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Ribeiro AF, Castro MC, Lotta G, Carvalho RDJ, Zamudio M, Barberia LG. Early response to COVID-19 in Brazil: The impact of a targeted approach to suspected cases and on epidemiological surveillance efforts. IJID REGIONS 2023; 7:242-251. [PMID: 37143704 PMCID: PMC10116149 DOI: 10.1016/j.ijregi.2023.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 04/11/2023] [Accepted: 04/12/2023] [Indexed: 05/06/2023]
Abstract
Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) entered Brazil before travel restrictions and border closures were imposed. This study reports the characteristics of suspected and confirmed coronavirus disease 2019 (COVID-19) cases among symptomatic international travelers in Brazil and their contacts. Methods The REDCap platform developed by the Brazilian Ministry of Health was analyzed to identify and investigate suspected cases of COVID-19 recorded during the period January 1 to March 20, 2020. The impact of Brazil's targeted approach to suspected cases from specific countries on epidemiological surveillance efforts during the early stages of the COVID-19 pandemic were analyzed. Results Based on molecular RT-PCR tests, there were 217 (4.2%) confirmed, 1030 (20.1%) unconfirmed, 722 (14.1%) suspected, and 3157 (61.6%) non-investigated cases among travelers returning from countries included on the alert list for surveillance, as defined by the Ministry of Health. Among the 3372 travelers who went to countries not included on the alert list, there were 66 (2.0%) confirmed, 845 (25.3%) unconfirmed, 521 (15.6%) suspected, and 1914 (57.2%) non-investigated cases. A comparison of the characteristics of confirmed cases returning from alert and non-alert countries did not reveal a statistically significant difference in symptoms. Almost half of the hospitalized travelers with known travel dates and hospitalization status (53.6%) were inbound from countries not included on the alert list, and RT-PCR tests were reported for only 30.5%. Conclusions Policies adopted at entry points to contain the introduction of SARS-CoV-2 in Brazil were not ideal. An analysis of the early response shows that surveillance of travelers, including testing strategies, data standards, and reporting systems, was insufficient.
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Affiliation(s)
- Ana Freitas Ribeiro
- Institute of Infectious Diseases Emilio Ribas, Health Secretary of the State, Pacaembu, São Paulo, Brazil
- Municipal University of São Caetano do Sul, Centro, São Caetano do Sul, Brazil
| | - Marcia C Castro
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
| | - Gabriela Lotta
- Department of Public Administration, Getúlio Vargas Foundation, São Paulo, SP, Brazil
| | - Rebeca de J Carvalho
- Department of Public Administration and Government, FGV EAESP Business Administration School of São Paulo, Bela Vista, São Paulo - SP, Brazil
| | - Marcela Zamudio
- Department of Political Science, University of São Paulo, Cidade Universitária, São Paulo - SP, Brazil
| | - Lorena G Barberia
- Department of Political Science, University of São Paulo, Cidade Universitária, São Paulo - SP, Brazil
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Abstract
The World Health Organisation has reported that the viral disease known as COVID-19, caused by SARS-CoV-2, is the leading cause of death by a single infectious agent. This narrative review examines certain components of the pandemic: its origins, early clinical data, global and UK-focussed epidemiology, vaccination, variants, and long COVID.
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Affiliation(s)
- A. D. Blann
- School of Applied Sciences, University of Huddersfield Queensgate, Huddersfield, United Kingdom
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Rajkumar RP. Is There a Relationship Between ADHD and COVID-19 Prevalence and Mortality Indices? An Analysis of Data From 156 Countries. J Atten Disord 2022; 26:1069-1077. [PMID: 34784830 DOI: 10.1177/10870547211056894] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To examine the relationship between nation-level prevalence of ADHD and COVID-19 prevalence and mortality indices. METHOD Associations between nation-wise estimated prevalence, crude mortality rates and case-fatality ratios for COVID-19 and estimated prevalence rates for ADHD were examined, controlling for medical conditions known to be associated with COVID-19 outcome, as well as demographic, climate-related, and economic variables. RESULTS Prevalence of ADHD was positively correlated with COVID-19 prevalence and crude mortality rates on bivariate analyses, though the strength of this association was low. On multivariate regression, prevalence of ADHD was negatively associated with COVID-19 prevalence and crude mortality rates, though only the former finding was statistically significant. CONCLUSION The association between ADHD and COVID-19 prevalence and mortality at a national level is inconsistent, modest, and may be largely due to confounding factors such as age, lifestyle factors, and medical comorbidities.
