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Bibliography on: covid-19

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ESP: PubMed Auto Bibliography 17 Sep 2020 at 01:39 Created: 

covid-19

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS coronavirus 2, or SARS-CoV-2), a virus closely related to the SARS virus. The disease was discovered and named during the 2019-20 coronavirus outbreak. Those affected may develop a fever, dry cough, fatigue, and shortness of breath. A sore throat, runny nose or sneezing is less common. While the majority of cases result in mild symptoms, some can progress to pneumonia and multi-organ failure. The infection is spread from one person to others via respiratory droplets produced from the airways, often during coughing or sneezing. Time from exposure to onset of symptoms is generally between 2 and 14 days, with an average of 5 days. The standard method of diagnosis is by reverse transcription polymerase chain reaction (rRT-PCR) from a nasopharyngeal swab or sputum sample, with results within a few hours to 2 days. Antibody assays can also be used, using a blood serum sample, with results within a few days. The infection can also be diagnosed from a combination of symptoms, risk factors and a chest CT scan showing features of pneumonia. Correct handwashing technique, maintaining distance from people who are coughing and not touching one's face with unwashed hands are measures recommended to prevent the disease. It is also recommended to cover one's nose and mouth with a tissue or a bent elbow when coughing. Those who suspect they carry the virus are recommended to wear a surgical face mask and seek medical advice by calling a doctor rather than visiting a clinic in person. Masks are also recommended for those who are taking care of someone with a suspected infection but not for the general public. There is no vaccine or specific antiviral treatment, with management involving treatment of symptoms, supportive care and experimental measures. The case fatality rate is estimated at between 1% and 3%. The World Health Organization (WHO) has declared the 2019-20 coronavirus outbreak a Public Health Emergency of International Concern (PHEIC). As of 29 February 2020, China, Hong Kong, Iran, Italy, Japan, Singapore, South Korea and the United States are areas having evidence of community transmission of the disease.

NOTE: To obtain the entire bibliography (all 52832 citations) in bibtek format (a format that can be easily loaded into many different reference-manager software programs, click HERE.

Created with PubMed® Query: "SARS-CoV-2" OR "COVID-19" OR (wuhan AND "coronavirus") NOT pmcbook NOT ispreviousversion

Citations The Papers (from PubMed®)

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RevDate: 2020-09-16

Belančić A, Klobučar Majanović S, D Štimac (2020)

The escalating global burden of obesity following the COVID-19 times - Are we ready?.

RevDate: 2020-09-16

Guo JW, Radloff CL, Wawrzynski SE, et al (2020)

Mining twitter to explore the emergence of COVID-19 symptoms.

Public health nursing (Boston, Mass.) [Epub ahead of print].

BACKGROUND: The Centers for Disease Control and Prevention (CDC) in United States initially alerted the public to three COVID-19 signs and symptoms-fever, dry cough, and shortness of breath. Concurrent social media posts reflected a wider range of symptoms of COVID-19 besides these three symptoms. Because social media data have a potential application in the early identification novel virus symptoms, this study aimed to explore what symptoms mentioned in COVID-19-related social media posts during the early stages of the pandemic.

METHODS: We collected COVID-19-related Twitter tweets posted in English language between March 30, 2020 and April 19, 2020 using search terms of COVID-19 synonyms and three common COVID-19 symptoms suggested by the CDC in March. Only unique tweets were extracted for analysis of symptom terms.

RESULTS: A total of 36 symptoms were extracted from 30,732 unique tweets. All the symptoms suggested by the CDC for COVID-19 screening in March, April, and May were mentioned in tweets posted during the early stages of the pandemic.

DISCUSSION: The findings of this study revealed that many COVID-19-related symptoms mentioned in Twitter tweets earlier than the announcement by the CDC. Monitoring social media data is a promising approach to public health surveillance.

RevDate: 2020-09-16

Damm M, Garbe J, Eisenmann S, et al (2020)

[Challenges of the COVID-19 pandemic in gastrointestinal endoscopy: expectations and implementation of recommendations].

Zeitschrift fur Gastroenterologie [Epub ahead of print].

INTRODUCTION: The COVID-19 pandemic represents a major challenge for health care systems worldwide. Recent data suggests an increased risk for personnel of gastrointestinal (GI) endoscopy units for SARS-CoV-2 infections. Several societies have provided recommendations for the current situation, but their feasibility is unclear and real-world data on preparedness of endoscopy units are lacking.

AIMS & METHODS: A web-based survey among German GI-endoscopy heads was conducted from April 1 to April 7, 2020. It comprised 33 questions based on the ESGE (European Society of Gastrointestinal Endoscopy) recommendations and was distributed electronically by the German Society of Gastroenterology, Digestive and Metabolic Diseases (DGVS).

RESULTS: Of 551 completed surveys, 202 (37 %) endoscopy units cancelled less than 40 % of their procedures. Small-volume units (< 4000 procedures/year) cancelled significantly less procedures than high-volume units (> 4000). Complete spatial separation of high-risk patients was possible in only 17 %. Most units systematically identified patients at risk (91 %) and used risk adapted personal protective equipment (PPE, 85 %). For the future, shortages in PPE (83 %), staff (69 %) and relevant financial losses (80 %) were expected.

CONCLUSIONS: Recommendations on structural measures were only partially fulfilled and cancellations of procedures were heterogeneous. Clear definitions of indications to perform endoscopies during such a pandemic are needed. Further, structural recommendations should be adapted and strategies to compensate financial losses need to be developed.

RevDate: 2020-09-16

Saki M, H Zarif Najafi (2020)

The COVID-19 pandemic suggests opportunities for researchers to investigate pertinent topics in orthodontics.

The Angle orthodontist, 90(5):742-744.

RevDate: 2020-09-16

Chin KE, Kwon D, Gan Q, et al (2020)

Transition from a Standard to a Hybrid On-Site and Remote Anatomic Pathology Training Model During the COVID-19 Pandemic.

Archives of pathology & laboratory medicine pii:444040 [Epub ahead of print].

CONTEXT: As teaching hospitals institute social distancing and defer non-emergent procedures to cope with the coronavirus disease 2019 (COVID-19) pandemic, the need for daily onsite presence, unless necessary has been reduced for all medical staff including trainees. Pathology training programs must adapt to these changes to ensure overall safety without significantly compromising training and educational mission of the institution.

OBJECTIVE: To describe the hybrid on-site and remote anatomic pathology training model in response to the COVID-19 pandemic, which was implemented in our pathology department and report the clinical fellows' responses to the survey about their experiences.

DESIGN: The hybrid model was implemented March 25, 2020. Fellows alternate weekly between working on-site and working remotely. On-site, fellows wear personal protective equipment and maintain social distancing. Remotely, fellows use digital pathology to review cases and supplement with online educational activities. Virtual "coffee breaks," meditation, and exercise are part of the curriculum. Online platforms, including WebEx, Google Classroom, and Canvas, are used to continue educational activities. The survey was open May 19 through June 8.

RESULTS: Twenty-eight of the 29 clinical fellows (96%) responded. Many of the respondents indicated substantial increase in their skill with using digital pathology and online platforms during the pandemic. The top most helpful resources were the United States and Canadian Academy of Pathology Interactive Microscopy courses (22/23=91% of clinical fellows found very or somewhat helpful), ExpertPath (19/23=82%), the College of American Pathologists virtual learning series (18/23=78%), the World Health Organization Blue Books (16/23=70%), the American Society of Cytopathology webinars (14/23=61%), and our institutional digital slide collection (12/23=52%).

CONCLUSIONS: Hybrid on-site and remote training can maximize anatomic pathology learning opportunities while maintaining the safety of trainees, hospital personnel, and the community.

RevDate: 2020-09-16

Schub D, Klemis V, Schneitler S, et al (2020)

High levels of SARS-CoV-2 specific T-cells with restricted functionality in severe course of COVID-19.

JCI insight pii:142167 [Epub ahead of print].

BACKGROUND: Patients infected with SARS-CoV-2 differ in the severity of disease. We hypothesized that characteristics of SARS-CoV-2 specific immunity correlate with disease severity.

METHODS: In this study, SARS-CoV-2 specific T-cells and antibodies were characterized in uninfected controls and patients with different COVID-19 related disease severity. SARS-CoV-2 specific T-cells were flow-cytometrically quantified after stimulation with SARS-CoV-2 peptide pools and analyzed for expression of cytokines (IFNγ, IL-2 and TNFα) and markers for activation, proliferation and functional anergy. SARS-CoV-2 specific IgG and IgA antibodies were quantified using ELISA. Moreover, global characteristics of lymphocyte subpopulations were compared between patient groups and uninfected controlsResults: Despite severe lymphopenia affecting all major lymphocyte subpopulations, patients with severe disease mounted significantly higher levels of SARS-CoV-2 specific T-cells as compared to convalescent individuals. SARS-CoV-2 specific CD4 T-cells dominated over CD8 T-cells and closely correlated with the number of plasmablasts and SARS-CoV-2 specific IgA- and IgG-levels. Unlike in convalescents, SARS-CoV-2 specific T-cells in patients with severe disease showed marked alterations in phenotypical and functional properties, which also extended to CD4 and CD8 T-cells in general.

CONCLUSION: Given the strong induction of specific immunity to control viral replication in patients with severe disease, the functionally altered characteristics may result from the need for contraction of specific and general immunity to counteract excessive immunopathology in the lung.

TRIAL REGISTRATION: n.a.

FUNDING: The study was supported by institutional funds by M.S., and in part by grants of Saarland University (to M.S. and. R.B), the State of Saarland, and the Dr. Rolf M. Schwiete Stiftung to R.B.

RevDate: 2020-09-16

Brann DH, Tsukahara T, Weinreb C, et al (2020)

Non-neuronal expression of SARS-CoV-2 entry genes in the olfactory system suggests mechanisms underlying COVID-19-associated anosmia.

Science advances, 6(31):.

Altered olfactory function is a common symptom of COVID-19, but its etiology is unknown. A key question is whether SARS-CoV-2 (CoV-2) - the causal agent in COVID-19 - affects olfaction directly, by infecting olfactory sensory neurons or their targets in the olfactory bulb, or indirectly, through perturbation of supporting cells. Here we identify cell types in the olfactory epithelium and olfactory bulb that express SARS-CoV-2 cell entry molecules. Bulk sequencing demonstrated that mouse, non-human primate and human olfactory mucosa expresses two key genes involved in CoV-2 entry, ACE2 and TMPRSS2. However, single cell sequencing revealed that ACE2 is expressed in support cells, stem cells, and perivascular cells, rather than in neurons. Immunostaining confirmed these results and revealed pervasive expression of ACE2 protein in dorsally-located olfactory epithelial sustentacular cells and olfactory bulb pericytes in the mouse. These findings suggest that CoV-2 infection of non-neuronal cell types leads to anosmia and related disturbances in odor perception in COVID-19 patients.

RevDate: 2020-09-16

Park HH, Kim HN, Kim H, et al (2020)

Acetylated K676 TGFBIp as a severity diagnostic blood biomarker for SARS-CoV-2 pneumonia.

Science advances, 6(31): pii:sciadv.abc1564.

The outbreak of the highly contagious and deadly severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as coronavirus disease 2019 (COVID-19), has posed a serious threat to public health across the globe, calling for the development of effective diagnostic markers and therapeutics. Here, we report a highly reliable severity diagnostic biomarker, acetylated 676th lysine transforming growth factor-beta-induced protein (TGFBIp K676Ac). TGFBIp K676Ac was consistently elevated in the blood of patients with SARS-CoV-2 pneumonia (n = 113), especially in patients in the intensive care unit (ICU) compared to non-ICU patients. Patients' blood samples showed increased cytokines and lymphopenia, which are exemplary indicators of SARS-CoV-2 pneumonia. Treatment with TGFBIp neutralizing antibodies suppressed the cytokine storm. The increased level of TGFBIp K676Ac in ICU patients suggests the promise of this protein as a reliable severity diagnostic biomarker for severe SARS-CoV-2 disease.

RevDate: 2020-09-16

Singer BD (2020)

COVID-19 and the next influenza season.

Science advances, 6(31): pii:sciadv.abd0086.

RevDate: 2020-09-16

Wayne DB, Green M, EG Neilson (2020)

Medical education in the time of COVID-19.

Science advances, 6(31): pii:sciadv.abc7110.

RevDate: 2020-09-16

Liu F, Page A, Strode SA, et al (2020)

Abrupt decline in tropospheric nitrogen dioxide over China after the outbreak of COVID-19.

Science advances, 6(28): pii:sciadv.abc2992.

China's policy interventions to reduce the spread of the coronavirus disease 2019 have environmental and economic impacts. Tropospheric nitrogen dioxide indicates economic activities, as nitrogen dioxide is primarily emitted from fossil fuel consumption. Satellite measurements show a 48% drop in tropospheric nitrogen dioxide vertical column densities from the 20 days averaged before the 2020 Lunar New Year to the 20 days averaged after. This decline is 21 ± 5% larger than that from 2015 to 2019. We relate this reduction to two of the government's actions: the announcement of the first report in each province and the date of a province's lockdown. Both actions are associated with nearly the same magnitude of reductions. Our analysis offers insights into the unintended environmental and economic consequences through reduced economic activities.

RevDate: 2020-09-16

Green J, Edgerton J, Naftel D, et al (2020)

Elusive consensus: Polarization in elite communication on the COVID-19 pandemic.

Science advances, 6(28): pii:sciadv.abc2717.

Cues sent by political elites are known to influence public attitudes and behavior. Polarization in elite rhetoric may hinder effective responses to public health crises, when accurate information and rapid behavioral change can save lives. We examine polarization in cues sent to the public by current members of the U.S. House and Senate during the onset of the COVID-19 pandemic, measuring polarization as the ability to correctly classify the partisanship of tweets' authors based solely on the text and the dates they were sent. We find that Democrats discussed the crisis more frequently-emphasizing threats to public health and American workers-while Republicans placed greater emphasis on China and businesses. Polarization in elite discussion of the COVID-19 pandemic peaked in mid-February-weeks after the first confirmed case in the United States-and continued into March. These divergent cues correspond with a partisan divide in the public's early reaction to the crisis.

RevDate: 2020-09-16

Panda PK, Arul MN, Patel P, et al (2020)

Structure-based drug designing and immunoinformatics approach for SARS-CoV-2.

Science advances, 6(28): pii:sciadv.abb8097.

