surgery was 42.8%. There is a significant difference between treating departments and type of surgical procedure with the mortality rate.
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Affiliation(s)
| | - Dr Benito Vargas-Ábrego
- Thorax Surgery Service in Charge of Tracheotomies at the Hospital General de México "Dr. Eduardo Liceaga", Mexico
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20
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Meena J, Yadav J, Saini L, Yadav A, Kumar J. Clinical Features and Outcome of SARS-CoV-2 Infection in Children: A Systematic Review and Meta-analysis. Indian Pediatr 2020; 57:820-826. [PMID: 32583808 PMCID: PMC7498550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2023]
Abstract
OBJECTIVE Knowledge about COVID-19 in children is limited due to the paucity of reported data. The pediatric age group comprises only less than 5% of total COVID-19 worldwide, therefore, large studies in this population are unlikely in the immediate future. Hence, we planned to synthesize the current data that will help in a better understanding of COVID-19 in children. EVIDENCE ACQUISITION Four different electronic databases (MEDLINE, EMBASE, Web of Science, and CENTRAL) were searched for articles related to COVID-19 in the pediatric population. We included studies reporting disease characteristics and outcomes of COVID-19 in patients aged less than 19 years. We performed a random-effect meta-analysis to provide pooled estimates of various disease characteristics. RESULTS 27 studies (4857 patients) fulfilling the eligibility criteria were included in this systematic review, from a total of 883 records. About half of the patients had each of fever and cough, 11% (6-17%) had fast breathing, and 6-13% had gastrointestinal manifestations. Most of the patients had mild to moderate disease, and only 4% had a severe or critical illness. Leukopenia was the commonest reported laboratory abnormality. CONCLUSIONS Even among the symptomatic COVID-19 cases, severe manifestations are seen in very few children. Though fever and respiratory symptoms are most common, many children also have gastrointestinal manifestations.
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Affiliation(s)
- Jitendra Meena
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Jaivinder Yadav
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Lokesh Saini
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Arushi Yadav
- Department of Radiodiagnosis, Government Medical College and Hospital, Chandigarh; India
| | - Jogender Kumar
- Post Graduate Institute of Medical Education and Research, Chandigarh, India. Correspondence to: Dr Jogender Kumar, Assistant Professor, Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
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21
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Meena J, Yadav J, Saini L, Yadav A, Kumar J. Clinical Features and Outcome of SARS-CoV-2 Infection in Children: A Systematic Review and Meta-analysis. Indian Pediatr 2020; 57. [PMID: 32583808 PMCID: PMC7498550 DOI: 10.1007/s13312-020-1961-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Knowledge about COVID-19 in children is limited due to the paucity of reported data. The pediatric age group comprises only less than 5% of total COVID-19 worldwide, therefore, large studies in this population are unlikely in the immediate future. Hence, we planned to synthesize the current data that will help in a better understanding of COVID-19 in children. EVIDENCE ACQUISITION Four different electronic databases (MEDLINE, EMBASE, Web of Science, and CENTRAL) were searched for articles related to COVID-19 in the pediatric population. We included studies reporting disease characteristics and outcomes of COVID-19 in patients aged less than 19 years. We performed a random-effect meta-analysis to provide pooled estimates of various disease characteristics. RESULTS 27 studies (4857 patients) fulfilling the eligibility criteria were included in this systematic review, from a total of 883 records. About half of the patients had each of fever and cough, 11% (6-17%) had fast breathing, and 6-13% had gastrointestinal manifestations. Most of the patients had mild to moderate disease, and only 4% had a severe or critical illness. Leukopenia was the commonest reported laboratory abnormality. CONCLUSIONS Even among the symptomatic COVID-19 cases, severe manifestations are seen in very few children. Though fever and respiratory symptoms are most common, many children also have gastrointestinal manifestations.