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Affiliation(s)
- Ravi Philip Rajkumar
- Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
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Development of the DNA-based biosensors for high performance in detection of molecular biomarkers: More rapid, sensitive, and universal. Biosens Bioelectron 2022; 197:113739. [PMID: 34781175 PMCID: PMC8553638 DOI: 10.1016/j.bios.2021.113739] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 10/25/2021] [Indexed: 02/07/2023]
Abstract
The molecular biomarkers are molecules that are closely related to specific physiological states. Numerous molecular biomarkers have been identified as targets for disease diagnosis and biological research. To date, developing highly efficient probes for the precise detection of biomarkers has become an attractive research field which is very important for biological and biochemical studies. During the past decades, not only the small chemical probe molecules but also the biomacromolecules such as enzymes, antibodies, and nucleic acids have been introduced to construct of biosensor platform to achieve the detection of biomarkers in a highly specific and highly efficient way. Nevertheless, improving the performance of the biosensors, especially in clinical applications, is still in urgent demand in this field. A noteworthy example is the Corona Virus Disease 2019 (COVID-19) that breaks out globally in a short time in 2020. The COVID-19 was caused by the virus called SARS-CoV-2. Early diagnosis is very important to block the infection of the virus. Therefore, during these months scientists have developed dozens of methods to achieve rapid and sensitive detection of the virus. Nowadays some of these new methods have been applied for producing the commercial detection kit and help people against the disease worldwide. DNA-based biosensors are useful tools that have been widely applied in the detection of molecular biomarkers. The good stability, high specificity, and excellent biocompatibility make the DNA-based biosensors versatile in application both in vitro and in vivo. In this paper, we will review the major methods that emerged in recent years on the design of DNA-based biosensors and their applications. Moreover, we will also briefly discuss the possible future direction of DNA-based biosensors design. We believe this is helpful for people interested in not only the biosensor field but also in the field of analytical chemistry, DNA nanotechnology, biology, and disease diagnosis.
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Suthar AB, Schubert S, Garon J, Couture A, Brown AM, Charania S. Coronavirus Disease Case Definitions, Diagnostic Testing Criteria, and Surveillance in 25 Countries with Highest Reported Case Counts. Emerg Infect Dis 2022; 28:148-156. [PMID: 34932450 PMCID: PMC8714223 DOI: 10.3201/eid2801.211082] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
We compared case definitions for suspected, probable, and confirmed coronavirus disease (COVID-19), as well as diagnostic testing criteria, used in the 25 countries with the highest reported case counts as of October 1, 2020. Of the identified countries, 56% followed World Health Organization (WHO) recommendations for using a combination of clinical and epidemiologic criteria as part of the suspected case definition. A total of 75% of identified countries followed WHO recommendations on using clinical, epidemiologic, and diagnostic criteria for probable cases; 72% followed WHO recommendations to use PCR testing to confirm COVID-19. Finally, 64% of countries used testing eligibility criteria at least as permissive as WHO. We observed marked heterogeneity in testing eligibility requirements and in how countries define a COVID-19 case. This heterogeneity affects the ability to compare case counts, transmission, and vaccine effectiveness, as well as estimates derived from case surveillance data across countries.