The prevalence of respiratory illness caused by the novel SARS-CoV-2 virus associated with multiple organ failures is spreading rapidly because of its contagious human-to-human transmission and inadequate globalhealth care systems. Pharmaceutical repurposing, an effective drug development technique using existing drugs, could shorten development time and reduce costs compared to those of de novo drug discovery. We carried out virtual screening of antiviral compounds targeting the spike glycoprotein (S), main protease (Mpro), and the SARS-CoV-2 receptor binding domain (RBD)-angiotensin-converting enzyme 2 (ACE2) complex of SARS-CoV-2. PC786, an antiviral polymerase inhibitor, showed enhanced binding affinity to all the targets. Furthermore, the postfusion conformation of the trimeric S protein RBD with ACE2 revealed conformational changes associated with PC786 drug binding. Exploiting immunoinformatics to identify T cell and B cell epitopes could guide future experimental studies with a higher probability of discovering appropriate vaccine candidates with fewer experiments and higher reliability.

RevDate: 2020-09-16

Di Giorgio S, Martignano F, Torcia MG, et al (2020)

Evidence for host-dependent RNA editing in the transcriptome of SARS-CoV-2.

Science advances, 6(25): pii:sciadv.abb5813.

The COVID-19 outbreak has become a global health risk, and understanding the response of the host to the SARS-CoV-2 virus will help to combat the disease. RNA editing by host deaminases is an innate restriction process to counter virus infection, but it is not yet known whether this process operates against coronaviruses. Here, we analyze RNA sequences from bronchoalveolar lavage fluids obtained from coronavirus-infected patients. We identify nucleotide changes that may be signatures of RNA editing: adenosine-to-inosine changes from ADAR deaminases and cytosine-to-uracil changes from APOBEC deaminases. Mutational analysis of genomes from different strains of Coronaviridae from human hosts reveals mutational patterns consistent with those observed in the transcriptomic data. However, the reduced ADAR signature in these data raises the possibility that ADARs might be more effective than APOBECs in restricting viral propagation. Our results thus suggest that both APOBECs and ADARs are involved in coronavirus genome editing, a process that may shape the fate of both virus and patient.

RevDate: 2020-09-16

Shilatifard A (2020)

COVID-19: Rescue by transcriptional inhibition.

Science advances, 6(27): pii:sciadv.abc6891.

RevDate: 2020-09-16

Li X, Giorgi EE, Marichannegowda MH, et al (2020)

Emergence of SARS-CoV-2 through recombination and strong purifying selection.

Science advances, 6(27): pii:sciadv.abb9153.

COVID-19 has become a global pandemic caused by the novel coronavirus SARS-CoV-2. Understanding the origins of SARS-CoV-2 is critical for deterring future zoonosis, discovering new drugs, and developing a vaccine. We show evidence of strong purifying selection around the receptor binding motif (RBM) in the spike and other genes among bat, pangolin, and human coronaviruses, suggesting similar evolutionary constraints in different host species. We also demonstrate that SARS-CoV-2's entire RBM was introduced through recombination with coronaviruses from pangolins, possibly a critical step in the evolution of SARS-CoV-2's ability to infect humans. Similar purifying selection in different host species, together with frequent recombination among coronaviruses, suggests a common evolutionary mechanism that could lead to new emerging human coronaviruses.

RevDate: 2020-09-16

Zhang S, Xu Y, Li J, et al (2020)

Symptomless multi-variable apnea prediction index assesses adverse outcomes in patients with Corona Virus Disease 2019.

Sleep medicine, 75:294-300 pii:S1389-9457(20)30397-X [Epub ahead of print].

PURPOSE: To explore the relationship between symptomless multi-Variable apnea prediction (sMVAP) index and adverse outcomes of patients with Corona Virus Disease 2019 (COVID-19).

METHODS: According to the sMVAP quartiles, we divided all patients into four groups. The clinical electronic medical records, nursing records, laboratory findings, and radiological examinations for all patients with laboratory confirmed Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection were reviewed. Cox proportional hazard ratio (HR) models were used to determine the risk factors associated with in hospital death.

RESULTS: A total of 97 patients were included in this study. The "Quartile 4" group 's ICU transfer rate was significantly higher than the "Quartile 1" group. Coronary heart disease, high d-dimer and sMVAP at admission were associated with increased odds of death.

CONCLUSIONS: Using the sMVAP index for obstructive sleep apnea hypopnea syndrome (OSAHS) risk assessment, and then predicting the adverse outcomes of COVID-19 patients, is an effective method. Therefore, the use of sMVAP index for OSAHS screening for inpatients with COVID-19 should be vigorously promoted, and high-risk patients should be effectively managed.

RevDate: 2020-09-16

Caruso R, Belloni S, Albanesi B, et al (2020)

Comment on "pathways to psychological wellbeing for patients with bladder cancer and their partners-in-care" and contextualization in the COVID-19 pandemic.

RevDate: 2020-09-16

Boyraz G, Legros DN, A Tigershtrom (2020)

COVID-19 and traumatic stress: The role of perceived vulnerability, COVID-19-related worries, and social isolation.

Journal of anxiety disorders, 76:102307 pii:S0887-6185(20)30121-3 [Epub ahead of print].

The purpose of the present study was to propose and test two models to understand the relationship between perceived vulnerability to COVID-19 (PVC) and COVID-19-related traumatic stress (TS), as well as the variables that may mediate and moderate this relationship among individuals who have not yet been infected with COVID-19. Using an online survey, data were collected between late March and early April 2020. Participants were recruited through Amazon Mechanical Turk and included 747 adults living in the United States. Supporting our hypotheses, results indicated that both COVID-19-related worries and social isolation were significant mediators of the relationship between PVC and TS (Model 1). In addition, the results of a moderated mediation analysis indicated that the indirect effect of PVC on TS through COVID-19-related worries was stronger for participants who reported greater social isolation (Model 2). Although future research is needed, these findings suggest that both social isolation and disease-related worries may be important variables that can be targeted in interventions to reduce pandemic-related TS.

RevDate: 2020-09-16

Kumar N, Gupta R, Kumar H, et al (2020)

Impact of home confinement during COVID-19 pandemic on Parkinson's disease.

RevDate: 2020-09-16

Valenzuela-Rodriguez G, Zambrano LI, Muñoz-Lara F, et al (2020)

Intranational differences in the case fatality rates for COVID-19 among Peruvian physicians.

RevDate: 2020-09-16

Ghorbani A, Samarfard S, Ramezani A, et al (2020)

Quasi-species nature and differential gene expression of severe acute respiratory syndrome coronavirus 2 and phylogenetic analysis of a novel Iranian strain.

Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases pii:S1567-1348(20)30387-7 [Epub ahead of print].

A novel coronavirus related to severe acute respiratory syndrome virus, (SARS-CoV-2) is the causal agent of the COVID-19 pandemic. Despite the genetic mutations across the SARS-CoV-2 genome being recently investigated, its transcriptomic genetic polymorphisms at inter-host level and the viral gene expression level based on each Open Reading Frame (ORF) remains unclear. Using available High Throughput Sequencing (HTS) data and based on SARS-CoV-2 infected human transcriptomic data, this study presents a high-resolution map of SARS-CoV-2 single nucleotide polymorphism (SNP) hotspots in a viral population at inter-host level. Four throat swab samples from COVID-19 infected patients were pooled, with RNA-Seq read retrieved from SRA NCBI to detect 21 SNPs and a replacement across the SARS-CoV-2 genomic population. Twenty-two RNA modification sites on viral transcripts were identified that may cause inter-host genetic diversity of this virus. In addition, the canonical genomic RNAs of N ORF showed higher expression in transcriptomic data and RT-qPCR compared to other SARS-CoV-2 ORFs, indicating the importance of this ORF in virus replication or other major functions in virus cycle. Phylogenetic and ancestral sequence analyses based on the entire genome revealed that an Iranian strain and a Turkish isolate of SARS-COV-2 are closely related to each other and confirming that SARS-CoV-2 is possibly derived from a recombination event between SARS-CoV and Bat SARS-like CoV. Ancestor analysis of the isolates from different locations including Iran suggest shared Chinese ancestry. These results propose the importance of potential inter-host level genetic variations to the evolution of SARS-COV-2, and the formation of viral quasi-species. The RNA modifications discovered in this study may cause amino acid sequence changes in polyprotein, spike protein, product of ORF8 and nucleocapsid (N) protein, suggesting further insights to understanding the functional impacts of mutations in the life cycle and pathogenicity of SARS-CoV-2.

RevDate: 2020-09-16

Evans ML, Lindauer M, ME Farrell (2020)

A Pandemic within a Pandemic - Intimate Partner Violence during Covid-19.

The New England journal of medicine [Epub ahead of print].

RevDate: 2020-09-16

Joung J, Ladha A, Saito M, et al (2020)

Detection of SARS-CoV-2 with SHERLOCK One-Pot Testing.

RevDate: 2020-09-16

Rubin EJ, Baden LR, S Morrissey (2020)

Audio Interview: Operation Warp Speed and Covid-19 Therapeutics.

The New England journal of medicine, 383(12):e92.

RevDate: 2020-09-16

Cohen JB, Hanff TC, Corrales-Medina V, et al (2020)

Randomized elimination and prolongation of ACE inhibitors and ARBs in coronavirus 2019 (REPLACE COVID) Trial Protocol.

Journal of clinical hypertension (Greenwich, Conn.) [Epub ahead of print].

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for coronavirus disease 2019 (COVID-19), is associated with high incidence of multiorgan dysfunction and death. Angiotensin-converting enzyme 2 (ACE2), which facilitates SARS-CoV-2 host cell entry, may be impacted by angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), two commonly used antihypertensive classes. In a multicenter, international randomized controlled trial that began enrollment on March 31, 2020, participants are randomized to continuation vs withdrawal of their long-term outpatient ACEI or ARB upon hospitalization with COVID-19. The primary outcome is a hierarchical global rank score incorporating time to death, duration of mechanical ventilation, duration of renal replacement or vasopressor therapy, and multiorgan dysfunction severity. Approval for the study has been obtained from the Institutional Review Board of each participating institution, and all participants will provide informed consent. A data safety monitoring board has been assembled to provide independent oversight of the project.

RevDate: 2020-09-16

Mun DH, Pradere B, Shariat SF, et al (2020)

Intraoperative aerosol viral transmission in minimally invasive surgery: A scoping review and impact on clinical guidelines and practice during the onset of the COVID-19 pandemic.

BJU international [Epub ahead of print].

OBJECTIVE: To identify the available evidence on aerosol viral transmission risk during minimally invasive surgery (MIS) and evaluate its impact on guidelines development and clinical activity worldwide during the COVID-19 pandemic.

MATERIALS AND METHODS: We performed a scoping review on PubMed, Cochrane, Embase, clinical trial register, and grey literature repository databases to identify reports on viral transmission via surgical smoke or aerosolization. A systematic review of all available national and international guidelines was also performed to report their recommendations. Additionally, a worldwide transdisciplinary survey was performed to capture the actual compliance to dedicated guidelines and their impact on minimally invasive surgical activity.

RESULTS: Based on a selection of 17 studies, there is no evidence to support the concerns of an intraoperative viral transmission via pneumoperitoneum aerosolization. Most national surgical and urologic societies either did address this topic or referred to international guidelines. The guidelines of the American College of Surgery, the Royal College of Surgeons and the European Association of Urology Robotic Urology Section recommended an avoidance of MIS due to an increased risk of intraoperative aerosol-enhanced transmission. The results of the survey completed by 334 respondents, from different surgical abdominal specialties, suggested a lack of compliance with the guidelines.

CONCLUSION: There seems to be a dissonance between contemporary guidelines and ongoing surgical activity, possibly due to the perceived lack of evidence. Recommendations regarding changes in clinical practice should be based on the best available research evidence and experience. A scoping review of the evidence and an assessment of the benefits and harms together with a survey showed that laparoscopic procedures do not seem to increase the risk of viral transmission. Nevertheless, the low number of publications and low quality of existing evidence limits the validity of the review.

RevDate: 2020-09-16

Mangioni D, Dondossola D, Antonelli B, et al (2020)

Coronavirus disease 2019 and transplantation: tackling the challenges of SARS-CoV-2 infection in waiting list candidates.

We have read with great interest the article by Polak et al. on the behalf of the European Liver and Intestine Transplant Association (ELITA) and the European Liver Transplant Registry (ELTR) recently published in your Journal [1]. The authors provided valuable information on incidence and mortality of coronavirus disease 2019 (COVID-19) among liver transplant (LT) candidates and recipients in Europe. They also gave a clear picture on current practices of donor and recipient management among several European LT Centers.

RevDate: 2020-09-16

Brose A, Blanke ES, Schmiedek F, et al (2020)

Change in Mental Health Symptoms During the COVID-19 Pandemic: The Role of Appraisals and Daily Life Experiences.

Journal of personality [Epub ahead of print].

Intro When confronted with major threats, people often experience decline in well-being. The central purpose of this study was to identify mechanisms underlying change of well-being in times of threat, using the example of the COVID-19 pandemic, with a focus on appraisals of the pandemic and affective states, stress, as well as mindfulness in daily life. METHODS: We conducted a study across 3.5 weeks, including pretest, posttest, and a diary phase in-between. We worked with a sample of 460 adults, pre- and post-test information, as well as 7189 observations from the diary phase. RESULTS: Results showed that deterioration in mental health symptoms across the duration of the study was associated with (a) change towards less fortunate appraisals of the pandemic and (b), more negative affect and less mindfulness in daily life. Furthermore, appraisals of the pandemic at pretest predicted experiences in daily life, with more negative appraisals of the pandemic predicting more negative affect and stressor occurrence as well as less mindfulness. Discussion These findings speak to the dynamic nature of well-being and appraisals in times of threat, and highlight the role of experiences in daily life in changes in well-being.

RevDate: 2020-09-16

Burton MJ, Clarkson JE, Goulao B, et al (2020)

Use of antimicrobial mouthwashes (gargling) and nasal sprays by healthcare workers to protect them when treating patients with suspected or confirmed COVID-19 infection.

The Cochrane database of systematic reviews, 9:CD013626.

BACKGROUND: COVID-19 infection poses a serious risk to patients and - due to its contagious nature - to those healthcare workers (HCWs) treating them. If the mouth and nose of HCWs are irrigated with antimicrobial solutions, this may help reduce the risk of active infection being passed from infected patients to HCWs through droplet transmission or direct contact. However, the use of such antimicrobial solutions may be associated with harms related to the toxicity of the solutions themselves, or alterations in the natural microbial flora of the mouth or nose. Understanding these possible side effects is particularly important when the HCWs are otherwise fit and well.

