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Bibliography on: covid-19

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ESP: PubMed Auto Bibliography 27 Nov 2020 at 01:37 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 75260 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: 2020-11-26

Abduljabbar T, Alhamdan RS, Al Deeb M, et al (2020)

Association of Salivary Content Alteration and Early Ageusia Symptoms in COVID-19 Infections: A Systemic Review.

European journal of dentistry [Epub ahead of print].

Coronavirus disease (COVID-19) is a major threat to the health and prosperity of human life at present. It has resulted in loss of thousands of lives globally and has brought countries to the brink of economic, social, and health collapse. A major issue of this infection is the ease with which it transmits through salivary droplets and its survival for long durations outside the body. Therefore, its early detection is critical in prevention, diagnostic, and management efforts of COVID-19 patients. Loss of taste and smell is one of the early symptoms reported in these patients and the virus is abundantly found in the salivary secretion of the infected symptomatic and asymptomatic patients. Infection and inflammation of salivary glands are common among viral infections, particularly in the early stages, which lead to salivary composition changes. Chemosensory sensation of taste is critically dependent on the salivary flow rate and its inorganic constituents, protein levels, specific 3',5'-cyclic adenosine monophosphate and 3',5'-cyclic guanosine monophosphate levels, ghrelins, pH levels, and enzymes. Therefore, the question arises, "Does COVID-19 infection alter the salivary components and composition leading to early transient symptoms of Ageusia and hypogeusia?" This review shows association of the COVID-19 and Ageusia, in addition to the early viral infection of salivary glands and possible changes in salivary flow and content. Therefore, suggesting a potential association between early ageusia in COVID-19 infection and salivary compositional changes.

RevDate: 2020-11-26

Lal A, Sanaullah A, M Saleem MK, et al (2020)

Psychological Distress among Adults in Home Confinement in the Midst of COVID-19 Outbreak.

European journal of dentistry [Epub ahead of print].

OBJECTIVES: The aim of this study was to evaluate psychological distress caused by the novel coronavirus disease 2019 (COVID-19) pandemic among the adult population residing in Pakistan.

MATERIALS AND METHODS: This cross-sectional survey-based study comprised 1,000 adults residing in Pakistan. A questionnaire was formulated and circulated among adult population of Pakistan, the depression and anxiety symptoms using Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) scales were assessed.

STATISTICAL ANALYSIS: Independent t-test, cross tabulation, and regression analysis were used to identify variables having impact on PHQ-9 and GAD-7 scores. A p-value of ≤ 0.05 was considered statistically significant.

RESULTS: Among 1,000 participants, 573 were males and 427 were females who completed the survey. Majority were restricted to home for more than 40 days. Considerable number of participants reported depressive (540, 54%) and anxiety (480, 48%) symptoms. Gender, age, earnings, and occupation have significant relation with psychological distress, although similar was not found with education levels.

CONCLUSION: Psychological distress, a concerning yet addressable issue was found among adults arising amid COVID-19 outbreak. Currently, physical health effects of COVID-19 are being looked, while mental health effects being under-addressed. This issue should be addressed to avoid any psychological impact in future.

RevDate: 2020-11-26

Mujayanto R, R Indraswary (2020)

Differential Diagnosis of COVID-19 Enanthema.

European journal of dentistry [Epub ahead of print].

RevDate: 2020-11-26

Lommatzsch M, Rabe KF, Taube C, et al (2020)

[Risk Assessment for Patients with Chronic Respiratory and Pulmonary Conditions in the Context of the SARS-CoV-2 Pandemic - Statement of the German Respiratory Society (DGP) with the Support of the German Association of Respiratory Physicians (BdP)].

Pneumologie (Stuttgart, Germany) [Epub ahead of print].

RevDate: 2020-11-26

Pivonello R, Auriemma RS, Pivonello C, et al (2020)

SEX DISPARITIES IN COVID-19 SEVERITY AND OUTCOME: ARE MEN WEAKER OR WOMEN STRONGER?.

Neuroendocrinology pii:000513346 [Epub ahead of print].

The COVID-19 outbreak is a global public health issue, having profound effects on most aspects of societal well-being, including physical and mental health. A plethora of studies, globally, have suggested the existence of a sex disparity in the outcome of COVID-19 patients, that is mainly due to mechanisms of viral infection, immune response to the virus, development of a hyperinflammation, and development of systemic complications, particularly thromboembolism. These differences appear to be more pronounced in elderly COVID-19 patients. Epidemiological data report a sex difference in the severity and outcome of COVID-19 disease with a more favourable course of the disease in women compared to men, regardless of age range although the rate of SARS-CoV-2 infection seems to be similar in both sexes. Sex hormones, including androgens and estrogens, may not only impact viral entry and load, but also shape the clinical manifestations, complications and, ultimately, the outcome of COVID-19 disease. The current review comprehensively summarizes current literature on sex disparities in susceptibility and outcomes of COVID-19 disease as well as the literature underpinning the pathophysiological and molecular mechanisms, which may provide a rationale to a sex disparity. These include sex hormone influences on molecules that facilitate virus entry and priming, as well as the immune and inflammatory response, as well as coagulation and thrombosis diathesis. Based on present evidence, women appear to be relatively protected from COVID-19 because of a more effective immune response and a less pronounced systemic inflammation, with consequent moderate clinical manifestations of the disease, together with a lesser predisposition to thromboembolism. Conversely, men appear to be particularly susceptible to COVID-19 disease because of a less effective immune response with consequent increased susceptibility to infections, together with a greater predisposition to thromboembolism. In elderlies, sex disparities in overall mortality following SARS-CoV-2 infection is even more palpable, as elderly men appear more prone to severe COVID-19 because of a greater predisposition to infections, a weaker immune defence and an enhanced thrombotic state compared to women. The review highlights potential novel therapeutic approaches employing the administration of hormonal or anti-hormonal therapy in combination with antiviral drugs in COVID-19 patients.

RevDate: 2020-11-26

Kang C, Meng F, Feng Q, et al (2020)

Implementation of quarantine in China during the outbreak of COVID-19.

RevDate: 2020-11-26

Arafat SMY, Alradie-Mohamed A, Kar SK, et al (2020)

Does COVID-19 pandemic affect sexual behaviour? A cross-sectional, cross-national online survey.

RevDate: 2020-11-26

Meng H, Xu Y, Dai J, et al (2020)

Analyze the psychological impact of COVID-19 among the elderly population in China and make corresponding suggestions.