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Anand SV, Shuy YK, Lee PSS, Lee ES. One Year on: An Overview of Singapore's Response to COVID-19-What We Did, How We Fared, How We Can Move Forward. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9125. [PMID: 34501718 PMCID: PMC8431401 DOI: 10.3390/ijerph18179125] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 07/30/2021] [Accepted: 08/20/2021] [Indexed: 01/28/2023]
Abstract
Background-One year has passed since the first COVID-19 case in Singapore. This scoping review commemorates Singaporean researchers that have expanded the knowledge on this novel virus. We aim to provide an overview of healthcare-related articles published in peer-reviewed journals, authored by the Singapore research community about COVID-19 during the first year of the pandemic. Methods-This was reported using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) protocol. It included healthcare-related articles about COVID-19 published between 23 January 2020 and 22 January 2021 with a Singapore-affiliated author. MEDLINE, Embase, Scopus, Web of Science, CINAHL, PsycINFO, Google Scholar, and local journals were searched. The articles were screened independently by two reviewers. Results-The review included 504 articles. Most of the articles narrated the changes to hospital practice (210), while articles on COVID-19 pathology (94) formed most of the non-narrative papers. Publications on public health (61) and the indirect impacts to clinical outcomes (45) were other major themes explored by the research community. The remaining articles detailed the psychological impact of the pandemic (35), adaptations of medical education (30), and narratives of events (14). Conclusion-Amidst a resurgence of community cases involving variant COVID-19 strains, the resources from the research community will provide valuable guidance to navigate these uncertain times.
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Affiliation(s)
- S Vivek Anand
- Ministry of Health Holdings, Singapore 099253, Singapore;
| | - Yao Kang Shuy
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308207, Singapore;
| | - Poay Sian Sabrina Lee
- Clinical Research Unit, National Healthcare Group Polyclinics, Singapore 138543, Singapore;
| | - Eng Sing Lee
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308207, Singapore;
- Clinical Research Unit, National Healthcare Group Polyclinics, Singapore 138543, Singapore;
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Chung SC, Marlow S, Tobias N, Alogna A, Alogna I, You SL, Khunti K, McKee M, Michie S, Pillay D. Lessons from countries implementing find, test, trace, isolation and support policies in the rapid response of the COVID-19 pandemic: a systematic review. BMJ Open 2021; 11:e047832. [PMID: 34187854 PMCID: PMC8251680 DOI: 10.1136/bmjopen-2020-047832] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE To systematically learn lessons from the experiences of countries implementing find, test, trace, isolate, support (FTTIS) in the first wave of the COVID-19 pandemic. DESIGN, DATA SOURCES AND ELIGIBILITY CRITERIA We searched MEDLINE (PubMed), Cochrane Library, SCOPUS and JSTOR, initially between 31 May 2019 and 21 January 2021. Research articles and reviews on the use of contact tracing, testing, self-isolation and quarantine for COVID-19 management were included in the review. DATA EXTRACTION AND SYNTHESIS We extracted information including study objective, design, methods, main findings and implications. These were tabulated and a narrative synthesis was undertaken given the diverse research designs, methods and implications. RESULTS We identified and included 118 eligible studies. We identified the core elements of an effective find, test, trace, isolate, support (FTTIS) system needed to interrupt the spread of a novel infectious disease, where treatment or vaccination was not yet available, as pertained in the initial stages of the COVID-19 pandemic. We report methods used to shorten case finding time, improve accuracy and efficiency of tests, coordinate stakeholders and actors involved in an FTTIS system, support individuals isolating and make appropriate use of digital tools. CONCLUSIONS We identified in our systematic review the key components of an FTTIS system. These include border controls, restricted entry, inbound traveller quarantine and comprehensive case finding; repeated testing to minimise false diagnoses and pooled testing in resource-limited circumstances; extended quarantine period and the use of digital tools for contact tracing and self-isolation. Support for mental or physical health and livelihoods is needed for individuals undergoing self-isolation/quarantine. An integrated system with rolling-wave planning can best use effective FTTIS tools to respond to the fast-changing COVID-19 pandemic. Results of the review may inform countries considering implementing these measures.