OBJECTIVES: To assess the benefits and harms of antimicrobial mouthwashes and nasal sprays used by healthcare workers (HCWs) to protect themselves when treating patients with suspected or confirmed COVID-19 infection.

SEARCH METHODS: Information Specialists from Cochrane ENT and Cochrane Oral Health searched the Central Register of Controlled Trials (CENTRAL 2020, Issue 6); Ovid MEDLINE; Ovid Embase and additional sources for published and unpublished trials. The date of the search was 1 June 2020. SELECTION CRITERIA: This is a question that urgently requires evidence, however at the present time we did not anticipate finding many completed randomised controlled trials (RCTs). We therefore planned to include the following types of studies: RCTs; quasi-RCTs; non-randomised controlled trials; prospective cohort studies; retrospective cohort studies; cross-sectional studies; controlled before-and-after studies. We set no minimum duration for the studies. We sought studies comparing any antimicrobial mouthwash and/or nasal spray (alone or in combination) at any concentration, delivered to HCWs, with or without the same intervention being given to the patients with COVID-19.

DATA COLLECTION AND ANALYSIS: We used standard Cochrane methodological procedures. Our primary outcomes were: 1) incidence of symptomatic or test-positive COVID-19 infection in HCWs; 2) significant adverse event: anosmia (or disturbance in sense of smell). Our secondary outcomes were: 3) viral content of aerosol, when present (if intervention administered to patients); 4) other adverse events: changes in microbiome in oral cavity, nasal cavity, oro- or nasopharynx; 5) other adverse events: allergy, irritation/burning of nasal, oral or oropharyngeal mucosa (e.g. erosions, ulcers, bleeding), long-term staining of mucous membranes or teeth, accidental ingestion. We planned to use GRADE to assess the certainty of the evidence for each outcome.

MAIN RESULTS: We found no completed studies to include in this review. We identified three ongoing studies (including two RCTs), which aim to enrol nearly 700 participants. The interventions included in these trials are povidone iodine, nitric oxide and GLS-1200 oral spray (the constituent of this spray is unclear and may not be antimicrobial in nature). AUTHORS' CONCLUSIONS: We identified no studies for inclusion in this review. This is not surprising given the relatively recent emergence of COVID-19 infection. It is promising that the question posed in this review is being addressed by two RCTs and a non-randomised study. We are concerned that only one of the ongoing studies specifically states that it will evaluate adverse events and it is not clear if this will include changes in the sense of smell or to the oral and nasal microbiota, and any consequences thereof. Very few interventions have large and dramatic effect sizes. If a positive treatment effect is demonstrated when studies are available for inclusion in this review, it may not be large. In these circumstances in particular, where those receiving the intervention are otherwise fit and well, it may be a challenge to weigh up the benefits against the harms if the latter are of uncertain frequency and severity.

RevDate: 2020-09-16

Burton MJ, Clarkson JE, Goulao B, et al (2020)

Antimicrobial mouthwashes (gargling) and nasal sprays administered to patients with suspected or confirmed COVID-19 infection to improve patient outcomes and to protect healthcare workers treating them.

The Cochrane database of systematic reviews, 9:CD013627.

BACKGROUND: COVID-19 infection poses a serious risk to patients and - due to its contagious nature - to those healthcare workers (HCWs) treating them. If the mouth and nose of patients with infection are irrigated with antimicrobial solutions, this may help the patients by killing any coronavirus present at those sites. It may also reduce the risk of the active infection being passed to HCWs through droplet transmission or direct contact. However, the use of such antimicrobial solutions may be associated with harms related to the toxicity of the solutions themselves or alterations in the natural microbial flora of the mouth or nose.

OBJECTIVES: To assess the benefits and harms of antimicrobial mouthwashes and nasal sprays administered to patients with suspected or confirmed COVID-19 infection to both the patients and the HCWs caring for them.

SEARCH METHODS: Information Specialists from Cochrane ENT and Cochrane Oral Health searched the Central Register of Controlled Trials (CENTRAL 2020, Issue 6); Ovid MEDLINE; Ovid Embase and additional sources for published and unpublished trials. The date of the search was 1 June 2020. SELECTION CRITERIA: This is a question that urgently requires evidence, however at the present time we did not anticipate finding many completed RCTs. We therefore planned to include the following types of studies: randomised controlled trials (RCTs); quasi-RCTs; non-randomised controlled trials; prospective cohort studies; retrospective cohort studies; cross-sectional studies; controlled before-and-after studies. We set no minimum duration for the studies. We sought studies comparing antimicrobial mouthwash and/or nasal spray (alone or in combination) at any concentration, delivered with any frequency or dosage to suspected/confirmed COVID-19 patients.

DATA COLLECTION AND ANALYSIS: We used standard Cochrane methodological procedures. Our primary outcomes were: 1) RECOVERY* (www.recoverytrial.net) outcomes in patients (mortality; hospitalisation status; use of ventilation; use of renal dialysis or haemofiltration); 2) incidence of symptomatic or test-positive COVID-19 infection in HCWs; 3) significant adverse event: anosmia (or disturbance in sense of smell). Our secondary outcomes were: 4) change in COVID-19 viral load in patients; 5) COVID-19 viral content of aerosol (when present); 6) other adverse events: changes in microbiome in oral cavity, nasal cavity, oro- or nasopharynx; 7) other adverse events: allergy, irritation/burning of nasal, oral or oropharyngeal mucosa (e.g. erosions, ulcers, bleeding), long-term staining of mucous membranes or teeth, accidental ingestion. We planned to use GRADE to assess the certainty of the evidence for each outcome.

MAIN RESULTS: We found no completed studies to include in this review. We identified 16 ongoing studies (including 14 RCTs), which aim to enrol nearly 1250 participants. The interventions included in these trials are ArtemiC (artemisinin, curcumin, frankincense and vitamin C), Citrox (a bioflavonoid), cetylpyridinium chloride, chlorhexidine, chlorine dioxide, essential oils, hydrogen peroxide, hypertonic saline, Kerecis spray (omega 3 viruxide - containing neem oil and St John's wort), neem extract, nitric oxide releasing solution, povidone iodine and saline with baby shampoo. AUTHORS' CONCLUSIONS: We identified no studies for inclusion in this review. This is not surprising given the relatively recent emergence of COVID-19 infection. It is promising that the question posed in this review is being addressed by a number of RCTs and other studies. We are concerned that few of the ongoing studies specifically state that they will evaluate adverse events such as changes in the sense of smell or to the oral and nasal microbiota, and any consequences thereof. Very few interventions have large and dramatic effect sizes. If a positive treatment effect is demonstrated when studies are available for inclusion in this review, it may not be large. In these circumstances in particular it may be a challenge to weigh up the benefits against the harms if the latter are of uncertain frequency and severity.

RevDate: 2020-09-16

Burton MJ, Clarkson JE, Goulao B, et al (2020)

Antimicrobial mouthwashes (gargling) and nasal sprays to protect healthcare workers when undertaking aerosol-generating procedures (AGPs) on patients without suspected or confirmed COVID-19 infection.

The Cochrane database of systematic reviews, 9:CD013628.

BACKGROUND: COVID-19 infection poses a serious risk to patients and - due to its contagious nature - to those healthcare workers (HCWs) treating them. The risks of transmission of infection are greater when a patient is undergoing an aerosol-generating procedure (AGP). Not all those with COVID-19 infection are symptomatic, or suspected of harbouring the infection. If a patient who is not known to have or suspected of having COVID-19 infection is to undergo an AGP, it would nonetheless be sensible to minimise the risk to those HCWs treating them. If the mouth and nose of an individual undergoing an AGP are irrigated with antimicrobial solutions, this may be a simple and safe method of reducing the risk of any covert infection being passed to HCWs through droplet transmission or direct contact. Alternatively, the use of antimicrobial solutions by the HCW may decrease the chance of them acquiring COVID-19 infection. However, the use of such antimicrobial solutions may be associated with harms related to the toxicity of the solutions themselves or alterations in the natural microbial flora of the mouth or nose.

OBJECTIVES: To assess the benefits and harms of antimicrobial mouthwashes and nasal sprays administered to HCWs and/or patients when undertaking AGPs on patients without suspected or confirmed COVID-19 infection.

SEARCH METHODS: Information Specialists from Cochrane ENT and Cochrane Oral Health searched the Central Register of Controlled Trials (CENTRAL 2020, Issue 6); Ovid MEDLINE; Ovid Embase and additional sources for published and unpublished trials. The date of the search was 1 June 2020. SELECTION CRITERIA: This is a question that urgently requires evidence, however at the present time we did not anticipate finding many completed RCTs. We therefore planned to include the following types of studies: randomised controlled trials (RCTs); quasi-RCTs; non-randomised controlled trials; prospective cohort studies; retrospective cohort studies; cross-sectional studies; controlled before-and-after studies. We set no minimum duration for the studies. We sought studies comparing any antimicrobial mouthwash and/or nasal spray (alone or in combination) at any concentration, delivered to the patient or HCW before and/or after an AGP.

DATA COLLECTION AND ANALYSIS: We used standard Cochrane methodological procedures. Our primary outcomes were: 1) incidence of symptomatic or test-positive COVID-19 infection in HCWs or patients; 2) significant adverse event: anosmia (or disturbance in sense of smell). Our secondary outcomes were: 3) COVID-19 viral content of aerosol (when present); 4) change in COVID-19 viral load at site(s) of irrigation; 5) other adverse events: changes in microbiome in oral cavity, nasal cavity, oro- or nasopharynx; 6) other adverse events: allergy, irritation/burning of nasal, oral or oropharyngeal mucosa (e.g. erosions, ulcers, bleeding), long-term staining of mucous membranes or teeth, accidental ingestion. We planned to use GRADE to assess the certainty of the evidence for each outcome.

MAIN RESULTS: We found no completed studies to include in this review. AUTHORS' CONCLUSIONS: We identified no studies for inclusion in this review, nor any ongoing studies. The absence of completed studies is not surprising given the relatively recent emergence of COVID-19 infection. However, we are disappointed that this important clinical question is not being addressed by ongoing studies.

RevDate: 2020-09-16

Beynon C, Perkins R, L Edelman (2020)

Breaking Down Stigma: Honoring Nursing Home Staff During COVID-19.

Journal of gerontological nursing, 46(8):5.

RevDate: 2020-09-16

Chaney S, Basirat A, McDermott R, et al (2020)

COVID-19 & Hydroxychloroquine side-effects: Glucose 6-phosphate dehydrogenase deficiency (G6PD) and acute haemolytic anaemia.

QJM : monthly journal of the Association of Physicians pii:5906530 [Epub ahead of print].

RevDate: 2020-09-16

Collins GS, Riley RD, M van Smeden (2020)

Flaws in the development and validation of a covid-19 prediction model.

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America pii:5906588 [Epub ahead of print].

RevDate: 2020-09-16

Malik MI, Fox N, Chopra A, et al (2020)

Positive Pleural Fluid RT-PCR for Virus Detection in SARS-CoV-2 Pneumonia.

QJM : monthly journal of the Association of Physicians pii:5906531 [Epub ahead of print].

RevDate: 2020-09-16

Tyler CV (2020)

We are all in this together: Lessons learned on a COVID-19 unit.

The Journal of family practice, 69(7):325-326.

RevDate: 2020-09-16

Srivastava A, Pandey RK, Singh PP, et al (2020)

Most frequent South Asian haplotypes of ACE2 share identity by descent with East Eurasian populations.

PloS one, 15(9):e0238255 pii:PONE-D-20-12219.

It was shown that the human Angiotensin-converting enzyme 2 (ACE2) is the receptor of recent coronavirus SARS-CoV-2, and variation in this gene may affect the susceptibility of a population. Therefore, we have analysed the sequence data of ACE2 among 393 samples worldwide, focusing on South Asia. Genetically, South Asians are more related to West Eurasian populations rather than to East Eurasians. In the present analyses of ACE2, we observed that the majority of South Asian haplotypes are closer to East Eurasians rather than to West Eurasians. The phylogenetic analysis suggested that the South Asian haplotypes shared with East Eurasians involved two unique event polymorphisms (rs4646120 and rs2285666). In contrast with the European/American populations, both of the SNPs have largely similar frequencies for East Eurasians and South Asians, Therefore, it is likely that among the South Asians, host susceptibility to the novel coronavirus SARS-CoV-2 will be more similar to that of East Eurasians rather than to that of Europeans.

RevDate: 2020-09-16

Pavel STI, Yetiskin H, Aydin G, et al (2020)

Isolation and characterization of severe acute respiratory syndrome coronavirus 2 in Turkey.

PloS one, 15(9):e0238614 pii:PONE-D-20-13168.

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and associated with severe respiratory illness emerged in Wuhan, China, in late 2019. The virus has been able to spread promptly across all continents in the world. The current pandemic has posed a great threat to public health concern and safety. Currently, there are no specific treatments or licensed vaccines available for COVID-19. We isolated SARS-CoV-2 from the nasopharyngeal sample of a patient in Turkey with confirmed COVID-19. We determined that the Vero E6 and MA-104 cell lines are suitable for supporting SARS-CoV-2 that supports viral replication, development of cytopathic effect (CPE) and subsequent cell death. Phylogenetic analyses of the whole genome sequences showed that the hCoV-19/Turkey/ERAGEM-001/2020 strain clustered with the strains primarily from Australia, Canada, England, Iran and Kuwait and that the cases in the nearby clusters were reported to have travel history to Iran and to share the common unique nucleotide substitutions.

RevDate: 2020-09-16

Chorus C, Sandorf ED, N Mouter (2020)

Diabolical dilemmas of COVID-19: An empirical study into Dutch society's trade-offs between health impacts and other effects of the lockdown.

PloS one, 15(9):e0238683 pii:PONE-D-20-17983.

We report and interpret preferences of a sample of the Dutch adult population for different strategies to end the so-called 'intelligent lockdown' which their government had put in place in response to the COVID-19 pandemic. Using a discrete choice experiment, we invited participants to make a series of choices between policy scenarios aimed at relaxing the lockdown, which were specified not in terms of their nature (e.g. whether or not to allow schools to re-open) but in terms of their effects along seven dimensions. These included health-related effects, but also impacts on the economy, education, and personal income. From the observed choices, we were able to infer the implicit trade-offs made by the Dutch between these policy effects. For example, we find that the average citizen, in order to avoid one fatality directly or indirectly related to COVID-19, is willing to accept a lasting lag in the educational performance of 18 children, or a lasting (>3 years) and substantial (>15%) reduction in net income of 77 households. We explore heterogeneity across individuals in terms of these trade-offs by means of latent class analysis. Our results suggest that most citizens are willing to trade-off health-related and other effects of the lockdown, implying a consequentialist ethical perspective. Somewhat surprisingly, we find that the elderly, known to be at relatively high risk of being affected by the virus, are relatively reluctant to sacrifice economic pain and educational disadvantages for the younger generation, to avoid fatalities. We also identify a so-called taboo trade-off aversion amongst a substantial share of our sample, being an aversion to accept morally problematic policies that simultaneously imply higher fatality numbers and lower taxes. We explain various ways in which our results can be of value to policy makers in the context of the COVID-19 and future pandemics.