RevDate: 2020-11-26

Dixit A, Marthoenis M, Arafat SMY, et al (2020)

Binge watching behavior during COVID 19 pandemic: A cross-sectional, cross-national online survey.

RevDate: 2020-11-26

Arafat SMY, Kar SK, Marthoenis M, et al (2020)

Psychological underpinning of panic buying during pandemic (COVID-19).

RevDate: 2020-11-26

Tay YH, Lim L, Cheng A, et al (2020)

Disrupting the disruption: Using digital tools to support psychiatry residency training in Singapore during the COVID-19 pandemic.

RevDate: 2020-11-26

Vecchio S, Ramella R, Drago A, et al (2020)

COVID19 pandemic and people with opioid use disorder: innovation to reduce risk.

Psychiatry research, 289:113047 pii:S0165-1781(20)31027-1 [Epub ahead of print].

The Covid-19 pandemic is creating a vast and growing number of challenges for all. People with a history of opioid use disorder (OUD) also may be exposed to additional risks. Piedmont one of the areas most severely affected by the Covid-19 pandemic, with large numbers of people infected and related mortality. In the region, specialists responsible for OUD care identified the risk that the existing care system exposed patients to. Teams designed and implemented innovation approaches to enable continuation of care and reduce the inherent system risk to patients with OUD.

RevDate: 2020-11-26

Ornell F, Moura HF, Scherer JN, et al (2020)

The COVID-19 pandemic and its impact on substance use: Implications for prevention and treatment.

The COVID-19 pandemic has brought major challenges to healthcare systems and public health policies globally, as it requires novel treatment and prevention strategies to adapt for the impact of the pandemic. Individuals with substance user disorders (SUD) are at risk population for contamination due to multiple factors-attributable to their clinical, psychological and psychosocial conditions. Moreover, social and economic changes caused by the pandemic, along with the traditional difficulties regarding treatment access and adherence-will certainly worsen during this period, therefore aggravate their condition. In addition, this population are potential vectors of transmission. In that sense, specific strategies for prevention and treatment must be discussed. health care professionals dealing with SUD must be aware of the risks and challenges they will meet during and after the COVID-19 outbreak. Addiction care must be reinforced, instead of postponed, in order to avoid complications of both SUD and COVID-19 and to prevent the transmission of coronavirus.

RevDate: 2020-11-26

Yang H, J Ma (2020)

How an Epidemic Outbreak Impacts Happiness: Factors that Worsen (vs. Protect) Emotional Well-being during the Coronavirus Pandemic.

Psychiatry research, 289:113045 pii:S0165-1781(20)30990-2 [Epub ahead of print].

What are the factors that worsen (vs. protect) emotional well-being during a pandemic outbreak such as COVID-19? Through two large-scale nationwide surveys (N1 = 11,131; N2 = 3,000) conducted in China immediately before versus during the coronavirus outbreak, we found that the onset of the coronavirus epidemic led to a 74% drop in overall emotional well-being. Factors associated with the likelihood of contracting the disease (e.g., residing near the epicenter), extent of potential harm (e.g., being an elderly), and relational issues (e.g., those within a marriage) exacerbated the detrimental effect of the outbreak on emotional well-being. Further, individuals' perception of their knowledge about coronavirus infection was another factor. Regardless of the actual amount of knowledge they possessed, those perceiving themselves as more knowledgeable, were able to experience more happiness during the outbreak. Higher perceived knowledge was associated with a stronger sense of control, which mediated the differences in emotional well-being. These patterns persisted even after controlling for a host of demographic and economic variables. In conclusion, public policies and mental health interventions aimed at boosting/protecting psychological well-being during epidemics should take account of these factors.

RevDate: 2020-11-26

Bojdani E, Rajagopalan A, Chen A, et al (2020)

COVID-19 Pandemic: Impact on psychiatric care in the United States.

Psychiatry research, 289:113069 pii:S0165-1781(20)31226-9 [Epub ahead of print].

The World Health Organization declared the coronavirus outbreak a pandemic on March 11, 2020. Infection by the SARS-CoV2 virus leads to the COVID-19 disease which can be fatal, especially in older patients with medical co-morbidities. The impact to the US healthcare system has been disruptive, and the way healthcare services are provided has changed drastically. Here, we present a compilation of the impact of the COVID-19 pandemic on psychiatric care in the US, in the various settings: outpatient, emergency room, inpatient units, consultation services, and the community. We further present effects seen on psychiatric physicians in the setting of new and constantly evolving protocols where adjustment and flexibility have become the norm, training of residents, leading a team of professionals with different expertise, conducting clinical research, and ethical considerations. The purpose of this paper is to provide examples of "how to" processes based on our current front-line experiences and research to practicing psychiatrists and mental health clinicians, inform practitioners about national guidelines affecting psychiatric care during the pandemic, and inform health care policy makers and health care systems about the challenges and continued needs of financial and administrative support for psychiatric physicians and mental health systems.

RevDate: 2020-11-26

Daniel HH, AE Begoña (2020)

Access barriers to electroconvulsive therapy during COVID-19 pandemic.

RevDate: 2020-11-26

Mazza M, Marano G, Lai C, et al (2020)

Danger in danger: Interpersonal violence during COVID-19 quarantine.

Psychiatry research, 289:113046 pii:S0165-1781(20)30912-4 [Epub ahead of print].

BACKGROUND: Intimate partner violence (IPV) is defined as physical or sexual violence, emotional abuse and stalking. It is typically experienced by women but can also be experienced by men. During quarantine due to the COVID-19, home risks to become a very dangerous place for victims of domestic violence.

METHOD: Very recent studies focusing on abusive situations during COVID emergence were identified in PubMed/Medline, Scopus, Embase.

RESULTS: During the COVID-19 outbreak people have encountered an invisible and dark enemy and an experience of impotence. Due to the feelings of frustration and agitation, aggression arises with possible transgenerational transmission of trauma and violence.

CONCLUSIONS: Especially during quarantine and COVID emergence around the world there is a need of programs aimed to prevent acts of domestic violence and to achieve accurate assessment of multiple domains of abuse (psychological, physical, sexual) provided by trained multidisciplinary staffs (including psychiatrists, psychologists, social and legal services).

RevDate: 2020-11-26

Zgueb Y, Bourgou S, Neffeti A, et al (2020)

Psychological crisis intervention response to the COVID 19 pandemic: A Tunisian centralised Protocol.

Psychiatry research, 289:113042 pii:S0165-1781(20)31056-8 [Epub ahead of print].