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Affiliation(s)
- Sheng-Chia Chung
- Institute of Health Informatics, University College London, London, UK
| | - Sushila Marlow
- Department of Chemical Engineering, University College London, London, UK
| | - Nicholas Tobias
- Bartlett School of Planning, University College London, London, UK
| | | | - Ivano Alogna
- British Institute of International and Comparative Law, London, UK
| | - San-Lin You
- Department of Medicine, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
- Big Data Research Center, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Martin McKee
- European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine, London, UK
| | - Susan Michie
- Centre for Behaviour Change, Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Deenan Pillay
- Division of Infection and Immunity, University College London, London, UK
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Wang SM, Park SH, Kim NY, Kang DW, Na HR, Um YH, Han S, Park SS, Lim HK. Association between Dementia and Clinical Outcome after COVID-19: A Nationwide Cohort Study with Propensity Score Matched Control in South Korea. Psychiatry Investig 2021; 18:523-529. [PMID: 34218641 PMCID: PMC8256148 DOI: 10.30773/pi.2021.0064] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 03/31/2021] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE Despite a high prevalence of dementia in older adults hospitalized with severe acute respiratory syndrome coronavirus 2 infection (SARS-CoV-2), or so called COVID-19, research investigating association between preexisting diagnoses of dementia and prognosis of COVID-19 is scarce. We aimed to investigate treatment outcome of patients with dementia after COVID-19. METHODS We explored a nationwide cohort with a total of 2,800 subjects older than 50 years who were diagnosed with COVID-19 between January and April 2020. Among them, 223 patients had underlying dementia (dementia group). We matched 1:1 for each dementia- non-dementia group pair yielding 223 patients without dementia (no dementia group) using propensity score matching. RESULTS Mortality rate after COVID-19 was higher in dementia group than in no dementia group (33.6% vs. 20.2%, p=0.002). Dementia group had higher proportion of patients requiring invasive ventilatory support than no dementia group (34.1% vs. 22.0%, p=0.006). Multivariable analysis showed that dementia group had a higher risk of mortality than no dementia group (odds ratio=3.05, p<0.001). We also found that patients in dementia group had a higher risk of needing invasive ventilatory support than those in no dementia group. CONCLUSION Our results suggest that system including strengthen quarantines are required for patients with dementia during the COVID- 19 pandemic.
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Affiliation(s)
- Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - See Hyun Park
- Department of Pharmacology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Nak-Young Kim
- Department of Psychiatry, Keyo Hospital, Uiwang, Republic of Korea
| | - Dong Woo Kang
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hae-Ran Na
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yoo Hyun Um
- Department of Psychiatry, St. Vincent Hospital, College of Medicine, The Catholic University of Korea, Suwon, Republic of Korea
| | - Seunghoon Han
- Department of Pharmacology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sung-Soo Park
- Department of Hematology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyun Kook Lim
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Ucciferri C, Caiazzo L, Di Nicola M, Borrelli P, Pontolillo M, Auricchio A, Vecchiet J, Falasca K. Parameters associated with diagnosis of COVID-19 in emergency department. IMMUNITY INFLAMMATION AND DISEASE 2021; 9:851-861. [PMID: 33960733 PMCID: PMC8239864 DOI: 10.1002/iid3.440] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/26/2021] [Accepted: 03/29/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVES We designed this study to identify laboratory and radiological parameters, which could be useful to guide the clinician, in the evaluation of a suspected case of coronavirus disease 19 (COVID-19). METHODS This retrospective, observational, single-center-study recruited patients with a suspect of COVID-19 data were extracted from electronic medical records using a standardized data collection form. RESULTS A total of 566 patients with suspect COVID-19 infection were enrolled (280 were COVID-19+). The COVID-19 population was characterized with bilateral-pneumonia, a lower count of neutrophil, lymphocyte and monocyte, a lower neutrophil to lymphocyte-ratio (NLR). Lower of platelet count, d-dimer, troponin I, and serum calcium were in COVID-19 patients. The occurrence of COVID-19 diagnosis increased, independently of other variables, with pneumonia (odds ratio [OR]: 3.60; p < .001), neutrophil below normal range (OR: 4.15; p < .05), lactate dehydrogenase (OR: 2.09; p < .01) and sodium above normal range (OR: 2.34; p < .01). In patients with possible respiratory acute affections we found a higher neutrophil, higher monocyte, a higher NLR and a more elevation in d-dimer. In the Sepsis group showed higher level of white blood cell, C-reactive protein, d-dimer, and procalcitonin. CONCLUSIONS Our study confirms that patients with COVID-19 have typical radiological and laboratory characteristics. The parameters highlighted in the study can help identify COVID-19 patients, also highlighting which are the main differential diagnoses to be made and the parameters that facilitate the differential diagnosis.