RevDate: 2020-09-16

Mitra A, Pakhare AP, Roy A, et al (2020)

Impact of COVID-19 epidemic curtailment strategies in selected Indian states: An analysis by reproduction number and doubling time with incidence modelling.

PloS one, 15(9):e0239026 pii:PONE-D-20-14797.

The Government of India in-network with the state governments has implemented the epidemic curtailment strategies inclusive of case-isolation, quarantine and lockdown in response to ongoing novel coronavirus (COVID-19) outbreak. In this manuscript, we attempt to estimate the impact of these steps across ten selected Indian states using crowd-sourced data. The trajectory of the outbreak was parameterized by the reproduction number (R0), doubling time, and growth rate. These parameters were estimated at two time-periods after the enforcement of the lockdown on 24th March 2020, i.e. 15 days into lockdown and 30 days into lockdown. The authors used a crowd sourced database which is available in the public domain. After preparing the data for analysis, R0 was estimated using maximum likelihood (ML) method which is based on the expectation minimum algorithm where the distribution probability of secondary cases is maximized using the serial interval discretization. The doubling time and growth rate were estimated by the natural log transformation of the exponential growth equation. The overall analysis shows decreasing trends in time-varying reproduction numbers (R(t)) and growth rate (with a few exceptions) and increasing trends in doubling time. The curtailment strategies employed by the Indian government seem to be effective in reducing the transmission parameters of the COVID-19 epidemic. The estimated R(t) are still above the threshold of 1, and the resultant absolute case numbers show an increase with time. Future curtailment and mitigation strategies thus may take into account these findings while formulating further course of action.

RevDate: 2020-09-16

Sutton J, Renshaw SL, CT Butts (2020)

COVID-19: Retransmission of official communications in an emerging pandemic.

PloS one, 15(9):e0238491 pii:PONE-D-20-17359.

As the most visible face of health expertise to the general public, health agencies have played a central role in alerting the public to the emerging COVID-19 threat, providing guidance for protective action, motivating compliance with health directives, and combating misinformation. Social media platforms such as Twitter have been a critical tool in this process, providing a communication channel that allows both rapid dissemination of messages to the public at large and individual-level engagement. Message dissemination and amplification is a necessary precursor to reaching audiences, both online and off, as well as inspiring action. Therefore, it is valuable for organizational risk communication to identify strategies and practices that may lead to increased message passing among online users. In this research, we examine message features shown in prior disasters to increase or decrease message retransmission under imminent threat conditions to develop models of official risk communicators' messages shared online from February 1, 2020-April 30, 2020. We develop a lexicon of keywords associated with risk communication about the pandemic response, then use automated coding to identify message content and message structural features. We conduct chi-square analyses and negative binomial regression modeling to identify the strategies used by official risk communicators that respectively increase and decrease message retransmission. Findings show systematic changes in message strategies over time and identify key features that affect message passing, both positively and negatively. These results have the potential to aid in message design strategies as the pandemic continues, or in similar future events.

RevDate: 2020-09-16

Low DM, Rumker L, Talker T, et al (2020)

Natural Language Processing Reveals Vulnerable Mental Health Support Groups and Heightened Health Anxiety on Reddit during COVID-19: An Observational Study.

Journal of medical Internet research [Epub ahead of print].

BACKGROUND: The COVID-19 pandemic is exerting a devastating impact on mental health, but it is not clear how people with different types of mental health problems were differentially impacted as the initial wave of cases hit.

OBJECTIVE: We leverage natural language processing (NLP) with the goal of characterizing changes in fifteen of the world's largest mental health support groups (e.g., r/schizophrenia, r/SuicideWatch, r/Depression) found on the website Reddit, along with eleven non-mental health groups (e.g., r/PersonalFinance, r/conspiracy) during the initial stage of the pandemic.

METHODS: We create and release the Reddit Mental Health Dataset including posts from 826,961 unique users from 2018 to 2020. Using regression, we analyze trends from 90 text-derived features such as sentiment analysis, personal pronouns, and a "guns" semantic category. Using supervised machine learning, we classify posts into their respective support group and interpret important features to understand how different problems manifest in language. We apply unsupervised methods such as topic modeling and unsupervised clustering to uncover concerns throughout Reddit before and during the pandemic.

RESULTS: We find that the r/HealthAnxiety forum showed spikes in posts about COVID-19 early on in January, approximately two months before other support groups started posting about the pandemic. There were many features that significantly increased during COVID-19 for specific groups including the categories "economic stress", "isolation", and "home" while others such as "motion" significantly decreased. We find that support groups related to attention deficit hyperactivity disorder (ADHD), eating disorders (ED), and anxiety showed the most negative semantic change during the pandemic out of all mental health groups. Health anxiety emerged as a general theme across Reddit through independent supervised and unsupervised machine learning analyses. For instance, we provide evidence that the concerns of a diverse set of individuals are converging in this unique moment of history; we discover that the more users posted about COVID-19, the more linguistically similar (less distant) the mental health support groups became to r/HealthAnxiety (ρ = -0.96, P<.001). Using unsupervised clustering, we find the Suicidality and Loneliness clusters more than doubled in amount of posts during the pandemic. Specifically, the support groups for borderline personality disorder and post-traumatic stress disorder became significantly associated with the Suicidality cluster. Furthermore, clusters surrounding Self-Harm and Entertainment emerged.

CONCLUSIONS: By using a broad set of NLP techniques and analyzing a baseline of pre-pandemic posts, we uncover patterns of how specific mental health problems manifest in language, identify at-risk users, and reveal the distribution of concerns across Reddit which could help provide better resources to its millions of users. We then demonstrate that textual analysis is sensitive to uncover mental health complaints as they arise in real time, identifying vulnerable groups and alarming themes during COVID-19, and thus may have utility during the ongoing pandemic and other world-changing events such as elections and protests from the present or the past.

RevDate: 2020-09-16

Pan Y, Xin M, Zhang C, et al (2020)

Associations between COVID-19 specific information exposure, mental health and self-reported compliance with personal preventive measures: evidence from a cross-sectional study at the initial phase of work resumption following the COVID-19 outbreak in China.

Journal of medical Internet research [Epub ahead of print].

BACKGROUND: Risk and crisis communication plays an essential role in public health emergency response. The COVID-19 pandemic triggered spontaneous and intensive media attention, which affects both the public's adoption of personal preventive measures and mental health.

OBJECTIVE: This study investigated the associations between exposure to COVID-19 specific information and mental health (depression and sleep quality) and self-reported compliance with personal preventive measures (facemask wearing and hand sanitizing); and tested whether such associations were moderated by thoughtful consideration of the veracity of exposed information.

METHODS: A cross-sectional closed online survey was conducted among a sample of factory workers at the beginning of work resumption in Shenzhen, China. A stratified two-stage cluster sampling design was used for recruitment. A total of 3,035 factory workers that had resumed work completed an online self-administered questionnaire. Multivariate linear and logistic regression models were used for analyses.

RESULTS: The prevalence of probable moderate-to-severe depression and good/excellent sleep quality was 5.6% (n=170) and 69.5% (n=2,110), respectively. The prevalence of self-reported consistent facemask wearing in any public places and sanitizing hands every time after returning from public spaces or touching installations was 95.7% (n=2,903) and 70.9% (n=2,151), respectively. Around 33.3-54.0% reported a daily exposure to COVID-19 specific information through online media and television for more than one hour. After controlling for significant background variables, higher information exposure via television and newspaper/magazines were associated with better sleep quality (adjusted B=0.05 & 0.07, P<.001) and higher self-reported compliance with hand sanitizing (adjusted odds ratios [AOR]=1.18 & 1.21, P<.001). Higher exposure via online unofficial media was associated with better self-reported compliance with hand sanitizing (AOR=1.08, P=.037) but also higher depressive symptoms (adjusted B=0.20, P=.001). In contrast, higher exposure through face-to-face communication was associated with higher depressive symptoms (adjusted B=0.45, P<.001), worse sleep quality (adjusted B=-0.04, P=.012), and poorer self-reported compliance with hand sanitizing (AOR=0.91, P=.020). Exposure to information about COVID-19 patients' positive outcomes, development of vaccines/effective treatment and heroic stories about frontline healthcare workers were associated with both better mental health and higher self-reported compliance with preventive measures. Higher overall information exposure was associated with higher depressive symptoms among participants who were less likely to carefully consider the veracity of exposed information, while also associated with better sleep quality among those with more thoughtful consideration of exposed information.

CONCLUSIONS: This study provides empirical evidence on how amount, sources, and contents of information exposure influenced mental health and compliance with personal preventive measures at the initial phase of work resumption in China; and thoughtful consideration of information quality played an important moderating role. Our findings may inform strategic risk communication used by government and public health authorities during the COVID-19 pandemic.

RevDate: 2020-09-16

Ali SH, Foreman J, Tozan Y, et al (2020)

Trends and predictors of COVID-19 information sources and their relationship with knowledge and beliefs related to the pandemic: a nationwide cross-sectional study.

JMIR public health and surveillance [Epub ahead of print].

BACKGROUND: The COVID-19 pandemic has led to a heightened need to understand health information seeking behaviors in order to address disparities in knowledge and beliefs about the crisis.

OBJECTIVE: This study assessed socio-demographic predictors of the use and trust of different COVID-19 information sources, and the association between information sources, knowledge and beliefs about the pandemic.

METHODS: An online survey was conducted among U.S. adults in two rounds within March-April 2020 using social-media advertisement-based recruitment. Participants were asked on their use of eleven different COVID-19 information sources as well as their most trusted source of information. Selection of COVID-related knowledge and belief questions was identified using past empirical literature and salient concerns at the time of survey implementation.

RESULTS: The sample consists of 11,242 participants. Traditional media sources (TV, radio or podcasts, or newspapers) when combined were the largest sources of COVID-19 information (91.2%). Among those using mainstream media sources for COVID-19 information (n=7,811, 69.5%), popular outlets included CNN (24.0%), Fox News (19.3%), and other local or national networks (35.2%). The largest individual information source was government websites (87.6%), which was also the most trusted source of information (43.3%); odds of trusting government websites were lower among males (AOR: 0.58, 95% CI:0.53-0.63) and those aged 40-59 and ≥60 years compared to aged 18-38 years (AOR: 0.83, 95% CI:0.74-0.92; AOR: 0.62, 95% CI:0.54-0.71). Participants used an average of 6.1 sources (SD: 2.3). Participants who were male, aged 40-59 or ≥60, not working/unemployed or retired, or Republican were likely to use fewer sources while those with children and with higher educational attainment were likely to use more sources. Participants in April were markedly less likely to use (AORuse 0.41, 95%CI:0.35-0.46) and trust (AORtrust 0.51, 95%CI:0.47-0.56) government sources. The association between information source and COVID-19 knowledge was mixed, while many COVID-19 beliefs were significantly predicted by information source; similar trends were observed with reliance on different types of mainstream media outlets.

CONCLUSIONS: COVID-19 information source was significantly determined by participant socio-demographic characteristics and was also associated with both knowledge and beliefs about the pandemic. Study findings can help inform COVID-19 health communication campaigns and highlight the impact of using a variety of different and trusted information sources.

RevDate: 2020-09-16

Mann S, Novintan S, Hazemi-Jebelli Y, et al (2020)

Lessons from COVID-19: Equity, Adaptability and Community.

JMIR medical education [Epub ahead of print].

UNSTRUCTURED: As UK medical students, we recently completed three months of 'remote learning', before sitting end-of-year exams online, and we are now entering our final year of medical school. Based on our experiences and our understanding of others' experiences, we believe that three key lessons have been universal for medical students across the world. The lessons learned throughout this process address the need for a fair system for medical students, the importance of adaptability in all aspects of medical education and the value of a strong medical school community. These lessons can be applied in the years to come, to improve medical education as we know it.

RevDate: 2020-09-16

Padala KP, Wilson KB, Gauss CH, et al (2020)

VA Video Connect For Clinical Care In Older Adults in a Rural State during COVID-19: A Cross-sectional Study.

Journal of medical Internet research [Epub ahead of print].

BACKGROUND: The COVID-19 pandemic has accelerated the need for telehealth to home. Although the Department of Veterans Affairs is a leading provider of telehealth, disparities might exist in reaching older Veterans living in rural areas.

OBJECTIVE: VA Video Connect (VVC) is a video conferencing app that enables Veterans to connect with their provider in a secure and private session. The objective was to study the capability and willingness of older Veterans to participate in a VVC visit during the COVID-19 pandemic.

METHODS: A cross-sectional study was conducted on older Veterans (N=118) at the Central Arkansas Veterans Healthcare System. Participants were interviewed over the phone. Availability of internet, email, and a device with camera were recorded. Veteran's willingness to complete the appointment via a VVC visit was asked. Those not capable of participating in a VVC visit were asked if they had a caregiver available to help.

RESULTS: Mean age was 72.6 (±8.3) years, 92% were male, 69% were Caucasian and 30% were African Americans. Thirty-six percent were rural. Majority reported having internet (77%), and email (70%), but only 56% had a device with camera. Overall, 53% were willing and capable of participating in a VVC visit. Availability of internet access was significantly lower in rural compared to non-rural participants (p=0.045); and in those with ≤ high school education compared to > high school education (p=0.020). Willingness to participate in the VVC visit was significantly lower in rural compared to non-rural participants (p=0.030). Of the VVC-capable and willing participants that had visits in the study period (N = 54), 65% opted for VVC and 35% preferred a phone visit. 77% of the scheduled VVC visits were successful.

CONCLUSIONS: Despite the advances in technology, and the willingness on the part of healthcare systems, there are some lingering issues with capability and willingness to participate in video telehealth visits particularly among older adults residing in rural areas.

RevDate: 2020-09-16

Dubey AD (2020)

The Resurgence of Cyber-Racism COVID-19 Pandemic and its After Effects.

JMIR public health and surveillance [Epub ahead of print].

BACKGROUND: With the increasing number of patients of COVID-19 all over the world, a particular section of the world population has been blaming China and World Health Organization for the spread of this disease. Due to this, a number of cases related to racism and hatred have been encountered all over. With Donald Trump using the term Chinese Virus, this cause has gained momentum and Ethnic Asians are now being targeted. The online situation also looks the same where certain segment of people are posting hateful comments and posts.