In order to manage the urgent psychological need for support in response to the anticipated reaction of the population to the COVID-19 pandemic, we developed a new psychological crisis intervention model by implementing a centralised psychological support system for all of Tunisia. We set up a helpline which is accessible throughout the country, including those without access to Internet. This model integrates medical students, child and adolescent psychiatrists, psychiatrists, psychologists and social services to provide psychological intervention to the general population and medical staff. It will make a sound basis for developing a more effective psychological crisis intervention response system.

RevDate: 2020-11-26

Griffiths MD, MA Mamun (2020)

COVID-19 suicidal behavior among couples and suicide pacts: Case study evidence from press reports.

RevDate: 2020-11-26

Bilal , Latif F, Bashir MF, et al (2020)

Role of electronic media in mitigating the psychological impacts of novel coronavirus (COVID-19).

The current research initiative focuses on the role of Pakistani media in eliminating panic and depression among health practitioners and the general public due to the outbreak of novel coronavirus (COVID-19). In Pakistan, electronic media is the most common source of information due to the higher rural population and the lower literacy rate and media's handling of COVID-19 coverage so far creates panic and depression. We suggest that special televised transmissions featuring psychologists and physiatrists should be aired to reduce the panic. Media also mitigates the stress of frontline medical staff by paying special attributes to them.

RevDate: 2020-11-26

Mukhtar S, W Rana (2020)

COVID-19 and individuals with mental illness in psychiatric facilities.

RevDate: 2020-11-26

Tamiolaki A, AE Kalaitzaki (2020)

"That which does not kill us, makes us stronger": COVID-19 and Posttraumatic Growth.

RevDate: 2020-11-26

Rajkumar RP (2020)

Contamination and infection: What the coronavirus pandemic could reveal about the evolutionary origins of obsessive-compulsive disorder.

RevDate: 2020-11-26

Voitsidis P, Gliatas I, Bairachtari V, et al (2020)

Insomnia during the COVID-19 pandemic in a Greek population.

Insomnia is a major health issue associated with great psychological burden. Research of insomnia during a pandemic crisis is limited. The aim of the present study was to explore sleep difficulties during the COVID-19 pandemic in a Greek population. The three-day online survey included questions about sociodemographic characteristics, contact with COVID-19 and COVID-19-related negative attitudes, as well as the Athens Insomnia Scale (AIS), the Intolerance to Uncertainty scale (IUS), the De Jong Gierveld Loneliness scale (JGLS) and the Patient Health Questionnaire-2 (PHQ-2) Depression Scale. Altogether, 2,427 individuals participated in the study (with 2,363 of them providing all basic demographic data). Sleep problems were detected in 37.6% of the participants. Women and people in urban areas were more vulnerable to sleep problems, while younger age showed a non-significant trend. Those uncertain about having themselves, or someone close to them contracted the virus, also demonstrated elevated insomnia scores. Lastly, according to the regression analysis, higher levels of intolerance to uncertainty, COVID-19-related worry, loneliness, as well as more severe depressive symptoms, were all predictive of insomnia. Results may be used for the development of therapeutic strategies and implementation of social policies to support people with sleep difficulties.

RevDate: 2020-11-26

Júnior JG, Moreira MM, Pinheiro WR, et al (2020)

The mental health of those whose rights have been taken away: An essay on the mental health of indigenous peoples in the face of the 2019 Coronavirus (2019-nCoV) outbreak.

BACKGROUND: In Latin America there are about 45 million indigenous people in 826 communities that represent 8.3% of the population. An estimated 798,365 Aboriginal and Torres Strait Islander were in Australia, 5,2 million indigenous people living in America and 2,13 million in Canada. Racial/ethnic disparities in mental health service use have increased especially in the context of the new coronavirus pandemic. Thus, we aimed to describe the mental health situation of the indigenous population in the context of the COVID-19 pandemic METHOD: : The studies were identified in well-known international journals found in three electronic databases: PubMed, Scopus, and MEDLINE. The data were cross-checked with information from the main international newspapers.

RESULTS: According to the literature, due to the COVID-19 pandemic there is a lack of specialized mental health services and professionals, a restricted access to quality information and a lack of access to inputs, causing negative feelings and it can exacerbate pre-existing mental problems (eg: depression, suicidal ideation, smoking and binge drink). The cultural differences are a risk factor to worsen the mental health of this already vulnerable population.

CONCLUSION: providing psychological first aid is an essential care component for indigenous populations that have been victims COVID-19 pandemic.

RevDate: 2020-11-26

Mediavilla R, Fernández-Jiménez E, Rodríguez-Vega B, et al (2020)

Adapting mental health care after the COVID-19 outbreak: Preliminary findings from a public general hospital in Madrid (Spain).

RevDate: 2020-11-26

Cao Y, Wu H, Zhai W, et al (2020)

A safety consideration of mesenchymal stem cell therapy on COVID-19.

Stem cell research, 49:102066 pii:S1873-5061(20)30367-6 [Epub ahead of print].

Due to the multi-potential differentiation and immunomodulatory function, mesenchymal stem cells (MSCs) have been widely used in the therapy of chronic and autoimmune diseases. Recently, the novel coronavirus disease 2019 (COVID-19) has grown to be a global public health emergency but no effective drug is available to date. Several studies investigated MSCs therapy for COVID-19 patients. However, it remains unclear whether MSCs could be the host cells of SARS-CoV-2 (severe acute respiratory syndrome coronavirus-2) and whether they might affect the SARS-CoV-2 entry into other cells. Here, we report that human MSCs barely express ACE2 and TMPRSS2, two receptors required for the virus endocytosis, indicating that MSCs are free from SARS-CoV-2 infection. Furthermore, we observed that MSCs were unable to induce the expression of ACE2 and TMPRSS2 in epithelial cells and macrophages. Importantly, under different inflammatory challenge conditions, implanted human MSCs failed to up-regulate the expression of ACE2 and TMPRSS2 in the lung tissues of mice. Intriguingly, we showed that a SARS-CoV-2 pseudovirus failed to infect MSCs and co-cultured MSCs did not increase the risk of SARS-CoV-2 pseudovirus infection in epithelial cells. All these results suggest that human MSCs have no risk of assisting SARS-CoV-2 infection and the use of MSCs as the therapy for COVID-19 patients is feasible and safe.

RevDate: 2020-11-26

Trivisano M, Specchio N, Pietrafusa N, et al (2020)

Impact of COVID-19 pandemic on pediatric patients with epilepsy - The caregiver perspective.

Epilepsy & behavior : E&B, 113:107527 pii:S1525-5050(20)30707-1 [Epub ahead of print].