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Affiliation(s)
- Claudio Ucciferri
- Department of Medicine and Science of Aging, Clinic of Infectious Diseases, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Luca Caiazzo
- Department of Medicine and Science of Aging, Clinic of Infectious Diseases, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Marta Di Nicola
- Laboratory of Biostatistics, Department of Medical, Oral, and Biotechnological Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Paola Borrelli
- Laboratory of Biostatistics, Department of Medical, Oral, and Biotechnological Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Michela Pontolillo
- Department of Medicine and Science of Aging, Clinic of Infectious Diseases, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Antonio Auricchio
- Department of Medicine and Science of Aging, Clinic of Infectious Diseases, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Jacopo Vecchiet
- Department of Medicine and Science of Aging, Clinic of Infectious Diseases, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Katia Falasca
- Department of Medicine and Science of Aging, Clinic of Infectious Diseases, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
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Tan JL, Lim MY, Lee CSY, Yeo SB. Resuming otolaryngology services following a COVID-19 lockdown in Singapore. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2021. [PMID: 33623967 DOI: 10.47102/annals-acadmedsg.2020416] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Jian Li Tan
- Department of Otorhinolaryngology, Tan Tock Seng Hospital, Singapore
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Tan GSE, Ding Y, Cui L, Mak TM, Mok CK, Kurup A, Parthasarathy P, Chia WN, Wang LF, Lin RTP, Leo YS, Vasoo S. Positive RT-PCR detected in patients recovered from COVID-19. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2021; 50:191-194. [PMID: 33733267 DOI: 10.47102/annals-acadmedsg.2020387] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
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Ganti S, Shanker S, Pek JH. COVID-19 among Foreign Workers in Dormitories - How One Emergency Department Responded. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2021. [PMID: 33463665 DOI: 10.47102/annals-acadmedsg.2020365] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Sameera Ganti
- Emergency Department, Sengkang General Hospital, Singapore
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El-Gilany AH. COVID-19 caseness: An epidemiologic perspective. J Infect Public Health 2021; 14:61-65. [PMID: 33352377 PMCID: PMC7832429 DOI: 10.1016/j.jiph.2020.11.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 10/10/2020] [Accepted: 11/08/2020] [Indexed: 01/22/2023] Open
Abstract
The concept of caseness in the COVID-19 virus is important for early case finding and reporting. These are essential steps for prevention and control. This review defines and differentiates between types of cases and specifies the elements of each case definition in general with their application to COVID-19, where appropriate. These terms and their application are useful for the surveillance team, epidemiologists, clinicians, policy makers as well as the public in general.
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Accorsi TAD, Amicis KD, Brígido ARD, Belfort DDSP, Habrum FC, Scarpanti FG, Magalhães IR, Silva Filho JRDO, Sampaio LPC, Lira MTSDS, Morbeck RA, Pedrotti CHS, Cordioli E. Assessment of patients with acute respiratory symptoms during the COVID-19 pandemic by Telemedicine: clinical features and impact on referral. EINSTEIN-SAO PAULO 2020; 18:eAO6106. [PMID: 33295428 PMCID: PMC7690926 DOI: 10.31744/einstein_journal/2020ao6106] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 10/19/2020] [Indexed: 12/15/2022] Open
Abstract
Objective: To characterize variables associated with referral to the emergency department following Telemedicine consultation during the COVID-19 pandemic. Methods: Cross-sectional retrospective study conducted between March and May 2020, with a sample of 500 adult patients. The inclusion criterion was the manifestation of respiratory symptoms, regardless of type. Results: The mean age of patients was 34.7±10.5 years, and 59% were women. Most patients (62.6%) perceived their own health status as malaise and some (41.4%) self-diagnosed COVID-19. Cough (74.4%), rhinorrhea (65.6%), sore throat (38.6%) and sneezing (20.6%) were the most common infection-related symptoms. Overall, 29.4% and 16% of patients reported dyspnea and chest pain, respectively. The Roth score was calculated for a sizeable number of patients (67.6%) and was normal, moderately altered or severely altered in 83.5%, 10.7% and 5.6% of patients, respectively. The percentage of suspected COVID-19 cases was 67.6%. Of these, 75% were managed remotely and only one quarter referred for emergency assessment. Conclusion: Telemedicine assessment is associated with reclassification of patient's subjective impression, better inspection of coronavirus disease 2019 and identification of risk patients. Referral is therefore optimized to avoid inappropriate in-person assessment, and low-risk patients can be properly guided. Telemedicine should be implemented in the health care system as a cost-effective strategy for initial assessment of acute patients.