OBJECTIVE: The research study has been done to analyze the increasing racism online during COVID-19. This research aims to analyze the emotions and sentiments that have been associated with the terms like Chinese Virus, Wuhan Virus and Chinese Corona Virus.

METHODS: 16,000 tweets ranging from 11th April 2020 to 16th April 2020 were analyzed to find out the sentiments and emotions associated with the posts. This research has been done on R. Twitter API and SentimentR package were used for the collection of the tweets and then evaluating the sentiments respectively.

RESULTS: This results suggested that majority of the tweets were of negative sentiments and carried emotions of fear, sadness, anger and disgust. There were a high usage of slurs and profane words. Also, terms like China LieD People Died, Wuhan Health Organization, Kung Flu, China Must Pay and CCP is Terrorist were used a lot in these tweets.

CONCLUSIONS: This study gives an insight of the rising hatred and cyber racism on Twitter. This study has analyzed the twitter posts and concludes that there are a majority of people who are tweeting with mostly negative sentiments for ethnic Asian, China and WHO.

RevDate: 2020-09-16

Ahmed W, López Seguí F, Vidal-Alaball J, et al (2020)

COVID-19 and the "Film Your Hospital" Conspiracy Theory: Social Network Analysis of Twitter Data.

Journal of medical Internet research [Epub ahead of print].

BACKGROUND: During the COVID-19 pandemic a number of conspiracy theories have emerged. A popular theory notes that the pandemic is a hoax by suggesting that certain hospitals are 'empty'. Research has shown that accepting conspiracy theories raises the chances that an individual may ignore government advice around social-distancing and other public health interventions. Due to the chance of a second wave and/or future pandemics, it is important to gain an understanding of the drivers of misinformation and strategies to mitigate it.

OBJECTIVE: This study set out to evaluate the #FilmYourHospital conspiracy theory on Twitter, attempting to understand the drivers of the conspiracy theory on Twitter. More specifically, the objectives were as followed: what online sources of information were used as evidence to support the theory, what ratio of automated accounts compared to organic accounts were present in the network and what lessons can be learnt in order to mitigate the spread of such a conspiracy theory in the future.

METHODS: Twitter data related to the #FilmYourHospital hashtag was retrieved and analysed using social network analysis from a 7 day period from Monday 13 April and Monday 20 April. The dataset consisted of 22,785 tweets and 11,333 Twitter users. The Botometer tool was used to identify accounts with a higher probability of being bots.

RESULTS: The most important drivers of the conspiracy theory are ordinary citizens, one of the most influential being a pro-Brexit supporter. It was found that YouTube was the information source most linked to by users. The most retweeted post belonged to a bluetick 'verified' Twitter user, indicating that the user may have had more influence on the platform. It was found that there was a small number of automated accounts (bots) as well as accounts deleted within the network.

CONCLUSIONS: Hashtags using and sharing conspiracy theories can be targeted in an effort to delegitimize content containing misinformation. Social media organisations need to reinforce their efforts to label and/or remove content that contains misinformation. Public health authorities could enlist the assistance of influencers in order to spread anti-narrative content.

RevDate: 2020-09-16

Jeon J, Baruah G, Sarabadani S, et al (2020)

Identification of risk factors and symptoms of SARS-CoV-2 (COVID-19) using biomedical literature and social media data: Integrative and Consensus study.

Journal of medical Internet research [Epub ahead of print].

BACKGROUND: In December 2019, Coronavirus disease 2019 (COVID-19) outbreak started in China and rapidly spread around the world. Lack of any vaccine or optimized intervention raised the importance of characterizing risk factors and symptoms for the early identification and successful treatment of COVID-19 patients.

OBJECTIVE: This study aims to investigate and analyze biomedical literature and public social media data to understand the association of risk factors and symptoms with various outcomes of COVID-19 patients.

METHODS: Through semantic analysis, we collected 45 retrospective cohort studies, which evaluated 303 clinical and demographic variables across 13 different outcomes of COVID-19 patients, and 84,140 Twitter posts from 1,036 COVID-19 positive users. Machine-learning tools to extract biomedical information were introduced to identify uncommon or novel symptoms mentioning in social media. We then examined and compared two datasets to expand our landscape of risk factors and symptoms related to COVID-19.

RESULTS: From the biomedical literature, approximately 90% of clinical and demographic variables showed inconsistent associations with COVID-19 outcomes. Consensus analysis identified 72 risk factors that were specifically associated with individual outcomes. From the social media data, 51 symptoms were characterized and analyzed. By comparing social media data with biomedical literature, we identified 25 novel symptoms that were specifically mentioned in social media but have been not previously well characterized. Furthermore, there were certain combinations of symptoms that were frequently mentioned together in social media.

CONCLUSIONS: Identified outcome-specific risk factors, symptoms, and combinations of symptoms may serve as surrogate indicators to identify COVID-19 patients and predict their clinical outcomes providing appropriate treatments.

RevDate: 2020-09-16

Mira JJ, Vicente MA, López-Pineda A, et al (2020)

Development of the platform "Be+ against COVID", a website and a mobile app to prevent and address the stress reactions of healthcare workers caring COVID-19 patients.

JMIR mHealth and uHealth [Epub ahead of print].

BACKGROUND: COVID-19 became a major public health concern in March 2020. Due to the high rate of hospitalizations for COVID-19 in a short time, healthcare workers and other involved staff are subjected to extraordinary workload and high emotional distress.

OBJECTIVE: The objective of this study was to develop a digital tool to provide support resources that might prevent and approach acute stress reactions in healthcare workers and other support staff due to the current COVID-19 pandemic.

METHODS: The contents of the digital platform were created through an evidence-based review and consensus conference. The website was built using the Google Blogger tool. The Android version of the app was developed in Java and XML languages using Android Studio version 3.6., and the iOS version was developed in Swift language using Xcode version 11.5. The app was evaluated externally by the Andalusian Agency for Healthcare Quality.

RESULTS: We detected the needs and pressing situations of frontline healthcare workers, and then, we proposed a serial of recommendations and support resources to address them. These resources were redesigned using the feedback received. A website in three different languages (Spanish, English, and Portuguese) and a mobile app were developed with these contents, and the AppSaludable Quality Seal was granted to the app. A specific self-report scale to measure acute stress was included ad additional tools to support the healthcare workforce. This instrument has been used in several Latin American countries once has been adapted considering cultural differences. The resources section of the website was the most visited with 18.516 out of 68.913 visits (26.9%), and the 'self-report acute stress scale' was the most visited resource with 6.468 out of 18.516 visits (34.9%).

CONCLUSIONS: 'Be + against COVID' platform (website & app) was developed and launched to offer a pool of recommendations and support resources, which were specifically designed to protect the psychological well-being and the work morale of healthcare workers. This is an original initiative different from the usual psychological assistance hotlines.

RevDate: 2020-09-16

Sasangohar F, Bradshaw MR, Carlson M, et al (2020)

Adapting an outpatient psychiatric clinic to telehealth during COVID-19: A practice perspective.

Journal of medical Internet research [Epub ahead of print].

UNSTRUCTURED: As the demand for telepsychiatry increases during COVID-19, articulating strengths and challenges of telepsychiatry implementation are needed to improve clinical practices long-term. Currently, observations within United States contexts are lacking; therefore, we report on the rapid implementation and workflow experiences as a psychiatric practice based within a large healthcare system in Southeast Texas with a national catchment area. We discuss implementation logistics including modes of communication, scheduling, coordination, and capacity; psychological effects of online services, including both the loss of the physical therapeutic environment as well as unique interpersonal dynamics experienced in the virtual environment; and post-adoption patterns of engagement in our services and other clinical functions affected by the rapid adaptation to telemedicine. Our art therapy group programming serves as an applied case study, demonstrating the value of a well-managed online program (e.g., patients were receptive, well-engaged, and appreciated the continuity of accessible service) as well as the challenges (e.g., the need for backup plans and technological fallbacks, managing interruptions and telecommunications learning curves, and working around the difference in resources for art and music therapy between a well-stocked clinical setting versus clients' home spaces). We conclude from our experience that overall strengths of telepsychiatry include receptive and well-engaged response from patients, and the expansion of boundaries allowing for a directly contextualized view into patients' home lives. Challenges and corresponding recommendations include the need for more careful safety planning for high risk patients; maintaining professional boundaries in the newly informal virtual setting; designing the physical space both to frame the patient encounter and to maintain work-life balance for the therapist; allowing for delays and interruptions (including an initial acclimation session); and preserving interprofessional care team collaboration when the physical hallways normally facilitating such encounters are absent. We believe careful observations on strengths and challenges of telepsychiatry during this pandemic will better inform practices considering telepsychiatry adoption both within pandemic contexts and more broadly thereafter.

RevDate: 2020-09-16

Kennelly MJ (2020)

Caring for people with spinal cord injury in the time of COVID-19: Redefining the meaning of "essential".

The journal of spinal cord medicine, 43(5):563-564.

RevDate: 2020-09-16

Abdullahi IN, Emeribe AU, Adekola HA, et al (2020)

Leveraging on the genomics and immunopathology of SARS-CoV-2 for vaccines development: prospects and challenges.

Human vaccines & immunotherapeutics [Epub ahead of print].

The incidence and case-fatality rates (CFRs) of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection, the etiological agent for Coronavirus Disease 2019 (COVID-19), have been rising unabated. Even though the entire world has been implementing infection prevention and control measures, the pandemic continues to spread. It has been widely accepted that preventive vaccination strategies are the public health measures for countering this pandemic. This study critically reviews the latest scientific advancement in genomics, replication pattern, pathogenesis, and immunopathology of SARS-CoV-2 infection and how these concepts could be used in the development of vaccines. We also offer a detailed discussion on the anticipated potency, efficacy, safety, and pharmaco-economic issues that are and will be associated with candidate COVID-19 vaccines.

RevDate: 2020-09-16

Holdoway A (2020)

Nutritional management of patients during and after COVID-19 illness.

British journal of community nursing, 25(Sup8):S6-S10.

The impact of nutrition on recovery from various illnesses is well recognised. Malnutrition can affect duration of hospitalisation and impede recovery, and therefore it is important to monitor this condition, especially in at-risk groups, such as older adults and those with chronic disease. Underlying malnutrition impairs the immune system, potentially making people more vulnerable to infections such as COVID-19 and impacting recovery. Patients recovering from severe illness are likely to have muscle wasting or feel weak and may have increased protein needs. In addition individuals who have been discharged from hospital may need ongoing nutritional rehabilitation. This article explores the range of symptoms of COVID-19 that can interfere with dietary intake, such as respiratory issues, loss of taste and smell and fatigue and weakness. It goes on to describe how community nurses can identify risk of malnutrition and dietary issues when working remotely. Additionally, it signposts to a range of resources developed to assist patients and carers in accessing appropriate dietary advice.

RevDate: 2020-09-16

Gustavson AM, Gordon AJ, Kenny ME, et al (2020)

Response to coronavirus 2019 in Veterans Health Administration facilities participating in an implementation initiative to enhance access to medication for opioid use disorder.

Substance abuse [Epub ahead of print].

The actions needed to mitigate the spread of the coronavirus 2019 (COVID-19) have forged rapid paradigm shifts across healthcare delivery. In a time of crisis, continued access to and delivery of medication for opioid use disorder (M-OUD) is essential to save lives. However, prior to COVID-19, large variability in M-OUD adoption existed across the Veteran Health Administration (VHA) and it is unknown whether the COVID-19 pandemic exacerbated this divide. For the past two years, our team worked with eight VHA facilities to enhance adoption of M-OUD through a multi-component implementation intervention. This commentary explores these providers' responses to COVID-19 and the subsequent impact on their progress toward increasing adoption of M-OUD. Briefly, the loosening of regulatory restrictions fostered accelerated adoption of M-OUD, rapid support for telehealth offered a mechanism to increase M-OUD access, and reevaluation of current practices surrounding M-OUD strengthened adoption. Overall, during the COVID-19 crisis, facilities and providers responded positively to the call for increased access to M-OUD and appropriate care of patients with OUD. The VHA providers' responses and continued progress in enhancing M-OUD amidst a crisis may, in part, be attributable to their participation in an implementation effort prior to COVID-19 that established resources, expert support, and a community of practice. We anticipate the themes presented are generalizable to other healthcare systems grappling to deliver care to patients with OUD during a crisis. We propose areas of future research and quality improvement to continue to provide access and high quality, life-saving care to patients with OUD.

RevDate: 2020-09-16

Lipsky MS, M Hung (2020)

Men and COVID-19: A Pathophysiologic Review.

American journal of men's health, 14(5):1557988320954021.

Coronaviruses are single-stranded ribonucleic acid viruses that can cause illnesses in humans ranging from the common cold to severe respiratory disease and even death.In March 2020, the World Health Organization declared the 2019 novel coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as the first pandemic. Compared to women, most countries with available data report that men with COVID-19 have greater disease severity and higher mortality. Lab and animal data indicate that men respond differently to the SARS-CoV-2 infection, offering possible explanations for the epidemiologic observations. The plausible theories underlying these observations include sex-related differences in angiotensin-converting enzyme 2 receptors, immune function, hormones, habits, and coinfection rates.In this review we examine these factors and explore the rationale as to how each may impact COVID-19. Understanding why men are more likely to experience severe disease can help in developing effective treatments, public health policies, and targeted strategies such as early recognition and aggressive testing in subgroups.

RevDate: 2020-09-16

Kipshidze N, Iversen P, Porter TR, et al (2020)

Targeted, Site-Specific, Delivery Vehicles of Therapeutics for COVID-19 Patients. Brief Review.

Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis, 26:1076029620954911.

Definitive pharmacological therapies for COVID-19 have yet to be identified. Several hundred trials are ongoing globally in the hope of a solution. However, nearly all treatments rely on systemic delivery but COVID-19 damages the lungs preferentially. The use of a targeted delivery approach is reviewed where engineered products are able to reach damaged lung tissue directly, which includes catheter-based and aerosol-based approaches. In this review we have outlined various target directed approaches which include microbubbles, extracellular vesicles including exosomes, adenosine nanoparticles, novel bio-objects, direct aerosol targeted pulmonary delivery and catheter-based drug delivery with reference to their relative effectiveness for the specific lesions. Currently several trials are ongoing to determine the effectiveness of such delivery systems alone and in conjunction with systemic therapies. Such approaches may prove to be very effective in the controlled and localized COVID-19 viral lesions in the lungs and potential sites. Moreover, localized delivery offered a safer delivery mode for such drugs which may have systemic adverse effects.