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Affiliation(s)
- Jitendra Meena
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Jaivinder Yadav
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Lokesh Saini
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Arushi Yadav
- Department of Radiodiagnosis, Government Medical College and Hospital, Chandigarh; India
| | - Jogender Kumar
- Post Graduate Institute of Medical Education and Research, Chandigarh, India. Correspondence to: Dr Jogender Kumar, Assistant Professor, Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
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22
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Bragazzi NL, Mansour M, Bonsignore A, Ciliberti R. The Role of Hospital and Community Pharmacists in the Management of COVID-19: Towards an Expanded Definition of the Roles, Responsibilities, and Duties of the Pharmacist. PHARMACY 2020; 8:E140. [PMID: 32784696 PMCID: PMC7558051 DOI: 10.3390/pharmacy8030140] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/05/2020] [Accepted: 08/06/2020] [Indexed: 12/23/2022] Open
Abstract
Since late December 2019, a novel, emerging coronavirus was identified as the infectious agent responsible for a generally mild but sometimes severe and even life-threatening disease, termed as "coronavirus disease 2019" (COVID-19). The pathogen was initially named as "2019 novel coronavirus" (2019-nCoV) and later renamed as "Severe Acute Respiratory Coronavirus type 2" (SARS-CoV-2). COVID-19 quickly spread from the first epicenter, the city of Wuhan, province of Hubei, mainland China, into neighboring countries, and became a global pandemic. As of July 15th 2020, the outbreak is still ongoing, with SARS-CoV-2 affecting 213 countries and territories. The coronavirus has caused a dramatic toll of deaths and imposed a severe burden, both from a societal and economic point of view. COVID-19 has challenged health systems, straining and overwhelming healthcare facilities and settings, including hospital and community pharmacies. On the other hand, COVID-19 has propelled several changes. During the last decades, pharmacy has shifted from being products-based and patient-facing to being services-based and patient-centered. Pharmacies have transitioned from being compounding centers devoted to the manipulation of materia medica to pharmaceutical centers, clinical pharmacies and fully integrated "medical-pharmaceutical networks", providing a significant range of non-prescribing services. Moreover, roles, duties and responsibilities of pharmacists have paralleled such historical changes and have known a gradual expansion, incorporating new skills and reflecting new societal demands and challenges. The COVID-19 outbreak has unearthed new opportunities for pharmacists: community and hospital pharmacists have, indeed, played a key role during the COVID-19 pandemic, suggesting that a fully integrated, inter-sectoral and inter-professional collaboration is necessary to face crises and public health emergencies. Preliminary, emerging evidence seems to suggest that, probably, a new era in the history of pharmacies ("the post-COVID-19 post-pharmaceutical care era") has begun, with community pharmacists acquiring more professional standing, being authentic heroes and frontline health workers.
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Affiliation(s)
- Nicola Luigi Bragazzi
- Department of Health Sciences (DISSAL), Postgraduate School of Public Health, Genoa University, 16132 Genoa, Italy
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON M3J 1P3, Canada
| | - Muhammad Mansour
- Department of Surgery A, Galilee Medical Center, Nahariya, Faculty of Medicine of the Galilee, Bar-Ilan University, Safed 5290002, Israel;
- Division of General Surgery, St. Michael’s Hospital, Unity Health Toronto, University of Toronto, Toronto, ON M5B 1W8, Canada
| | - Alessandro Bonsignore
- Section of Legal and Forensic Medicine, Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy;
| | - Rosagemma Ciliberti
- Section of History of Medicine and Bioethics, Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy;
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23
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Dopytalska K, Mikucka-Wituszyńska A, Ciechanowicz P, Szczerba M, Szymańska E, Walecka I. Organization of biologic therapy during the COVID-19 pandemic based on example of Dermatology Clinic Centre of Postgraduate Medical Education in Warsaw. J DERMATOL TREAT 2020; 33:864-868. [PMID: 32569493 DOI: 10.1080/09546634.2020.1782822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The COVID-19 pandemic spread to almost all countries in the world within a few months, necessitating changes in medical care for patients with SARS-CoV-2 infections as well as patients with various chronic diseases. Ensuring the safety of medical staff and patients in hospitals specializing in infectious diseases is a major logistical challenge. Psoriasis patients treated with immunosuppressive medications, including those under biologic therapy, are a special group. Many scientific societies do not recommend discontinuing therapy in patients without symptoms or confirmation of SARS-CoV-2 infection despite the potentially higher risk of respiratory tract infections in this patient population. Based on our own experience, we present the organization of the biologic therapy within the unit of a Single Specialty Infectious Hospital.