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Yamamoto-Moreno J, Pineda-Aguilar C, Ruiz-Pérez S, Gortarez-Quintana G, Ruiz-Dorado M. Effectiveness of COVID-19 case definition in identifying SARS-CoV-2 infection in northern Mexico. POPULATION MEDICINE 2020. [DOI: 10.18332/popmed/127470] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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H’ng MWC, Tan BP, Punamiya S. Setting Up an Interventional Radiology Suite in an Infectious Diseases Centre: Lessons from the Novel Coronavirus (COVID-19) Outbreak. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2020. [DOI: 10.47102/annals-acadmedsg.2020177] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Tiwari RV, Teo JSM, Sundaram P, Cheng CWS. Turning the Tide Against COVID-19: Adaptations of a Urology Department in a Public Hospital in Singapore. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2020. [DOI: 10.47102/annals-acadmedsg.2020143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Chew SY, Lee YS, Ghimiray D, Tan CK, Chua GSW. Characteristics and Outcomes of COVID-19 Patients with Respiratory Failure Admitted to a “Pandemic Ready” Intensive Care Unit – Lessons from Singapore. ANNALS ACADEMY OF MEDICINE SINGAPORE 2020. [DOI: 10.47102/annals-acadmedsg.2020161] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Introduction: Singapore was one of the first countries affected by the coronavirus disease 2019 (COVID-19) pandemic but has been able to prevent its healthcare system and intensive care units (ICU) from being overwhelmed. We describe the clinical features, management and outcomes of COVID-19 patients with respiratory failure admitted to our ICU. Materials and Methods: A case series of COVID-19 patients admitted to our ICU for respiratory failure from 7 February, with data censoring at 30 June 2020, was performed from a review of medical records. Results: Twenty-two COVID-19 patients were admitted to our ICU for respiratory failure. The median age was 54.5 years (IQR 30–45.5), 72.7% were male and had at least one comorbidity. The Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation (APACHE) II scores were 2.5 (IQR 1.25–7) and 10 (8.25–12) respectively. Thirteen patients required invasive mechanical ventilation (IMV) and had a median PaO2/FiO2 ratio of 194 mmHg (IQR 173–213) after intubation. The 28-day survival was 100%, with 2 patients demising subsequently. The overall ICU mortality rate was 9.1% at the time of data censoring. In IMV survivors, length of IMV and ICU stay were 11 days (IQR 9–17.75) and 16 days (IQR 12–32) respectively. Conclusion: Low COVID-19 ICU mortality was observed in our “pandemic-ready” ICU. This was achieved by having adequate surge capacity to facilitate early ICU admission and IMV, lung protective ventilation, and slow weaning. Being able to maintain clinical standards and evidence-based practices without having to resort to rationing contributed to better outcomes. Keywords: Acute respiratory distress syndrome, Coronavirus, Critical care, Pandemic, Pneumonia
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Sharma S, Keswani P, Bhargava A, Sharma R, Shekhawat A, Bhandari S. Overview of Early Cases of Coronavirus Disease 2019 (COVID-19) at a Tertiary Care Centre in North India. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2020. [DOI: 10.47102/annals-acadmedsg.2020135] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Introduction: As the coronavirus disease 2019 (COVID-19) pandemic continues to spread on an unprecedented scale from around the world, we described our experience in treating early COVID-19 cases in India. Materials and Methods: An observational study of COVID-19 patients admitted to a tertiary care centre in North India between 2 March–4 April 2020 was performed. The clinical, epidemiological, laboratory, treatment and outcome data of patients were evaluated. Results: A total of 75 patients were treated and 56 (74.66%) were