RevDate: 2020-09-16

Anderson PO (2020)

Antivirals for COVID-19 and Breastfeeding.

Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine [Epub ahead of print].

RevDate: 2020-09-16

Khiali S, T Entezari-Maleki (2020)

Anticoagulation in COVID-19: DDI Perspective.

Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis, 26:1076029620959457.

RevDate: 2020-09-16

Kimura M, Ojima T, Ide K, et al (2020)

Allaying Post-COVID19 Negative Health Impacts Among Older People: The "Need To Do Something With Others"-Lessons From the Japan Gerontological Evaluation Study.

Asia-Pacific journal of public health [Epub ahead of print].

Restrictions on going out, meeting other people, and participating in activities during the COVID-19 (coronavirus disease-2019) pandemic may have a prolonged effect on older people. This article discusses the importance of social relationships in the health of older people based on the results of the Japan Gerontological Evaluation Study (JAGES) that has conducted nationwide longitudinal studies. We selected cohort studies of JAGES, which investigated the relationships between social relationships and health, with more than 10 000 participants and published after 2010. The results showed that having contact with others, eating with others, and participating in social activities were negatively related to incident dementia, functional disability, depression, and premature death. A minimum of weekly contact with others, eating with others, and social participation by maintaining physical distancing are needed, even during the COVID-19 pandemic. For reducing the risks of transmission of coronavirus and its negative effects on health in the future, using the internet may be beneficial. The development of technological support networks for older people may be necessary.

RevDate: 2020-09-16

Lewis K (2020)

COVID-19: Preliminary Data on the Impact of Social Distancing on Loneliness and Mental Health.

Journal of psychiatric practice, 26(5):400-404.

The COVID-19 pandemic and its need for social distancing as a response have the potential to increase the experience of loneliness in the population, with an associated increase in symptoms of mental disorders. As the world has largely adapted to remote platforms for employment, socializing, and health service delivery, the degree to which virtual opportunities for social engagement may offset the impact of limited in-person interactions on mental health functioning is unknown. This column offers preliminary data from an ongoing experience sampling study of the prevalence, course, and impact of loneliness on mental health in a community adult sample living under social distancing requirements during the COVID-19 pandemic. Initial findings aggregated across all experience sampling reports showed negative associations between virtual social contact (via text, phone, or videoconferencing) and feelings of loneliness, while in-person interactions appeared to have no impact on loneliness. In addition, respondents reported frequent instances of negative effects on physical and mental health, including disruptions in sleep and recurring suicidal ideation. While further analyses are needed, these findings are consistent with similar emerging reports showing increased rates of mental health concerns during periods of social distancing. Possible avenues for addressing these concerns using remote interventions are explored.

RevDate: 2020-09-16

Freischlag JA (2020)

Patient Safety Indicators: Inpatient, Outpatient, and COVID 19.

Annals of surgery, 272(4):620.

RevDate: 2020-09-16

Mazouri-Karker S, Karsegard J, Percheron Vendeuvre L, et al (2020)

[Cross glances on the videoconsultation].

Revue medicale suisse, 16(706):1709-1713.

The covid-19 outbreak prompted many health care providers to use video consultation for the first time. While it is particularly useful in times of pandemic, a number of patients wish to continue using video consultation as it allows easy access to their physician. However, many physicians may be uncomfortable communicating with new technologies and without performing a traditional physical examination. Training in communication and virtual physical examination in telemedicine appears to be necessary, making it possible to make videoconsultation sustainable into daily practice while guaranteeing quality of care.

RevDate: 2020-09-16

Mazouri-Karker S, Percheron Vendeuvre L, Sandoval J, et al (2020)

[Telemedicine at the heart of management of the COVID-19 crisis].

Revue medicale suisse, 16(706):1699-1702.

During the COVID-19 crisis, telemedicine was at the center of the health management systems in the canton of Geneva. Telemedicine contributed to the triage and follow-up of patients with a suspected or confirmed diagnosis of COVID-19, as well as to the coordination of different healthcare actors in the patient's trajectory. New partnerships and reinforcement of coordination in the Geneva healthcare and social care networks with an unprecedented use of telemedicine tools were able to ensure patient care while preserving frontline healthcare providers. Telemedicine has benefited during this time from a temporary relaxation of measures and regulations governing its practice, encouraging its deployment in a crisis situation. However, for these tools to be effective, they need to become an integral part of our healthcare systems.

RevDate: 2020-09-16

Percheron Vendeuvre L, Lecygne C, Jeannot JG, et al (2020)

[Telemedicine in the era of COVID-19: a revolution ? The experience of the University Hospitals of Geneva].

Revue medicale suisse, 16(706):1695-1698.

The COVID-19 pandemic has imposed a reorganization of our health care system leading to an unhoped-for boom in telemedicine, particularly in Geneva. The deployment of HUG@home at the Geneva University Hospitals and of docteur@home in the doctors' offices has allowed health professionals to come together around a single solution thus ensuring continuity of care for patients with chronic diseases but also the triage and follow-up of patients with COVID-19 in compliance with security and confidentiality rules. The ease of use of remote consultation tools is essential for the sustainable anchoring of telemedicine in practice. The supervision of practices, training and the financial valorization of telemedicine are also necessary for the development of quality care.

RevDate: 2020-09-16

Beacon TH, Su RC, Lakowski TM, et al (2020)

SARS-CoV-2 multifaceted interaction with the human host. Part II: Innate immunity response, immunopathology, and epigenetics.

IUBMB life [Epub ahead of print].

The SARS-CoV-2 makes its way into the cell via the ACE2 receptor and the proteolytic action of TMPRSS2. In response to the SARS-CoV-2 infection, the innate immune response is the first line of defense, triggering multiple signaling pathways to produce interferons, pro-inflammatory cytokines and chemokines, and initiating the adaptive immune response against the virus. Unsurprisingly, the virus has developed strategies to evade detection, which can result in delayed, excessive activation of the innate immune system. The response elicited by the host depends on multiple factors, including health status, age, and sex. An overactive innate immune response can lead to a cytokine storm, inflammation, and vascular disruption, leading to the vast array of symptoms exhibited by COVID-19 patients. What is known about the expression and epigenetic regulation of the ACE2 gene and the various players in the host response are explored in this review.

RevDate: 2020-09-16

Zubiaur P, Koller D, Saiz-Rodríguez M, et al (2020)

Important Pharmacogenetic Information for Drugs Prescribed During the SARS-CoV-2 Infection (COVID-19).

Clinical and translational science [Epub ahead of print].

In December 2019, the severe acute respiratory syndrome virus-2 pandemic began, causing the coronavirus disease 2019. A vast variety of drugs is being used off-label as potential therapies. Many of the repurposed drugs have clinical pharmacogenetic guidelines available with therapeutic recommendations when prescribed as indicated on the drug label. The aim of this review is to provide a comprehensive summary of pharmacogenetic biomarkers available for these drugs, which may help to prescribe them more safely.

RevDate: 2020-09-16

Castelao J, Graziani D, Soriano JB, et al (2020)

Findings and Prognostic Value of Lung Ultrasound in COVID-19 Pneumonia.

Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine [Epub ahead of print].

OBJECTIVES: The aim of this study was to systematically describe the findings of lung ultrasound (US) in patients with coronavirus 2019 (COVID-19) pneumonia and to analyze its prognostic value.

METHODS: Lung US examinations were performed in 63 patients with COVID-19 pneumonia admitted to a university hospital. Lung involvement was evaluated on a 4-point scale with a 12-area pulmonary division, obtaining a lung score (LS). Ultrasound findings and clinical characteristics were recorded.

RESULTS: All patients showed US involvement in at least 1 area (mean ± SD, 8 ± 3.5). The total LS was 15.3 ± 8.1, without differences between left and right lungs. Most affected regions were the lower region (95.2%) and the posterior region (73.8%). The total LS showed a strong correlation (r = -0.765) with the oxygen pressure-to-fraction of inspired oxygen ratio; by lung region, those with a higher correlation were the LS of the anterior region (r = -0.823) and the LS of the upper region (r = -0.731). In total, 22.2% of patients required noninvasive respiratory support (NIRS). A multivariate analysis showed that the anterior region LS, adjusted for age and sex, was significant (odds ratio, 2.159; 95% confidence interval, 1.309-3.561) for the risk of requiring NIRS. An anterior region LS of 4 or higher and a total LS of 19 or higher had similar characteristics to predict the need for NIRS.

CONCLUSIONS: Ultrasound involvement in COVID-19 pneumonia is bilateral and heterogeneous. Most affected regions are the posterior and the lower regions. The anterior region has prognostic value because its involvement strongly correlates with the risk of requiring NIRS, and an anterior region LS of 4 or higher has high sensitivity and specificity for predicting the need for NIRS.

RevDate: 2020-09-16

Bateman AC, Mueller S, Guenther K, et al (2020)

Assessing the Dilution Effect of Specimen Pooling on the Sensitivity of SARS-CoV-2 PCR Tests.

Journal of medical virology [Epub ahead of print].

The SARS-CoV-2 pandemic has led to an unprecedented demand for diagnostic tests. Many studies have modeled the efficiency gains of specimen pooling, but few have systematically evaluated the dilution effect of pooling on the sensitivity of tests. Using the frequency distribution of Ct values of our first 838 SARS-CoV-2 positive specimens, we modeled 100 specimens on the same frequency distribution. Given this distribution, we then tested dilutions of 1:5, 1:10, and 1:50 to find the percentage of specimens positive at each Ct value with each pool size. Using the frequency distribution and the percentage of specimens positive at each Ct value, we estimate that pools of 5 lead to 93% sensitivity, pools of 10 lead to 91% sensitivity, and pools of 50 lead to 81% sensitivity. Pools of 5 and 10 lead to some specimens with Ct values of ≥32 becoming negative, while pools of 50 lead to some specimens with Ct values of ≥28 becoming negative. These sensitivity estimates can inform laboratories seeking to implement pooling approaches as they seek to balance test efficiency with sensitivity. This article is protected by copyright. All rights reserved.

RevDate: 2020-09-16

Pikoos TD, Buzwell S, Sharp G, et al (2020)

The COVID-19 pandemic: Psychological and behavioral responses to the shutdown of the beauty industry.

The International journal of eating disorders [Epub ahead of print].

OBJECTIVE: During the COVID-19 pandemic, Australia implemented widespread closure of beauty and cosmetic services to control the virus spread. The effect of these restrictions is unknown, given that beauty services are widely used for stress relief or to enhance confidence. The current study explored the relationship between engagement in appearance-focused behaviors and distress regarding beauty service closure. Participants with high and low levels of dysmorphic concern were compared to determine whether COVID-19 restrictions may affect these groups differently.

METHOD: An online survey was completed by 216 participants living in Australia. Questions addressed engagement in appearance-focused behaviors during the COVID-19 pandemic and attitudes toward beauty service closure. The Dysmorphic Concern Questionnaire (DCQ) was used to group participants by low and high dysmorphic concern.

RESULTS: Appearance-focused behaviors decreased in the low DCQ group (n = 163) during the COVID-19 pandemic, while such behaviors in the high DCQ group (n = 53) remained unchanged. Individuals who were living alone, younger, reported higher dysmorphic concern and greater distress over beauty service closure engaged in more frequent appearance-focused behaviors (R2 = .57, p < .001). The high DCQ group reported greater distress over beauty service closure and increased desire to obtain future beauty treatments.

DISCUSSION: While COVID-19 restrictions may have provided a break from societal appearance pressure for those with low dysmorphic concern, appearance-focused behaviors persisted in individuals with high dysmorphic concern. A greater understanding of the long-term impacts on appearance-related distress is needed to determine mental health priorities emerging from the COVID-19 pandemic.

RevDate: 2020-09-16

Kalkowska DA, KM Thompson (2020)

Expected Implications of Globally Coordinated Cessation of Serotype 3 Oral Poliovirus Vaccine (OPV) Before Serotype 1 OPV.

Risk analysis : an official publication of the Society for Risk Analysis [Epub ahead of print].

Globally coordinated cessation of all three serotypes of oral poliovirus vaccine (OPV) represents a critical part of a successful polio endgame, which the Global Polio Eradication Initiative (GPEI) plans to conduct in phases, with serotype 2 OPV cessation completed in mid 2016. Although in 2016 the GPEI expected to globally coordinate cessation of the remaining OPV serotypes (1 and 3) by 2021, continuing transmission of serotype 1 wild polioviruses to date makes those plans obsolete. With increasing time since the last reported polio case caused by serotype 3 wild poliovirus (in November 2012) leading to high confidence about its successful global eradication, the Global Commission for the Certification of Poliomyelitis Eradication recently certified its eradication. Questions now arise about the optimal timing of serotype 3 OPV (OPV3) cessation. Using an integrated global model that characterizes the risks, costs, and benefits of global polio policy and risk management options, we explored the implications of different options for coordinated cessation of OPV3 prior to COVID-19. Globally coordinating cessation of OPV3 as soon as possible offers the opportunity to reduce cases of vaccine-associated paralytic polio globally. In addition, earlier cessation of OPV3 should reduce the risks of creating serotype 3 circulating vaccine-derived polioviruses after OPV3 cessation, which represents a significant threat to the polio endgame given current GPEI plans to reduce preventive OPV supplemental immunization activities starting in 2019.

RevDate: 2020-09-16

Bandhala Rajan M, Kumar-M P, A Bhardwaj (2020)

The trend of cutaneous lesions during COVID-19 pandemic: lessons from a meta-analysis and systematic review.

International journal of dermatology [Epub ahead of print].

BACKGROUND: Besides predominant respiratory and gastrointestinal manifestations, reports on cutaneous manifestations in COVID-19 patients are being noted increasingly.

OBJECTIVES: To estimate the prevalence of cutaneous manifestations in COVID-19 patients.

METHODS: This study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. A detailed literature search was done in PubMed and Embase from December 1, 2019, till May 1, 2020. Studies reporting cutaneous manifestations in COVID-19 patients were included. Irrespective of the heterogeneity of data, a random effects model with inverse-variance approach was used for pooling the prevalence using meta package in R version 3.6.2.

RESULTS: Out of 15,143 articles, 2086 articles were selected for full-text read. Forty-three articles were selected for qualitative analysis, of which 10 articles (N = 1682) were included for meta-analysis. The pooled prevalence of overall cutaneous lesions was 5.69 (95% confidence interval [CI]: 1.87-15.98; I2 88%). The pooled prevalence of other outcome parameters were as follows: viral exanthem-like presentation 4.15 (95% CI: 1.33-12.23; I2 88%), maculopapular rash 3.81 (95% CI: 1.02-13.18; I2 87%), vesiculobullous lesions 1.67 (95% CI: 0.70-3.96; I2 0%).