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Affiliation(s)
- Klaudia Dopytalska
- Department of Dermatology, Centre of Postgraduate Medical Education, Central Clinical Hospital of the Ministry of the Interior, Warsaw, Poland
| | - Agata Mikucka-Wituszyńska
- Department of Dermatology, Centre of Postgraduate Medical Education, Central Clinical Hospital of the Ministry of the Interior, Warsaw, Poland
| | - Piotr Ciechanowicz
- Department of Dermatology, Centre of Postgraduate Medical Education, Central Clinical Hospital of the Ministry of the Interior, Warsaw, Poland
| | - Michał Szczerba
- Faculty of Medicine, University of Technology in Katowice, Katowice, Poland
| | - Elżbieta Szymańska
- Department of Dermatology, Centre of Postgraduate Medical Education, Central Clinical Hospital of the Ministry of the Interior, Warsaw, Poland
| | - Irena Walecka
- Department of Dermatology, Centre of Postgraduate Medical Education, Central Clinical Hospital of the Ministry of the Interior, Warsaw, Poland
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24
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Konala VM, Adapa S, Naramala S, Chenna A, Lamichhane S, Garlapati PR, Balla M, Gayam V. A Case Series of Patients Coinfected With Influenza and COVID-19. J Investig Med High Impact Case Rep 2020; 8:2324709620934674. [PMID: 32522037 PMCID: PMC7290261 DOI: 10.1177/2324709620934674] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Coronavirus disease 2019, also called COVID-19, is a global pandemic resulting in significant morbidity and mortality worldwide. In the United States, influenza infection occurs mainly during winter and several factors influence the burden of the disease, including circulating virus characteristics, vaccine effectiveness that season, and the duration of the season. We present a case series of 3 patients with coinfection of COVID-19 and influenza, with 2 of them treated successfully and discharged home. We reviewed the literature of patients coinfected with both viruses and discussed the characteristics, as well as treatment options.
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Affiliation(s)
| | | | | | - Avantika Chenna
- Phoebe Putney Memorial Hospital, Albany, GA, USA.,Medical College of Georgia, Augusta, GA, USA
| | | | | | - Mamtha Balla
- University of Toledo, OH, USA.,Promedica Toledo Hospital, Toledo, OH, USA
| | - Vijay Gayam
- Interfaith Medical Center, Brooklyn, NY, USA
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25
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Nakajima K. Serious Conditions in COVID-19 Accompanied With a Feature of Metabolic Syndrome. J Clin Med Res 2020; 12:273-275. [PMID: 32489501 PMCID: PMC7239577 DOI: 10.14740/jocmr4187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 04/29/2020] [Indexed: 01/25/2023] Open
Affiliation(s)
- Kei Nakajima
- School of Nutrition and Dietetics, Faculty of Health and Social Services, Kanagawa University of Human Services, 1-10-1 Heisei-cho, Yokosuka, Kanagawa 238-8522, Japan.,Graduate School of Health Innovation, Kanagawa University of Human Services, Research Gate Building Tonomachi 2-A, 3-25-10 Tonomachi, Kawasaki, Kanagawa 210-0821, Japan.,Department of Endocrinology and Diabetes, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama 350-8550, Japan
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26
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Adapa S, Chenna A, Balla M, Merugu GP, Koduri NM, Daggubati SR, Gayam V, Naramala S, Konala VM. COVID-19 Pandemic Causing Acute Kidney Injury and Impact on Patients With Chronic Kidney Disease and Renal Transplantation. J Clin Med Res 2020; 12:352-361. [PMID: 32587651 PMCID: PMC7295554 DOI: 10.14740/jocmr4200] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 05/19/2020] [Indexed: 01/08/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) caused by 2019 novel coronavirus (2019-nCoV) has caused significant mortality and has been declared as a global pandemic by the World Health Organization. The infection mainly presents as fever, cough, and breathing difficulty, and few patients develop very severe symptoms. The purpose of this review is to analyze the impact of the virus on the kidney. COVID-19 infection causes acute kidney injury (AKI) and is an independent risk factor for mortality. Angiotensin-converting enzyme 2 (ACE2) receptors, direct viral damage, and immune-mediated damage play important roles in the pathogenesis. AKI in COVID-19 infection could be from the synergistic effect of virus-induced direct cytotropic effect and cytokine-induced systemic inflammatory response. AKI caused in the viral infection has been analyzed from the available epidemiological studies. The proportion of patients developing AKI is significantly higher when they develop severe disease. Continuous renal replacement therapy (CRRT) is the most used blood purification technique when needed. The impact of COVID-19 infection on chronic kidney disease (CKD) and renal transplant patients is also discussed in the manuscript. No vaccine has been developed against the 2019-nCoV virus to date. The critical aspect of management is supportive care. Several investigative drugs have been studied, drugs approved for other indications have been used, and several clinical trials are underway across the globe. Recently remdesivir has received emergency use authorization by the Food and Drug Administration (FDA) in the USA for use in patients hospitalized with COVID-19. Prevention of the infection holds the key to management. The patients with underlying kidney problems and renal transplant patients are vulnerable to developing COVID-19 infection.