men. The clinical spectrum of COVID-19 ranged from asymptomatic to acute respiratory distress syndrome (ARDS). Fever (85.36%) was the most common symptom followed by cough (56.09%) and dyspnoea (19.51%). Findings from hemogram analysis showed that 32%, 21.33% and 18.67% of patients had lymphopaenia, eosinopenia and thrombocytopaenia, respectively. Inflammatory markers such as C-reactive protein, D-dimer, ferritin, fibrin degradation product and interleukin-6 were significantly elevated (P <0.05) in patients who required oxygen therapy than those who did not require it, suggesting the potential role such markers could play in predicting prognosis in patients. Mean hospital stay was 9.2 days and 72 (96%) patients made a complete recovery, but 3 (4%) patients demised after progressing to ARDS. Conclusion: The clinical and epidemiological spectrum of COVID-19 has jeopardised the health system in India. Without a proven therapy to combat this pandemic and with no sight of vaccines in the near future, a preventive strategy should be adopted to contain the spread of this infectious disease. Key words: Acute respiratory distress syndrome, Cytokine release syndrome, Interleukin-6, Lopinavir-ritonavir, Lymphopaenia
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Zhou JC, Hui TCH, Tan CH, Hau Wei Khoo HW, Young BE, Lye DC, Lee YS, Kaw GJL. Chest Radiography in Coronavirus Disease 2019 (COVID-19): Correlation with Clinical Course. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2020. [DOI: 10.47102/annals-acadmedsg.2020106] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 and was declared a global pandemic by the World Health Organization on 11 March 2020. A definitive diagnosis of COVID-19 is made after a positive result is obtained on reverse transcription-polymerase chain reaction assay. In Singapore, rigorous contact tracing was practised to contain the spread of the virus. Nasal swabs and chest radiographs (CXR) were also taken from individuals who were suspected to be infected by COVID-19 upon their arrival at a centralised screening centre. From our experience, about 40% of patients who tested positive for COVID-19 had initial CXR that appeared “normal”. In this case series, we described the temporal evolution of COVID-19 in patients with an initial “normal” CXR. Since CXR has limited sensitivity and specificity in COVID-19, it is not suitable as a first-line diagnostic tool. However, when CXR changes become unequivocally abnormal, close monitoring is recommended to manage potentially severe COVID-19 pneumonia. Key words: Diagnostic Radiology, Infectious Diseases, Pulmonary
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Lim TK. The Facts, Fallacies and Uncertainties about Coronavirus Disease 2019 (COVID-19). ANNALS ACADEMY OF MEDICINE SINGAPORE 2020. [DOI: 10.47102/annals-acadmedsg.2020217] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- Tow Keang Lim
- Department of Medicine, National University Hospital, Singapore
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Bhandari S, Sharma S, Bhargava A, Keswani P, Sharma R, Shekhawat A. Inflammatory Markers in COVID-19. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2020. [DOI: 10.47102/annals-acadmedsg.2020110] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Valdivia AR, Chaudhuri A. A need for consensus on mortality reporting related to the coronavirus disease-2019 pandemic in ongoing and future vascular registries and trials. J Vasc Surg 2020; 72:1507. [PMID: 32592742 PMCID: PMC7314666 DOI: 10.1016/j.jvs.2020.06.013] [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: 05/10/2020] [Accepted: 06/17/2020] [Indexed: 11/01/2022]
Affiliation(s)
- Andrés Reyes Valdivia
- Department of Vascular and Endovascular Surgery, Ramón y Cajaĺs University Hospital, Madrid, Spain
| | - Arindam Chaudhuri
- Bedfordshire - Milton Keynes Vascular Centre, Bedford, United Kingdom
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