The recent COVID-19 pandemic has disrupted care systems around the world. We assessed how the COVID-19 pandemic affected children with epilepsy in Italy, where lockdown measures were applied from March 8 to May 4, 2020. We compiled an Italian-language online survey on changes to healthcare and views on telehealth. Invitations were sent to 6631 contacts of all patients diagnosed with epilepsy within the last 5 years at the BambinoGesù Children's Hospital in Rome. Of the 3321 responses received, 55.6% of patients were seizure-free for at least 1 year before the COVID-19-related lockdown, 74.4% used anti-seizure medications (ASMs), and 59.7% had intellectual disability. Only 10 patients (0.4%) became infected with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Seizure frequency remained stable for most patients during the lockdown period (increased in 13.2%; decreased in 20.3%), and seizure duration, use of rescue medications, and adherence to treatment were unchanged. Comorbidities were more affected (behavioral problems worsened in 35.8%; sleep disorder worsened in 17.0%). Visits were canceled/postponed for 41.0%, but 25.1% had remote consultation during the lockdown period (93.9% were satisfied). Most responders (67.2%) considered continued remote consultations advantageous. Our responses support that patients/caregivers are willing to embrace telemedicine for some scenarios.

RevDate: 2020-11-26

Gupta M, Bansal A, Jain B, et al (2020)

Whether the weather will help us weather the COVID-19 pandemic: Using machine learning to measure twitter users' perceptions.

International journal of medical informatics, 145:104340 pii:S1386-5056(20)31582-3 [Epub ahead of print].

OBJECTIVE: The potential ability for weather to affect SARS-CoV-2 transmission has been an area of controversial discussion during the COVID-19 pandemic. Individuals' perceptions of the impact of weather can inform their adherence to public health guidelines; however, there is no measure of their perceptions. We quantified Twitter users' perceptions of the effect of weather and analyzed how they evolved with respect to real-world events and time.

MATERIALS AND METHODS: We collected 166,005 English tweets posted between January 23 and June 22, 2020 and employed machine learning/natural language processing techniques to filter for relevant tweets, classify them by the type of effect they claimed, and identify topics of discussion.

RESULTS: We identified 28,555 relevant tweets and estimate that 40.4 % indicate uncertainty about weather's impact, 33.5 % indicate no effect, and 26.1 % indicate some effect. We tracked changes in these proportions over time. Topic modeling revealed major latent areas of discussion.

DISCUSSION: There is no consensus among the public for weather's potential impact. Earlier months were characterized by tweets that were uncertain of weather's effect or claimed no effect; later, the portion of tweets claiming some effect of weather increased. Tweets claiming no effect of weather comprised the largest class by June. Major topics of discussion included comparisons to influenza's seasonality, President Trump's comments on weather's effect, and social distancing.

CONCLUSION: We exhibit a research approach that is effective in measuring population perceptions and identifying misconceptions, which can inform public health communications.

RevDate: 2020-11-26

Caradec E, Mouren D, Zrounba M, et al (2020)

COVID-19 in a patient with idiopathic pulmonary fibrosis successfully treated with Ruxolitinib.

RevDate: 2020-11-26

Seehuus M, Stanton AM, Handy AB, et al (2020)

Impact of COVID-19 predicts perceived risk more strongly than known demographic risk factors.

Journal of psychosomatic research, 140:110299 pii:S0022-3999(20)30861-8 [Epub ahead of print].

OBJECTIVE: To identify the factors associated with perceived COVID-19 risk among people living in the US.

METHODS: A cross-sectional representative sample of 485 US residents was collected in mid-April 2020. Participants were asked about (a) perceptions of COVID-19 risk, (b) demographic factors known to be associated with increased COVID-19 risk, and (c) the impact of COVID-19 on different life domains. We used a three-step hierarchical linear regression model to assess the differential contribution of the factors listed above on perceived COVID-19 risk.

RESULTS: The final model accounted for 16% of variability in perceived risk, F(18,458) = 4.8, p < .001. Participants who were White reported twice as much perceived risk as participants of color (B = -2.1, 95% CI[-3.4,-0.8]. Higher perceived risk was observed among those who reported a negative impact of the pandemic on their sleep (B = 1.5, 95% CI[0.8,2.1]) or work (B = 0.7, 95%CI[0.1,1.3]). The number of cases per capita in their state of residence, age, or proximity to someone with a COVID-19 diagnosis were not found to meaningfully predict perceived risk.

CONCLUSIONS: Perceived risk was not found to be associated with known demographic risk factors, except that the effect of race/ethnicity was in the opposite direction of existing evidence. Perception of COVID-19 risk was associated with the perceived personal impact of the pandemic.

RevDate: 2020-11-26

Barbieri L, Galli F, Conconi B, et al (2020)

Takotsubo syndrome in COVID-19 era: Is psychological distress the key?.

Journal of psychosomatic research, 140:110297 pii:S0022-3999(20)30859-X [Epub ahead of print].

Covid-19 pandemic, starting from Wuhan, China spread all over the world and Italy was one of the most affected countries, especially in Lombardy, where, on February 20, the first confirmed case was detected. Italian Government ordered a national lockdown on the 9 th March 2020, forcing the population to severe restrictive isolation measures. The burden on mental health of the medical emergency related to COVID19 is progressively been revealed. Takotsubo syndrome (TTS), is estimated to represent 1-3% of patients admitted with suspected STEMI, mostly affecting elderly women with emotional stress and/or acute illness preceding the presentation. Comparing patients hospitalised from February to May 2020 with those of the corresponding period in 2019 we observed a significantly increased number of TTS diagnosis in 2020 (11 patients vs 3 in 2019), especially during the first period of lockdown. The only two males were patients with COVID-19 and were the only two who died in hospital. At psychological examination all patients enrolled report to have lived a particularly stressful experience at IES-R in the last year, without presenting the symptoms of a post-traumatic stress disorder. Most patients were positive to the allostatic overload. Only one patient showed a clinical cut-off for HADS and no one for the Fear COVID-19 scale. We finally concluded that subjects with pre-pandemic psychological distress may have experienced additional psychological overload, opening the door to TTS by a series of physiological alterations as the secretion of cortisol and catecholamines, making the subject more vulnerable to the onset of TTS.

RevDate: 2020-11-26

Montrucchio G, Corcione S, Sales G, et al (2020)

Carbapenem resistant Klebsiella pneumoniae in ICU-admitted COVID-19 Patients: Keep an eye on the ball.