CONCLUSION: The estimated prevalence of cutaneous manifestations in COVID-19 was 5.69%. Other manifestations were urticaria, chilblain-like lesions, livedo reticularis, and finger/toe gangrene. Although it is premature to conclude the prevalence of the cutaneous manifestations during this ongoing pandemic, our report may be a stimulating factor for the physicians to perform further vigilant streamlined reporting of cutaneous manifestations in COVID-19 patients to estimate the final prevalence.

RevDate: 2020-09-16

Gálvez DA, Noal FC, de Araujo FB, et al (2020)

Virtual learning object: an asynchronous solution for virtual learning in dentistry post COVID-19.

Journal of dental education [Epub ahead of print].

RevDate: 2020-09-16

Nolan GS, Dunne JA, Kiely AL, et al (2020)

The effect of the COVID-19 pandemic on skin cancer surgery in the United Kingdom: a national, multi-centre, prospective cohort study and survey of Plastic Surgeons.

RevDate: 2020-09-16

Villegas-Echeveri JD, JF Carrillo (2020)

Navigating the COVID-19 waters with chronic pelvic pain.

International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics [Epub ahead of print].

RevDate: 2020-09-16

Polidoro M, de Assis Mendonça F, Meneghel SN, et al (2020)

Territories Under Siege: Risks of the Decimation of Indigenous and Quilombolas Peoples in the Context of COVID-19 in South Brazil.

Journal of racial and ethnic health disparities pii:10.1007/s40615-020-00868-7 [Epub ahead of print].

The current health, political, and environmental crisis ongoing in Brazil and the advances of the impacts of COVID-19 in traditional populations (as indigenous and quilombolas) are not yet prioritized in the scientific production about the novel coronavirus. We performed spatial correlation analysis to map the clusters and outliers of COVID-19 in South of Brazil to identify indigenous and quilombolas communities impacted right now in the pandemic. We show that communities located nearby metropolitan areas and mid-sized cities are the most impacted by the COVID-19 and the advance of the transmission to inner states may intensify the ongoing historical process of elimination of indigenous and quilombolas people. We call for a global response to the indigenous and quilombolas situation in Brazil, pointing to the need of more analysis in the country.

RevDate: 2020-09-16

Waterer GW, J Rello (2020)

Steroids and COVID-19: We Need a Precision Approach, Not One Size Fits All.

COVID-19 is a new infectious disease causing severe respiratory failure and death for which optimal treatment is currently unclear. Many therapies have been proven to be ineffective; however, promising findings related to corticosteroid therapy have been published. Analysis of published data including in this issue suggests that therapy with corticosteroids in the range of 6 mg of dexamethasone (or equivalent) per day likely has a positive effect in patients requiring mechanical ventilation but there remains considerable doubt in patients over the age of 70, in patients with diabetes and patients with milder disease. Clinicians must consider the individual potential risks and benefits of corticosteroid in patients with COVID-19 rather than routinely using them until more data is available.

RevDate: 2020-09-16

Foresta C, Rocca MS, A Di Nisio (2020)

Gender susceptibility to COVID-19: a review of the putative role of sex hormones and X chromosome.

Journal of endocrinological investigation pii:10.1007/s40618-020-01383-6 [Epub ahead of print].

BACKGROUND: The recent emergence of COVID-19 poses a global health emergency. One of the most frequently reported data is sex-related severity and mortality: according to the last available analysis on 239,709 patients in Italy, lethality is 17.7% in men and 10.8% in women, with 59% of total deaths being men. Interestingly, the infection rate is lower in males than in females, with 45.8% and 54.2% of positive cases, respectively, suggesting that gender-related factor may worsen disease evolution. A tentative hypothesis to explain these findings is the role of angiotensin-converting enzyme 2 (ACE2) and serine protease TMPRSS2 involved in viral infection.

PURPOSE: In this review, we summarize the available evidence pointing to gender-related differences in ACE2 and TMPRSS2 expression, from both genetic and endocrine points of view.

RESULTS: Altogether, available evidence points toward two not-mutually exclusive mechanisms in gender susceptibility to COVID-19 by sex hormonal regulation of ACE2 and TMPRSS2. On one hand, ACE2 expression could be increased in women, either by estrogens or constitutively by X chromosome inactivation escape or by reduced methylation, providing a larger reservoir of ACE2 to maintain the fundamental equilibrium of RAS regulatory axis. On the other, low levels of androgens in women may keep at low levels TMPRSS2 expression, representing a further protective factor for the development of COVID-19 infection, despite the increased expression of ACE2, which represents the Trojan horse for SARS-CoV-2 entry.

CONCLUSIONS: Both mechanisms consistently point to the role of sex hormones and sex chromosomes in the differential severity and lethality of COVID-19 in men and women.

RevDate: 2020-09-16

Cuschieri S, Balzan M, Gauci C, et al (2020)

Mass Events Trigger Malta's Second Peak After Initial Successful Pandemic Suppression.

Journal of community health pii:10.1007/s10900-020-00925-6 [Epub ahead of print].

The second COVID-19 wave is sweeping the globe as restrictions are lifted. Malta, the 'poster child of Europe's COVID-19 first wave success' also fell victim shortly after it welcomed the first tourists on 1st of July 2020. Only four positive cases were reported over the successive 15 days. Stability was disrupted when two major mass events were organized despite various health professional warnings. In a matter of few just days, daily cases rose to two-digit figures, with high community transmission, a drastic rise in active cases, and a rate per hundred thousand in Europe second only to Spain. Frontliners were swamped with swabbing requests while trying to sustain robust case management, contact tracing and follow-up. Indeed, the number of hospitalizations and the need for intensive ventilation increased. Despite the initial cases were among young adults, within weeks a small spill off on the more elderly population was observed. Restrictions were re-introduced including mandatory mask wearing in specific locations and capping of the total number of people in a single gathering. Malta is an island and the potential for containment would have been relatively simple and effective and permitting mass gatherings was unwise. Protecting the health of the population should take centre stage while carrying out extensive testing, contact tracing and surveillance. Containment and mitigation along with public cooperation is the key to curbing resurgences especially with the influenza season around the corner.

RevDate: 2020-09-16

Sakr Y, Giovini M, Leone M, et al (2020)

Pulmonary embolism in patients with coronavirus disease-2019 (COVID-19) pneumonia: a narrative review.

Annals of intensive care, 10(1):124 pii:10.1186/s13613-020-00741-0.

BACKGROUND: Preliminary reports have described significant procoagulant events in patients with coronavirus disease-2019 (COVID-19), including life-threatening pulmonary embolism (PE).

MAIN TEXT: We review the current data on the epidemiology, the possible underlying pathophysiologic mechanisms, and the therapeutic implications of PE in relation to COVID-19. The incidence of PE is reported to be around 2.6-8.9% of COVID-19 in hospitalized patients and up to one-third of those requiring intensive care unit (ICU) admission, despite standard prophylactic anticoagulation. This may be explained by direct and indirect pathologic consequences of COVID-19, complement activation, cytokine release, endothelial dysfunction, and interactions between different types of blood cells.

CONCLUSION: Thromboprophylaxis should be started in all patients with suspected or confirmed COVID-19 admitted to the hospital. The use of an intermediate therapeutic dose of low molecular weight (LMWH) or unfractionated heparin can be considered on an individual basis in patients with multiple risk factors for venous thromboembolism, including critically ill patients admitted to the ICU. Decisions about extending prophylaxis with LMWH after hospital discharge should be made after balancing the reduced risk of venous thromboembolism (VTE) with the risk of increased bleeding events and should be continued for 7-14 days after hospital discharge or in the pre-hospital phase in case of pre-existing or persisting VTE risk factors. Therapeutic anticoagulation is the cornerstone in the management of patients with PE. Selection of an appropriate agent and correct dosing requires consideration of underlying comorbidities.

RevDate: 2020-09-16

Lazzeri C, Bonizzoli M, Batacchi S, et al (2020)

Echocardiographic assessment of the right ventricle in COVID -related acute respiratory syndrome.

Internal and emergency medicine pii:10.1007/s11739-020-02494-x [Epub ahead of print].

In patients with the novel coronavirus (COVID-19) infection, the echocardiographic assessment of the right ventricle (RV) represents a pivotal element in the understanding of current disease status and in monitoring disease progression. The present manuscript is aimed at specifically describing the echocardiographic assessment of the right ventricle, mainly focusing on the most useful parameters and the time of examination. The RV direct involvement happens quite often due to preferential lung tropism of COVID-19 infection, which is responsible for an interstitial pneumonia characterized also by pulmonary hypoxic vasoconstriction (and thus an RV afterload increase), often evolving in acute respiratory distress syndrome (ARDS). The indirect RV involvement may be due to the systemic inflammatory activation, caused by COVID-19, which may affect the overall cardiovascular system mainly by inducing an increase in troponin values and in the sympathetic tone and altering the volemic status (mainly by affecting renal function). Echocardiographic parameters, specifically focused on RV (dimensions and function) and pulmonary circulation (systolic pulmonary arterial pressures, RV wall thickness), are to be measured in a COVID-19 patient with respiratory failure and ARDS. They have been selected on the basis of their feasibility (that is easy to be measured, even in short time) and usefulness for clinical monitoring. It is advisable to measure the same parameters in the single patient (based also on the availability of valid acoustic windows) which are identified in the first examination and repeated in the following ones, to guarantee a reliable monitoring. Information gained from a clinically-guided echocardiographic assessment holds a clinical utility in the single patients when integrated with biohumoral data (indicating systemic activation), blood gas analysis (reflecting COVID-19-induced lung damage) and data on ongoing therapies (in primis ventilatory settings).

RevDate: 2020-09-16

Cabrera Villegas A, Romero Robles LG, Boulvard Chollet XLE, et al (2020)

[18F]-FDG PET/CT in oncologic patients with unsuspected asymptomatic infection with SARS-CoV-2.

European journal of nuclear medicine and molecular imaging pii:10.1007/s00259-020-04979-5 [Epub ahead of print].

PURPOSE: Spain has been one of the most affected countries by the COVID-19 pandemic, being among the countries with worse numbers, including the death rate. However, most patients are asymptomatic, although they are very contagious. The objective of this study was to investigate the incidence in oncological patients infected with SARS-CoV-2 that are asymptomatic for COVID-19 and at home and that undergo PET/CT for oncologic indications, nonrelated to COVID-19, finding in the PET/CT lung alterations that are suggestive of SARS-CoV-2 infection.

METHODS: During the period of maximum incidence of the global pandemic in one of the most affected regions of Spain, there were 145 patients that met inclusion and exclusion criteria and were included in the study. Imaging findings previously described such as ground-glass opacities with low [18F]-FDG uptake were considered images suspicious for SARS-CoV-2 infection. Patients with these findings were referred to RT-PCR testing and close follow-up to confirm the presence or absence of COVID-19.

RESULTS: Suspicious lung imaging findings were present in 7 of 145 patients (4.8%). Five of these 7 patients were confirmed as presenting SARS-CoV-2 infection, this is, COVID-19. In the remaining two, it was not possible to confirm the presence of COVID-19 with RT-PCR, although in one of them, PET/CT allowed an early diagnosis of a lung infection related to a bacterial pneumonic infection that was promptly and adequately treated with antibiotics.

CONCLUSION: These results confirm that the prevalence of SARS-CoV-2 infection is higher than suspected and that there are asymptomatic patients that are attending imaging departments to be explored for their baseline oncologic processes. In these patients, PET/CT allows an early diagnosis of COVID-19.

RevDate: 2020-09-16

Pfenninger EG, UX Kaisers (2020)

[Provisioning of personal protective equipment in hospitals in preparation for a pandemic].

Der Anaesthesist pii:10.1007/s00101-020-00843-1 [Epub ahead of print].

BACKGROUND: At the beginning of the SARS-CoV‑2 outbreak, personal protective equipment (PPE) was scarce worldwide, leading to the treatment of patients partially without sufficient protection for the medical personnel. In order to be prepared for a new epidemic or pandemic or a "second wave" of COVID-19 outbreak and to meet a renewed deficiency of PPE, considerations were made on how personnel and patients can be better protected by appropriate provisioning.

OBJECTIVE: The aim of this study was to develop a tool to predict the necessary amount of PPE to be in stock at a transregional university hospital for a certain period of time during a pandemic.

MATERIAL AND METHODS: The consumption of PPE needed for every patient was calculated based on the following data of the Ulm University Hospital: the total consumption of healthcare workers' PPE for April 2020 recorded by the materials management department and the number of patients suffering from COVID-19 and their treatment days. From the amount of PPE necessary for every patient in the intensive care unit (ICU) or in an infection ward, a PPE calculator was created in which the estimated amount of PPE can be calculated with the input variables "patients in intensive care unit", "patients in infection ward" and "treatment days". To validate the PPE calculator, the actual consumption of PPE for May 2020 at the Ulm University hospital was compared to the theoretically calculated demand by the PPE calculator.

RESULTS: In April 2020 PPE consisting of 18 different items were kept in stock at Ulm University Hospital and in total 1,995,500 individual items were used. 22 intensive care patients with 257 nursing days and in the infection ward 39 patients with 357 nursing days were treated for COVID-19 disease, leading to a total of 603.2 man-days. A total of 34,550 KN95 masks, 1,558,780 gloves and 1100 goggles or protective visors were used, with a daily average of 49 NK95 masks and 2216 gloves required per ICU patient. In May 2020, 6 ICU patients and 19 patients in infection wards were treated for COVID-19 with 34 nursing days in intensive care and 201 nursing days in infection wards. The use of PPE material was 39% lower than in the previous month but in absolute terms 82% and on average 39% higher than calculated.

CONCLUSION: The developed tool allows our hospital to estimate the necessary amount of PPE to be kept in stock for future pandemics. By taking local conditions into account this tool can also be helpful for other hospitals.

RevDate: 2020-09-16

Akca UK, Kesici S, Ozsurekci Y, et al (2020)

Kawasaki-like disease in children with COVID-19.

Rheumatology international pii:10.1007/s00296-020-04701-6 [Epub ahead of print].