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Affiliation(s)
- Sreedhar Adapa
- Division of Nephrology, Department of Internal Medicine, Adventist Medical Center, Hanford, CA 93230, USA
| | - Avantika Chenna
- Phoebe Putney Memorial Hospital, Medical College of Georgia, Albany, GA 31701, USA
| | - Mamtha Balla
- Department of Internal Medicine, University of Toledo and Promedica Toledo Hospital, Toledo, OH 43606, USA
| | - Ganesh Prasad Merugu
- Division of Geriatric Medicine, Department of Family Medicine, University of Toledo, OH 43614, USA
| | | | | | - Vijay Gayam
- Department of Medicine, Interfaith Medical Center, Brooklyn, NY 11213, USA
| | - Srikanth Naramala
- Division of Rheumatology, Department of Internal Medicine, Adventist Medical Center, Hanford, CA 93230, USA
| | - Venu Madhav Konala
- Division of Medical Oncology, Department of Internal Medicine, Ashland Bellefonte Cancer Center, Ashland, KY 41169, USA
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27
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Gayam V, Konala VM, Naramala S, Garlapati PR, Merghani MA, Regmi N, Balla M, Adapa S. Presenting characteristics, comorbidities, and outcomes of patients coinfected with COVID-19 and Mycoplasma pneumoniae in the USA. J Med Virol 2020; 92:2181-2187. [PMID: 32449972 PMCID: PMC7280653 DOI: 10.1002/jmv.26026] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 05/13/2020] [Indexed: 01/02/2023]
Abstract
Coronavirus disease 2019 (COVID‐19) caused by severe acute respiratory syndrome‐coronavirus 2 (SARS‐CoV‐2) is spreading at a rapid pace, and the World Health Organization declared it as pandemic on 11 March 2020. Mycoplasma pneumoniae is an "atypical" bacterial pathogen commonly known to cause respiratory illness in humans. The coinfection from SARS‐CoV‐2 and mycoplasma pneumonia is rarely reported in the literature to the best of our knowledge. We present a study in which 6 of 350 patients confirmed with COVID‐19 were also diagnosed with M. pneumoniae infection. In this study, we described the clinical characteristics of patients with coinfection. Common symptoms at the onset of illness included fever (six [100%] patients); five (83.3%) patients had a cough, shortness of breath, and fatigue. The other symptoms were myalgia (66.6%), gastrointestinal symptoms (33.3%‐50%), and altered mental status (16.7%). The laboratory parameters include lymphopenia, elevated erythrocyte sedimentation rate, C‐reactive protein, lactate dehydrogenase, interleukin‐6, serum ferritin, and D‐dimer in all six (100%) patients. The chest X‐ray at presentation showed bilateral infiltrates in all the patients (100%). We also described electrocardiogram findings, complications, and treatment during hospitalization in detail. One patient died during the hospital course. The COVID‐19 pneumonia is a serious condition and can be associated with the common respiratory pathogens. Co‐infections with COVID‐19 can result in protracted respiratory symptoms, prolonged ICU stay, morbidity, and mortality if not detected and treated appropriately. The treatment of Co‐infection if y available might facilitate early recovery.