Journal of global antimicrobial resistance pii:S2213-7165(20)30292-7 [Epub ahead of print].

We report the cases of 7 ICU patients with COVID-19 related ARDS, who developed positive rectal swab and invasive infections due to CP-Kp. Notwithstanding the infection prevention measures introduced during COVID-19 pandemic and the changes in the hospitalized population, attention to CP-Kp infections must remain high, especially in critically ill setting.

RevDate: 2020-11-26

Griffin DO, Jensen A, Khan M, et al (2020)

Cytokine storm of a different flavor: the different cytokine signature of SARS-CoV2 the cause of COVID-19 from the original SARS outbreak.

Journal of global antimicrobial resistance pii:S2213-7165(20)30291-5 [Epub ahead of print].

We present a case series of three patients with COVID-19 who had a cytokine panel which revealed elevation of interleukin-6 (IL-6), but normal levels of interleukin-10 (IL-10), interferon-gamma (INF-γ) and interleukin-8 (IL-8) in contrast to the cytokine signature described in Severe Acute Respiratory Syndrome (SARS) and Middle Eastern Respiratory Syndrome (MERS). We also documented evidence of a compromised T-cell IFN-gamma response in two of these patients.

RevDate: 2020-11-26

Ceraudo M, Balestrino A, Cama A, et al (2020)

Pediatric neurosurgery after the COVID-19 pandemic: management strategies from a single pediatric hospital in Italy.

World neurosurgery pii:S1878-8750(20)32463-3 [Epub ahead of print].

BACKGROUND: COVID-19 pandemic had a great impact over all elective neurosurgical activity and important implications in management of neurosurgical urgencies. During the pandemic, some pediatric hospitals reported their experiences. After the emergency phase of the COVID-19 pandemic, the health-care system needs to be reorganized in order to manage again all non-urgent activities, while ensuring safety of both patients and HCW.

MATERIAL AND METHODS: We developed preventive measures to limit any possibility of COVID-19 spread, according to the principles of epidemiological prevention and suggestions from recent literature. In order to evaluate the efficacy of these measures, we retrospectively reviewed the neurosurgical activity at our Institution from May 4th to July 15th, 2020.

RESULTS: 119 patients were admitted in the Neurosurgical ward and 80 surgical procedures were performed. Furthermore, 130 outpatient clinics were scheduled. A total of 258 nasopharyngeal swabs and 249 specific interview were performed. In our series, no cases of positivity for SARS-CoV-2 infection were found and no surgical cases were postponed. Discussion We present the management of the neurosurgical activity after the emergency phase at the Neurosurgical Department of Giannina Gaslini Children's Hospital of Genoa, Italy.

CONCLUSION: Italian healthcare system is undertaking a process of reorganization of resources, in an attempt to restore all non urgent activities while ensuring safety. After the emergency phase, we are learning to live together with COVID-19 and, although epidemiological data are encouraging, we must be prepared for an eventual second peak.

RevDate: 2020-11-26

Pappa S, Giannakoulis VG, Papoutsi E, et al (2020)

Author reply - Letter to the editor regarding ''Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis'.

RevDate: 2020-11-26

Rohaim MA, El Naggar RF, Clayton E, et al (2020)

Structural and functional insights into non-structural proteins of coronaviruses.

Microbial pathogenesis pii:S0882-4010(20)31007-X [Epub ahead of print].

Coronaviruses (CoVs) are causing a number of human and animal diseases because of their zoonotic nature such as Middle East respiratory syndrome (MERS), severe acute respiratory syndrome (SARS) and coronavirus disease 2019 (COVID-19). These viruses can infect respiratory, gastrointestinal, hepatic and central nervous systems of human, livestock, birds, bat, mouse, and many wild animals. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a newly emerging respiratory virus and is causing CoVID-19 with high morbidity and considerable mortality. All CoVs belong to the order Nidovirales, family Coronaviridae, are enveloped positive-sense RNA viruses, characterised by club-like spikes on their surfaces and large RNA genome with a distinctive replication strategy. Coronavirus have the largest RNA genomes (∼26-32 kilobases) and their expansion was likely enabled by acquiring enzyme functions that counter the commonly high error frequency of viral RNA polymerases. Non-structural proteins (nsp) 7-16 are cleaved from two large replicase polyproteins and guide the replication and processing of coronavirus RNA. Coronavirus replicase has more or less universal activities, such as RNA polymerase (nsp 12) and helicase (nsp 13), as well as a variety of unusual or even special mRNA capping (nsp 14, nsp 16) and fidelity regulation (nsp 14) domains. Besides that, several smaller subunits (nsp 7- nsp 10) serve as essential cofactors for these enzymes and contribute to the emerging "nsp interactome." In spite of the significant progress in studying coronaviruses structural and functional properties, there is an urgent need to understand the coronaviruses evolutionary success that will be helpful to develop enhanced control strategies. Therefore, it is crucial to understand the structure, function, and interactions of coronaviruses RNA synthesizing machinery and their replication strategies.

RevDate: 2020-11-26

Green I, Merzon E, Vinker S, et al (2020)

COVID-19 susceptibility in bronchial asthma.

The journal of allergy and clinical immunology. In practice pii:S2213-2198(20)31240-X [Epub ahead of print].

BACKGROUND: Bronchial asthma has not been adequately assessed in the coronavirus disease 2019 (COVID-19). Respiratory allergy is associated with significant reductions in ACE2 receptors expression, which is the entry receptor for COVID-19.

OBJECTIVE: To observe COVID-19 susceptibility in patients with bronchial asthma, we have analyzed the prevalence of asthma in a large cohort of consecutive outpatient subjects who tested in the RT-PCR assay for COVID-19.

METHODS: This was a retrospective population-based cross-sectional study utilizing data from a large nation-wide health maintenance organization (HMO) in Israel. All HMO enrollees who had been tested for COVID-19 from February to June 2020 were included. Differences in demographic and clinical characteristics between the subjects with negative and positive COVID-19 RT-PCR tests and between COVID-19 RT-PCR positive subjects with and without asthma were analyzed.

RESULTS: A total of 37,469 subjects were tested for COVID-19 RT-PCR and 2,266 (6.05 %) of them were positive. A significantly higher proportion of smokers was observed in the COVID-19 negative group, than in the COVID-19 positive group (4,734 (13.45 %) vs 103 (4.55 %); p<0.001). Asthma was found in 153 (6.75 %) subjects of COVID-19 positive and in 3,388 (9.62 %) subjects of COVID-19 negative group (p<0.001). No significant impact of antileukotrienes, inhaled corticosteroids and long-acting beta-blockers use was revealed on COVID-19 positivity proportions. Multiple logistic regression analysis adjusted for sex, age, smoking, and comorbidity revealed a negative association of asthma with the likelihood of being positive for COVID-19 (OR 0.71 (95% confidence interval, 0.58-0.87); p=0.001).