Children with Coronavirus disease 2019 (COVID-19) are being reported to have manifestations of hyperinflammatory states and/or Kawasaki-like disease. In this study, we investigated children with typical and atypical Kawasaki disease (KD) likely to be associated with COVID-19. We have reported four children with Kawasaki-like disease probably associated with COVID-19. The clinical features were consistent with incomplete KD in three patients. SARS-CoV-2 RT-PCR was positive in one and the serology was positive in one patient with negative RT-PCR. Corticosteroids, anakinra, intravenous immunoglobulin (IVIG), and acetylsalicylic acid were used in the treatment. Three patients recovered after the treatment while one patient died. The literature review revealed 36 articles describing 320 children with Kawasaki-like disease associated with COVID-19. SARS-CoV-2 RT-PCR was negative in 120 (65.5%) of 183 patients while the serology was positive in 130 (83.8%) of 155 patients. The therapeutic options have included IVIG, acetylsalicylic acid, tocilizumab, anakinra, enoxaparin, and methylprednisolone. Pediatric COVID-19 cases may present with atypical/incomplete Kawasaki-like disease. Thus, pediatricians need to be aware of such atypical presentations resembling KD for early diagnosis of COVID-19.

RevDate: 2020-09-16

Juprasert JM, Gray KD, Moore MD, et al (2020)

Restructuring of a General Surgery Residency Program in an Epicenter of the Coronavirus Disease 2019 Pandemic: Lessons From New York City.

JAMA surgery, 155(9):870-875.

On March 1, 2020, the first case of coronavirus disease 2019 (COVID-19) was confirmed in New York, New York. Since then, the city has emerged as an epicenter for the ongoing pandemic in the US. To meet the anticipated demand caused by the predicted surge of patients with COVID-19, the Department of Surgery at NewYork-Presbyterian Hospital/Weill Cornell Medicine developed and executed an emergent restructuring of general surgery resident teams and educational infrastructure. The restructuring of surgical services described in this Special Communication details the methodology used to safely deploy the necessary amount of the resident workforce to support pandemic efforts while maintaining staffing for emergency surgical care, limiting unnecessary exposure of residents to infection risk, effectively placing residents in critical care units, and maintaining surgical education and board eligibility for the training program as a whole.

RevDate: 2020-09-16

Prasad M (2020)

On the Frontlines of the Coronavirus Disease 2019 (COVID-19) Crisis-The Many Faces of Leadership.

JAMA cardiology, 5(9):983-984.

RevDate: 2020-09-16

Mehta N, Kalra A, Nowacki AS, et al (2020)

Association of Use of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers With Testing Positive for Coronavirus Disease 2019 (COVID-19).

JAMA cardiology, 5(9):1020-1026.

Importance: The role of angiotensin-converting enzyme inhibitors (ACEI) and angiotensin II receptor blockers (ARB) in the setting of the coronavirus disease 2019 (COVID-19) pandemic is hotly debated. There have been recommendations to discontinue these medications, which are essential in the treatment of several chronic disease conditions, while, in the absence of clinical evidence, professional societies have advocated their continued use.

Objective: To study the association between use of ACEIs/ARBs with the likelihood of testing positive for COVID-19 and to study outcome data in subsets of patients taking ACEIs/ARBs who tested positive with severity of clinical outcomes of COVID-19 (eg, hospitalization, intensive care unit admission, and requirement for mechanical ventilation).

Retrospective cohort study with overlap propensity score weighting was conducted at the Cleveland Clinic Health System in Ohio and Florida. All patients tested for COVID-19 between March 8 and April 12, 2020, were included.

Exposures: History of taking ACEIs or ARBs at the time of COVID-19 testing.

Main Outcomes and Measures: Results of COVID-19 testing in the entire cohort, number of patients requiring hospitalizations, intensive care unit admissions, and mechanical ventilation among those who tested positive.

Results: A total of 18 472 patients tested for COVID-19. The mean (SD) age was 49 (21) years, 7384 (40%) were male, and 12 725 (69%) were white. Of 18 472 patients who underwent COVID-19 testing, 2285 (12.4%) were taking either ACEIs or ARBs. A positive COVID-19 test result was observed in 1735 of 18 472 patients (9.4%). Among patients who tested positive, 421 (24.3%) were admitted to the hospital, 161 (9.3%) were admitted to an intensive care unit, and 111 (6.4%) required mechanical ventilation. Overlap propensity score weighting showed no significant association of ACEI and/or ARB use with COVID-19 test positivity (overlap propensity score-weighted odds ratio, 0.97; 95% CI, 0.81-1.15).

Conclusions and Relevance: This study found no association between ACEI or ARB use and COVID-19 test positivity. These clinical data support current professional society guidelines to not discontinue ACEIs or ARBs in the setting of the COVID-19 pandemic. However, further study in larger numbers of hospitalized patients receiving ACEI and ARB therapy is needed to determine the association with clinical measures of COVID-19 severity.

RevDate: 2020-09-16

Fan Y, Guo T, Z Lu (2020)

Myocardial Injury in COVID-19-Can We Successfully Target Inflammation?-Reply.

JAMA cardiology, 5(9):1070-1071.

RevDate: 2020-09-16

Giannopoulos G, Vrachatis DA, SG Deftereos (2020)

Myocardial Injury in COVID-19-Can We Successfully Target Inflammation?.

JAMA cardiology, 5(9):1069-1070.

RevDate: 2020-09-16

Bessière F, Roccia H, Delinière A, et al (2020)

Assessment of QT Intervals in a Case Series of Patients With Coronavirus Disease 2019 (COVID-19) Infection Treated With Hydroxychloroquine Alone or in Combination With Azithromycin in an Intensive Care Unit.

JAMA cardiology, 5(9):1067-1069.

RevDate: 2020-09-16

Thomas LE, Bonow RO, MJ Pencina (2020)

Understanding Observational Treatment Comparisons in the Setting of Coronavirus Disease 2019 (COVID-19).

JAMA cardiology, 5(9):988-990.

RevDate: 2020-09-16

DeFilippis EM, Sinnenberg L, Reza N, et al (2020)

Trends in US Heart Transplant Waitlist Activity and Volume During the Coronavirus Disease 2019 (COVID-19) Pandemic.

JAMA cardiology, 5(9):1048-1052.

Importance: Solid organ transplants have declined significantly during the coronavirus disease (COVID-19) pandemic in the US. Limited data exist regarding changes in heart transplant (HT).

Objective: To describe national and regional trends in waitlist inactivations, waitlist additions, donor recovery, and HT volume during COVID-19.

This descriptive cross-sectional study used publicly available data from the United Network for Organ Sharing and US Centers for Disease Control and Prevention, using 8 prespecified United Network for Organ Sharing regions. Adult (18 years or older) HT candidates listed and deceased donors recovered between January 19 to May 9, 2020.

Exposures: COVID-19 pandemic.

Main Outcomes and Measures: Changes in waitlist inactivations, waitlist additions, deceased donor recovery, and transplant volumes from the pre-COVID-19 (January 19-March 15, 2020) to the COVID-19 era (March 15-May 9, 2020). Density mapping and linear regression with interrupted time series analysis were used to characterize changes over time and changes by region.

Results: During the COVID-19 era, there were 600 waitlist inactivations compared with 343 during the pre-COVID era (75% increase). Waitlist additions decreased from 637 to 395 (37% reduction). These changes were most profound in the Northeast and Great Lakes regions with high rates of COVID-19. Deceased donor recovery decreased by 26% from 1878 to 1395; the most significant decrease occurred in the North Midwest despite low COVID-19 prevalence. Heart transplant volumes were significantly reduced across all regions except the Northwest. The largest decrease was seen in the Northeast where COVID-19 case rates were highest. From the pre-COVID-19 era to the COVID-19 era, there was significant regional variation in waitlist additions (eg, 69% decrease in the Northeast vs 8.5% increase in the South Midwest; P < .001) and deceased donor recovery (eg, 41% decrease in North Midwest vs 16% decrease in South Midwest; P = .02).

Conclusions and Relevance: Heart transplant volumes have been significantly reduced in recent months, even in regions with a lower prevalence of COVID-19 cases. This has been accompanied by increased waitlist inactivations, decreased waitlist additions, and decreased donor recovery. Future studies are needed to determine if the COVID-19 pandemic is associated with changes in waitlist mortality.

RevDate: 2020-09-16

Mercuro NJ, Yen CF, Shim DJ, et al (2020)

Risk of QT Interval Prolongation Associated With Use of Hydroxychloroquine With or Without Concomitant Azithromycin Among Hospitalized Patients Testing Positive for Coronavirus Disease 2019 (COVID-19).

JAMA cardiology, 5(9):1036-1041.

Importance: Administration of hydroxychloroquine with or without azithromycin for the treatment of coronavirus disease 2019 (COVID-19)-associated pneumonia carries increased risk of corrected QT (QTc) prolongation and cardiac arrhythmias.

Objective: To characterize the risk and degree of QT prolongation in patients with COVID-19 in association with their use of hydroxychloroquine with or without concomitant azithromycin.

This was a cohort study performed at an academic tertiary care center in Boston, Massachusetts, of patients hospitalized with at least 1 positive COVID-19 nasopharyngeal polymerase chain reaction test result and clinical findings consistent with pneumonia who received at least 1 day of hydroxychloroquine from March 1, 2020, through April 7, 2020.

Main Outcomes and Measures: Change in QT interval after receiving hydroxychloroquine with or without azithromycin; occurrence of other potential adverse drug events.

Results: Among 90 patients given hydroxychloroquine, 53 received concomitant azithromycin; 44 (48.9%) were female, and the mean (SD) body mass index was 31.5 (6.6). Hypertension (in 48 patients [53.3%]) and diabetes mellitus (in 26 patients [28.9%]) were the most common comorbid conditions. The overall median (interquartile range) baseline QTc was 455 (430-474) milliseconds (hydroxychloroquine, 473 [454-487] milliseconds vs hydroxychloroquine and azithromycin, 442 [427-461] milliseconds; P < .001). Those receiving concomitant azithromycin had a greater median (interquartile range) change in QT interval (23 [10-40] milliseconds) compared with those receiving hydroxychloroquine alone (5.5 [-15.5 to 34.25] milliseconds; P = .03). Seven patients (19%) who received hydroxychloroquine monotherapy developed prolonged QTc of 500 milliseconds or more, and 3 patients (8%) had a change in QTc of 60 milliseconds or more. Of those who received concomitant azithromycin, 11 of 53 (21%) had prolonged QTc of 500 milliseconds or more and 7 of 53 (13 %) had a change in QTc of 60 milliseconds or more. The likelihood of prolonged QTc was greater in those who received concomitant loop diuretics (adjusted odds ratio, 3.38 [95% CI, 1.03-11.08]) or had a baseline QTc of 450 milliseconds or more (adjusted odds ratio, 7.11 [95% CI, 1.75-28.87]). Ten patients had hydroxychloroquine discontinued early because of potential adverse drug events, including intractable nausea, hypoglycemia, and 1 case of torsades de pointes.

Conclusions and Relevance: In this cohort study, patients who received hydroxychloroquine for the treatment of pneumonia associated with COVID-19 were at high risk of QTc prolongation, and concurrent treatment with azithromycin was associated with greater changes in QTc. Clinicians should carefully weigh risks and benefits if considering hydroxychloroquine and azithromycin, with close monitoring of QTc and concomitant medication usage.

RevDate: 2020-09-16

Hoehl S, Karaca O, Kohmer N, et al (2020)

Assessment of SARS-CoV-2 Transmission on an International Flight and Among a Tourist Group.

JAMA network open, 3(8):e2018044 pii:2770746.

RevDate: 2020-09-16

Abbasi J (2020)

The Science of Persuasion Offers Lessons for COVID-19 Prevention.

JAMA pii:2770888 [Epub ahead of print].

RevDate: 2020-09-16

Rubin R (2020)

Investigating Whether Blood Type Is Linked to COVID-19 Risk.

JAMA pii:2770889 [Epub ahead of print].

RevDate: 2020-09-16

Nuzzo JB, Bell JA, EE Cameron (2020)

Suboptimal US Response to COVID-19 Despite Robust Capabilities and Resources.

JAMA pii:2770891 [Epub ahead of print].

RevDate: 2020-09-16

Zeng W, Wang X, Li J, et al (2020)

Association of Daily Wear of Eyeglasses With Susceptibility to Coronavirus Disease 2019 Infection.

JAMA ophthalmology pii:2770872 [Epub ahead of print].

Importance: The proportion of daily wearers of eyeglasses among patients with coronavirus disease 2019 (COVID-19) is small, and the association between daily wear of eyeglasses and COVID-19 susceptibility has not been reported.

Objective: To study the association between the daily wearing of eyeglasses and the susceptibility to COVID-19.

This cohort study enrolled all inpatients with COVID-19 in Suizhou Zengdu Hospital, Suizhou, China, a designated hospital for COVID-19 treatment in the area, from January 27 to March 13, 2020. COVID-19 was diagnosed according to the fifth edition of Chinese COVID-19 diagnostic guidelines. The proportion of persons with myopia who wore eyeglasses in Hubei province was based on data from a previous study.

Exposures: Daily wearing of eyeglasses for more than 8 hours.

Main Outcomes and Measures: The main outcomes were the proportions of daily wearers of eyeglasses among patients admitted to the hospital with COVID-19 and among the local population. Data on exposure history, clinical symptoms, underlying diseases, duration of wearing glasses, and myopia status and the proportion of people with myopia who wore eyeglasses in Hubei province were collected. People who wore glasses for more than 8 hours a day were defined as long-term wearers.

Results: A total of 276 patients with COVID-19 were enrolled. Of these, 155 (56.2%) were male, and the median age was 51 (interquartile range, 41-58) years. All those who wore glasses for more than 8 hours a day had myopia and included 16 of 276 patients (5.8%; 95% CI, 3.04%-8.55%). The proportion of people with myopia in Hubei province, based on a previous study, was 31.5%, which was much higher than the proportion of patients with COVID-19 who had myopia in this sample.

Conclusions and Relevance: In this cohort study of patients hospitalized with COVID-19 in Suizhou, China, the proportion of inpatients with COVID-19 who wore glasses for extended daily periods (>8 h/d) was smaller than that in the general population, suggesting that daily wearers of eyeglasses may be less susceptible to COVID-19.

RevDate: 2020-09-16

Michaels D, GR Wagner (2020)

Occupational Safety and Health Administration (OSHA) and Worker Safety During the COVID-19 Pandemic.

JAMA pii:2770890 [Epub ahead of print].

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In the early 1990's, Robert Robbins was a faculty member at Johns Hopkins, where he directed the informatics core of GDB — the human gene-mapping database of the international human genome project. To share papers with colleagues around the world, he set up a small paper-sharing section on his personal web page. This small project evolved into The Electronic Scholarly Publishing Project.

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