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Affiliation(s)
- Vijay Gayam
- Department of Medicine, Interfaith Medical Center, Brooklyn, New York
| | - Venu M Konala
- Department of Internal Medicine, Divison of Medical Oncology, Ashland Bellefonte Cancer Center, Ashland, Kentucky
| | - Srikanth Naramala
- Division of Rheumatology, Department of Internal Medicine, Adventist Medical Center, Hanford, California
| | | | | | - Nirajan Regmi
- Department of Medicine, The Wright Center for Graduate Medical Education, Scranton, Pennsylvania
| | - Mamtha Balla
- Department of Internal Medicine, University of Toledo and Promedica Toledo Hospital, Toledo, Ohio
| | - Sreedhar Adapa
- Division of Nephrology, Department of Internal Medicine, Adventist Medical Center, Hanford, California
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28
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Adapa S, Aeddula NR, Konala VM, Chenna A, Naramala S, Madhira BR, Gayam V, Balla M, Muppidi V, Bose S. COVID-19 and Renal Failure: Challenges in the Delivery of Renal Replacement Therapy. J Clin Med Res 2020; 12:276-285. [PMID: 32489502 PMCID: PMC7239583 DOI: 10.14740/jocmr4160] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 04/17/2020] [Indexed: 01/08/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), first officially reported in December 2019 in Wuhan City, Hubei province, China, and has since lead to a pandemic. Most cases result in minor symptoms such as cough, fever, sore throat, myalgia, fatigue, nausea, diarrhea, loss of smell, and abdominal pain. As of April 8, 2020, more than 1,485,000 cases of COVID-19 have been reported in more than 200 countries and territories, resulting in over 90,000 deaths. Outcomes are worse in elderly patients, particularly males, and those with comorbidities, but can affect any age group. The incidence of acute kidney injury in patients with COVID-19 infection is about 3-15%; and in patients with severe infection requiring care in the intensive care unit, the rates of acute kidney injury increased significantly from 15% to 50%. Acute kidney injury is an independent risk factor for mortality in COVID-19 patients. The nephrologists, as well as intensivists, are facing immense daily challenges while providing care for these patients in the inpatient setting as well as end-stage renal disease patients on chronic dialysis in both inpatient and outpatient settings. In the current review article, we discussed the epidemiology and etiology of acute kidney injury, management of acute kidney injury including renal replacement therapy options (both hemodialysis and peritoneal dialysis) for inpatient floor, as well as intensive care unit settings. We also discussed the challenges faced by the outpatient dialysis units with COVID-19 infection. We discussed measures required to limit the spread of infection, as well as summarized the guidance as per the Centers for Disease Control and Prevention (CDC), American Society of Nephrology (ASN), American Society of Diagnostic and Interventional Nephrology (ASDIN) and the Vascular Access Society of the Americas (VASA).
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Affiliation(s)
- Sreedhar Adapa
- Division of Nephrology, Department of Internal Medicine, Adventist Medical Center, Hanford, CA 93230, USA
| | - Narothama Reddy Aeddula
- Division of Nephrology, Department of Internal Medicine, Deaconess Health System Inc, Evansville, IN, USA
| | - Venu Madhav Konala
- Division of Medical Oncology, Department of Internal Medicine, Ashland Bellefonte Cancer Center, 122 St Christopher Dr, Ashland, KY 41169, USA
| | - Avantika Chenna
- Phoebe Putney Memorial Hospital, 417 W 3rd Avenue, Albany, GA 31701, USA
- Medical College of Georgia, Augusta, GA, USA
| | - Srikanth Naramala
- Division of Rheumatology, Department of Internal Medicine, Adventist Medical Center, Hanford, CA 93230, USA
| | - Bhaskar Reddy Madhira
- Department of Hematology and Oncology, Sunny Upstate Medical University, Syracuse, NY, USA
| | - Vijay Gayam
- Department of Medicine, Interfaith Medical Center, Brooklyn, NY, USA
| | - Mamtha Balla
- Department of Internal Medicine, University of Toledo and Promedica Toledo Hospital, Toledo, OH 43606, USA
| | - Vijayadershan Muppidi
- Department of Internal Medicine, IU Health Ball Memorial Hospital, Muncie, IN 47303, USA
| | - Subhasish Bose
- Division of Nephrology, Lynchburg Nephrology Physicians, Lynchburg, VA, USA
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29
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Konala VM, Adapa S, Gayam V, Naramala S, Daggubati SR, Kammari CB, Chenna A. Co-infection with Influenza A and COVID-19. Eur J Case Rep Intern Med 2020; 7:001656. [PMID: 32399452 PMCID: PMC7213830 DOI: 10.12890/2020_001656] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 04/17/2020] [Indexed: 12/14/2022] Open
Abstract
COVID-19, also called severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2), originated in Wuhan, China. It has caused significant morbidity and mortality worldwide and has been declared a global pandemic by the WHO. Influenza occurs mainly during the winter, with the burden of disease determined by several factors, including the effectiveness of the vaccine that season, the characteristics of the circulating viruses, and how long the season lasts. We describe the case of a 66-year-old woman who was diagnosed with influenza A and COVID-19 co-infection.