CONCLUSION: we observed lower COVID-19 susceptibility in patients with pre-existing asthma.

RevDate: 2020-11-26

Baral S, Chandler R, Prieto RG, et al (2020)

Leveraging Epidemiological Principles to Evaluate Sweden's COVID-19 Response.

Annals of epidemiology pii:S1047-2797(20)30413-0 [Epub ahead of print].

RevDate: 2020-11-26

Duroseau N, Loh M, Sanders L, et al (2020)

Options for Teens with No Options: A Self-Managed Second Trimester Abortion.

BACKGROUND: Several states have deemed abortions as non-essential services, effectively calling for a halt to abortion care during the COVID-19 pandemic. In response, women may elect for self-managed abortions by obtaining abortion medications online.

CASE: A 15-year-old female presented with abdominal cramping and vaginal discharge after taking Misoprostol obtained from an online retailer for a self-managed abortion in her second trimester during the COVID-19 pandemic. Exam showed products of conception protruding from the vagina. The patient was emergently evaluated for an incomplete and possible septic abortion and underwent a dilation and evacuation (D&E) procedure.

SUMMARY AND CONCLUSION: Providers caring for adolescents should recognize the availability of self-managed abortions, become familiar with the expected course, possible complications, and the unique challenges of accessing abortion care faced by adolescents.

RevDate: 2020-11-26

Shen L, Zhang Z, F He (2020)

The phylogenetic relationship within SARS-CoV-2s: an expanding basal clade.

Molecular phylogenetics and evolution pii:S1055-7903(20)30289-X [Epub ahead of print].

The COVID-19 pandemic is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) whose origin is still shed in mystery. In this study, we developed a method to search the basal SARS-CoV-2 clade among collected SARS-CoV-2 genome sequences. We first identified the mutation sites in the SARS-CoV-2 whole genome sequence alignment. Then by the pairwise comparison of the numbers of mutation sites among all SARS-CoV-2s, the least mutated clade was identified, which is the basal clade under parsimony principle. In our first analysis, we used 168 SARS-CoV-2 sequences (GISAID dataset till 2020/03/04) to identify the basal clade which contains 33 identical viral sequences from seven countries. To our surprise, in our second analysis with 367 SARS-CoV-2 sequences (GISAID dataset till 2020/03/17), the basal clade has 51 viral sequences, 18 more sequences added. The much larger NCBI dataset shows that this clade has expanded with 85 unique sequences by 2020/04/04. The expanding basal clade tells a chilling fact that the least mutated SARS-CoV-2 sequence was replicating and spreading for at least four months. It is known that coronaviruses have the RNA proofreading capability to ensure their genome replication fidelity. Interestingly, we found that the SARS-CoV-2 without its nonstructural proteins 13 to 16 (Nsp13-Nsp16) exhibits an unusually high mutation rate. Our result suggests that SARS-CoV-2 has an unprecedented RNA proofreading capability which can intactly preserve its genome even after a long period of transmission. Our selection analyses also indicate that the positive selection event enabling SARS-CoV-2 to cross species and adapt to human hosts might have been achieved before its outbreak.

RevDate: 2020-11-26

Leiman DA, Maratt JK, Ketwaroo GA, et al (2020)

AGA Institute Quality Measure Development for the Diagnosis and Management of COVID-19.

Gastroenterology pii:S0016-5085(20)35474-3 [Epub ahead of print].

RevDate: 2020-11-26

Mascia G, Pescetelli F, Baldari A, et al (2020)

Interpretation of elevated high-sensitivity cardiac troponin I in elite soccer players previously infected by severe acute respiratory syndrome coronavirus 2.

International journal of cardiology pii:S0167-5273(20)34162-0 [Epub ahead of print].

OBJECTIVES: To clarify the meaning of elevated cardiac troponin in elite football athletes previously infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and screened for cardiovascular involvement in the wake of competitive sport resumption.

METHODS: We designed a retrospective cohort study with the collaboration of two Italian Serie A teams. Football players from both rosters (58 athletes) were systematically analysed. For every SARS-CoV-2 positive athlete, the Italian Football Federation protocol requested full blood tests including high-sensitivity cardiac troponin I (hscTnI), along with a complete cardiovascular examination. We extended the analysis to SARS-CoV-2 negative athletes.

RESULTS: A total of 13/58 players (22.4%) suffered from SARS-CoV-2infection: all had a negative cardiovascular examination and 2/13 (15%) showed increased hs-cTnI values (120,8 pg/ml and 72,6 pg/ml, respectively; upper reference level 39,2 pg/ml), which did not track with inflammatory biomarkers. Regarding the 45/58 (77,6%) non infected athletes, a slight increase in hs-cTnI was observed in 2 (4.5%) subjects (values: 61 pg/ml and 75 pg/ml respectively). All hs-cTnI positive athletes (4/58, 7%) underwent cardiac magnetic resonance (CMR), that excluded any cardiac injury.

CONCLUSIONS: In our retrospective study, SARS-CoV-2 infection in elite football athletes was not associated to clinical or biomarkers abnormalities. Increased hs-cTnI was rare and not significantly associated with previous SARS-COV2 infection nor with pathological findings at CMR, albeit elevated hs-cTnI was numerically more prevalent in the infected group.

RevDate: 2020-11-26

Bleakley C, Singh S, Garfield B, et al (2020)

Right ventricular dysfunction in critically ill COVID-19 ARDS.

International journal of cardiology pii:S0167-5273(20)34166-8 [Epub ahead of print].

AIMS: Comprehensive echocardiography assessment of right ventricular (RV) impairment has not been reported in critically ill patients with COVID-19. We detail the specific phenotype and clinical associations of RV impairment in COVID-19 acute respiratory distress syndrome (ARDS).

METHODS: Transthoracic echocardiography (TTE) measures of RV function were collected in critically unwell patients for associations with clinical, ventilatory and laboratory data.

RESULTS: Ninety patients (25.6% female), mean age 52.0 ± 10.8 years, veno-venous extracorporeal membrane oxygenation (VVECMO) (42.2%) were studied. A significantly higher proportion of patients were identified as having RV dysfunction by RV fractional area change (FAC) (72.0%,95% confidence interval (CI) 61.0-81.0) and RV velocity time integral (VTI) (86.4%, 95 CI 77.3-93.2) than by tricuspid annular plane systolic excursion (TAPSE) (23.8%, 95 CI 16.0-33.9), RVS' (11.9%, 95% CI 6.6-20.5) or RV free wall strain (FWS) (35.3%, 95% CI 23.6-49.0). RV VTI correlated strongly with RV FAC (p ≤0.01). Multivariate regression demonstrated independent associations of RV FAC with NTpro-BNP and PVR. RV-PA coupling correlated with PVR (univariate p < 0.01), as well as RVEDAi (p < 0.01), and RVESAi (p < 0.01), and was associated with P/F ratio (p 0.026), PEEP (p 0.025), and ALT (p 0.028).

CONCLUSIONS: Severe COVID-19 ARDS is associated with a specific phenotype of RV radial impairment with sparing of longitudinal function. Clinicians should avoid interpretation of RV health purely on long-axis parameters in these patients. RV-PA coupling potentially provides important additional information above standard measures of RV performance in this cohort.

RevDate: 2020-11-26

Gevertz JL, Greene JM, Sanchez-Tapia CH, et al (2020)

A novel COVID-19 epidemiological model with explicit susceptible and asymptomatic isolation compartments reveals unexpected consequences of timing social distancing.

Journal of theoretical biology pii:S0022-5193(20)30394-5 [Epub ahead of print].

Motivated by the current COVID-19 epidemic, this work introduces an epidemiological model in which separate compartments are used for susceptible and asymptomatic "socially distant" populations. Distancing directives are represented by rates of flow into these compartments, as well as by a reduction in contacts that lessens disease transmission. The dynamical behavior of this system is analyzed, under various different rate control strategies, and the sensitivity of the basic reproduction number to various parameters is studied. One of the striking features of this model is the existence of a critical implementation delay (CID) in issuing separation mandates: while a delay of about two weeks does not have an appreciable effect on the peak number of infections, issuing mandates even slightly after this critical time results in a far greater incidence of infection. Thus, there is a nontrivial but tight "window of opportunity" for commencing social distancing in order to meet the capacity of healthcare resources. However, if one wants to also delay the timing of peak infections -so as to take advantage of potential new therapies and vaccines- action must be taken much faster than the CID. Different relaxation strategies are also simulated, with surprising results. Periodic relaxation policies suggest a schedule which may significantly inhibit peak infective load, but that this schedule is very sensitive to parameter values and the schedule's frequency. Furthermore, we considered the impact of steadily reducing social distancing measures over time. We find that a too-sudden reopening of society may negate the progress achieved under initial distancing guidelines, but the negative effects can be mitigated if the relaxation strategy is carefully designed.

RevDate: 2020-11-26

Gama C, Relvas H, Lopes M, et al (2020)

The impact of COVID-19 on air quality levels in Portugal: a way to assess traffic contribution.

Environmental research pii:S0013-9351(20)31412-2 [Epub ahead of print].

The pandemic caused by coronavirus COVID-19 is having a worldwide impact that affects health, the economy and indirectly affects the air pollution in cities. In Portugal, the number of cases increased continually (32700 confirmed cases as of 31 May 2020), which has affected the health system and caused movement restrictions which in turn affects the air pollution in the country. This article analyses the indirect effect produced by this pandemic on air pollution in Portugal, by comparison of data from a period of movement restriction of the citizens by the government - COVID lockdown period (March-May 2020) with data from baseline conditions (mean of the mirrored periods from the five previous years (March-May from 2015-2019)). Air quality data - in particular NO2 and PM10 hourly concentration - from more than 20 monitoring stations spread over mainland Portugal was used to perform this evaluation. The mean reduction observed on pollutant concentrations was higher for NO2 (41%) than for PM10 (18%). For NO2, mean reductions were more significant in traffic (reaching values higher than 60% in some monitoring stations) and background urban sites than in rural stations. The reduction of NO2 concentration observed in traffic sites were compared to the estimation of traffic contribution by the incremental method, suggesting that this latter approach is not consistent (lower in same sites and higher in others) and alerting to the careful use of this approach in future works.

RevDate: 2020-11-26

Prado-Vivar B, Becerra-Wong M, Guadalupe JJ, et al (2020)

A case of SARS-CoV-2 reinfection in Ecuador.

RevDate: 2020-11-26

Crommelin DJA, Volkin DB, Hoogendoorn KH, et al (2020)

The science is there: key considerations for stabilizing viral vector-based Covid-19 vaccines.

Journal of pharmaceutical sciences pii:S0022-3549(20)30744-9 [Epub ahead of print].

Once Covid-19 vaccines become available, 5-10 billion vaccine doses should be globally distributed, stored and administered. In this commentary, we discuss how this enormous challenge could be addressed for viral vector-based Covid-19 vaccines by learning from the wealth of formulation development experience gained over the years on stability issues related to live attenuated virus vaccines and viral vector vaccines for other diseases. This experience has led -over time- to major improvements on storage temperature, shelf-life and in-use stability requirements. First, we will cover work on 'classical' live attenuated virus vaccines as well as replication competent viral vector vaccines. Subsequently, we address replication deficient viral vector vaccines. Freeze drying and storage at 2-8°C with a shelf life of years has become the norm. In the case of pandemics with incredibly high and urgent product demands, however, the desire for rapid and convenient distribution chains combined with short end-user storage times require that liquid formulations with shelf lives of months stored at 2-8 °C be considered. In confronting this "perfect storm" of Covid-19 vaccine stability challenges, understanding the many lessons learned from decades of development and manufacturing of live virus-based vaccines is the shortest path for finding promising and rapid solutions.

RevDate: 2020-11-26

Pasquali P, Romero-Aguilera G, D Moreno-Ramírez (2020)

Teledermatology Before, During, and After the COVID-19 Pandemic.

Actas dermo-sifiliograficas pii:S0001-7310(20)30480-4 [Epub ahead of print].

The use and acceptance of teledermatology (TD) increased more in the last 2 months of the recent lockdown owing to coronavirus disease 2019 than in the preceding 20 years. This sudden popularity-even among the greatest skeptics-was driven by the need to offer solutions to patients in both public and private settings who suddenly found themselves unable to access in-person dermatological care. Even departments already offering an asynchronous, store-and-forward TD service were obliged to create new systems to support direct interaction between specialists and patients (the direct-to-consumer model). This article suggests some practical ways to implement TD safely and to expedite and optimize teleconsultations; these ideas are not just applicable to a pandemic situation.