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Affiliation(s)
- Venu Madhav Konala
- Department of Internal Medicine, Division of Medical Oncology, Ashland Bellefonte Cancer Center, Ashland, KY, USA
| | - Sreedhar Adapa
- Department of Internal Medicine, Division of Nephrology, Adventist Medical Center, Hanford, CA, USA
| | - Vijay Gayam
- Department of Medicine, Interfaith Medical Center, Brooklyn, NY, USA
| | - Srikanth Naramala
- Department of Internal Medicine, Division of Rheumatology, Adventist Medical Center, Hanford, CA, USA
| | | | | | - Avantika Chenna
- Phobe Putney Memorial Hospital, Medical College of Georgia, Albany, GA, USA6
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30
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Farshidpour M, Kim D, Junna S, Merchant J. A brief review of liver injury in patients with Corona Virus Disease-19 during the pandemic. Indian J Gastroenterol 2020; 39:232-235. [PMID: 32621206 PMCID: PMC7333972 DOI: 10.1007/s12664-020-01068-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 06/18/2020] [Indexed: 02/04/2023]
Abstract
The novel coronavirus Severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2) infection has been mostly leading to respiratory distress syndrome, but liver injury has also been documented. The mechanism of liver injury is limited and poorly understood. However, the hepatic injury could be due to a consequence of systemic inflammatory response, viral infection of hepatocytes, or as a result of intensive care treatment or drug toxicity. Based on the current studies, this review article emphasizes on the demographic and potential mechanisms of Corona Virus Disease (COVID)-19-related liver dysfunction.
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Affiliation(s)
- Maham Farshidpour
- Division of Inpatient Medicine, Banner University Medical Center, Tucson, AZ USA
| | - David Kim
- Division of Gastroenterology and Hepatology, Banner University Medical Center, Tucson, AZ USA
| | - Shilpa Junna
- Division of Gastroenterology and Hepatology, Banner University Medical Center, Tucson, AZ USA
| | - Juanita Merchant
- Division of Gastroenterology and Hepatology, Banner University Medical Center, Tucson, AZ USA
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Ribeiro AP, Oliveira GL, Silva LS, Souza ERD. Saúde e segurança de profissionais de saúde no atendimento a pacientes no contexto da pandemia de Covid-19: revisão de literatura. REVISTA BRASILEIRA DE SAÚDE OCUPACIONAL 2020. [DOI: 10.1590/2317-6369000013920] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Resumo Objetivo: analisar a produção científica sobre a saúde dos trabalhadores da Saúde que atendem pacientes no contexto da pandemia de COVID-19. Métodos: realizou-se revisão de literatura que incluiu artigos publicados em 2020, indexados nas bases PubMed, Web of Science e na Biblioteca Virtual em Saúde (Medline e Lilacs). Resultados: foram analisados 52 artigos, segundo grupo profissional estudado, país onde a pesquisa foi realizada, tipo de estudo e tema abordado. Os conhecimentos e questões mais atuais e relevantes e as lacunas existentes sobre o tema foram evidenciados e discutidos do ponto de vista da Saúde Coletiva, particularmente da Saúde do Trabalhador. Mais da metade dos documentos foi produzida na China (55,7%) e focalizou as diferentes categorias profissionais de saúde em conjunto (57,7%). Estudos do tipo ensaio/opinião (46,1%) e estudos transversais (30,8%) foram os mais frequentes. Os temas destacados foram o conhecimento dos profissionais sobre a doença, os casos de COVID-19 entre os profissionais, a saúde mental dos trabalhadores da saúde e a segurança no trabalho. Conclusão: os estudos publicados no início da pandemia destacam a insuficiência de conhecimentos atualizados e falhas na proteção da saúde dos trabalhadores e recomendam o gerenciamento dos processos e locais de trabalho, dos casos de COVID-19, das políticas públicas e dos direitos dos trabalhadores.
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