RevDate: 2020-11-26

Liu H, Wu NC, Yuan M, et al (2020)

Cross-Neutralization of a SARS-CoV-2 Antibody to a Functionally Conserved Site Is Mediated by Avidity.

Immunity pii:S1074-7613(20)30464-7 [Epub ahead of print].

Most antibodies isolated from individuals with coronavirus disease 2019 (COVID-19) are specific to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, COVA1-16 is a relatively rare antibody that also cross-neutralizes SARS-CoV. Here, we determined a crystal structure of the COVA1-16 antibody fragment (Fab) with the SARS-CoV-2 receptor-binding domain (RBD) and negative-stain electron microscopy reconstructions with the spike glycoprotein trimer to elucidate the structural basis of its cross-reactivity. COVA1-16 binds a highly conserved epitope on the SARS-CoV-2 RBD, mainly through a long complementarity-determining region (CDR) H3, and competes with the angiotensin-converting enzyme 2 (ACE2) receptor because of steric hindrance rather than epitope overlap. COVA1-16 binds to a flexible up conformation of the RBD on the spike and relies on antibody avidity for neutralization. These findings, along with the structural and functional rationale for epitope conservation, provide insights for development of more universal SARS-like coronavirus vaccines and therapies.

RevDate: 2020-11-26

Lu M, Uchil PD, Li W, et al (2020)

Real-Time Conformational Dynamics of SARS-CoV-2 Spikes on Virus Particles.

Cell host & microbe pii:S1931-3128(20)30618-1 [Epub ahead of print].

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike (S) mediates viral entry into cells and is critical for vaccine development against coronavirus disease 2019 (COVID-19). Structural studies have revealed distinct conformations of S, but real-time information that connects these structures is lacking. Here we apply single-molecule fluorescence (Förster) resonance energy transfer (smFRET) imaging to observe conformational dynamics of S on virus particles. Virus-associated S dynamically samples at least four distinct conformational states. In response to human receptor angiotensin-converting enzyme 2 (hACE2), S opens sequentially into the hACE2-bound S conformation through at least one on-path intermediate. Conformational preferences observed upon exposure to convalescent plasma or antibodies suggest mechanisms of neutralization involving either competition with hACE2 for binding to the receptor-binding domain (RBD) or allosteric interference with conformational changes required for entry. Our findings inform on mechanisms of S recognition and conformations for immunogen design.

RevDate: 2020-11-26

Sherman SM, Smith LE, Sim J, et al (2020)

COVID-19 vaccination intention in the UK: results from the COVID-19 vaccination acceptability study (CoVAccS), a nationally representative cross-sectional survey.

Human vaccines & immunotherapeutics [Epub ahead of print].

To investigate factors associated with intention to be vaccinated against COVID-19 we conducted a cross-sectional survey of 1,500 UK adults, recruited from an existing online research panel. Data were collected between 14th and 17th July 2020. We used linear regression analyses to investigate associations between intention to be vaccinated for COVID-19 "when a vaccine becomes available to you" and sociodemographic factors, previous influenza vaccination, general vaccine attitudes and beliefs, attitudes and beliefs about COVID-19, and attitudes and beliefs about a COVID-19 vaccination. 64% of participants reported being very likely to be vaccinated against COVID-19, 27% were unsure, and 9% reported being very unlikely to be vaccinated. Personal and clinical characteristics, previous influenza vaccination, general vaccination beliefs, and beliefs and attitudes about COVID-19 and a COVID-19 vaccination explained 76% of the variance in vaccination intention. Intention to be vaccinated was associated with more positive general COVID-19 vaccination beliefs and attitudes, weaker beliefs that the vaccination would cause side effects or be unsafe, greater perceived information sufficiency to make an informed decision about COVID-19 vaccination, greater perceived risk of COVID-19 to others (but not risk to oneself), older age, and having been vaccinated for influenza last winter (2019/20). Despite uncertainty around the details of a COVID-19 vaccination, most participants reported intending to be vaccinated for COVID-19. Actual uptake may be lower. Vaccination intention reflects general vaccine beliefs and attitudes. Campaigns and messaging about a COVID-19 vaccination could consider emphasizing the risk of COVID-19 to others and necessity for everyone to be vaccinated.

RevDate: 2020-11-26

Owoicho O, Olwal CO, O Quaye (2020)

Potential of laser-induced fluorescence-light detection and ranging for future stand-off virus surveillance.

Microbial biotechnology [Epub ahead of print].

Viruses remain a significant public health concern worldwide. Recently, humanity has faced deadly viral infections, including Zika, Ebola and the current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The threat is associated with the ability of the viruses to mutate frequently and adapt to different hosts. Thus, there is the need for robust detection and classification of emerging virus strains to ensure that humanity is prepared in terms of vaccine and drug developments. A point or stand-off biosensor that can detect and classify viruses from indoor and outdoor environments would be suited for viral surveillance. Light detection and ranging (LiDAR) is a facile and versatile tool that has been explored for stand-off detection in different environments including atmospheric, oceans and forest sensing. Notably, laser-induced fluorescence-light detection and ranging (LIF-LiDAR) has been used to identify MS2 bacteriophage on artificially contaminated surgical equipment or released amidst other primary biological aerosol particles in laboratory-like close chamber. It has also been shown to distinguish between different picornaviruses. Currently, the potentials of the LIF-LiDAR technology for real-time stand-off surveillance of pathogenic viruses in indoor and outdoor environments have not been assessed. Considering the increasing applications of LIF-LiDAR for potential microbial pathogens detection and classification, and the need for more robust tools for viral surveillance at safe distance, we critically evaluate the prospects and challenges of LIF-LiDAR technology for real-time stand-off detection and classification of potentially pathogenic viruses in various environments.

RevDate: 2020-11-26

Maxwell AJ, Ding J, You Y, et al (2020)

Identification of key signaling pathways induced by SARS-CoV2 that underlie thrombosis and vascular injury in COVID-19 patients.

Journal of leukocyte biology [Epub ahead of print].

The SARS-CoV-2 pandemic has led to hundreds of thousands of deaths and billions of dollars in economic damage. The immune response elicited from this virus is poorly understood. An alarming number of cases have arisen where COVID-19 patients develop complications on top of the symptoms already associated with SARS, such as thrombosis, injuries of vascular system, kidney, and liver, as well as Kawasaki disease. In this review, we have used a bioinformatics approach to elucidate the immune response triggered by SARS-CoV-2 infection in primary human lung epithelial and transformed human lung alveolar. Additionally, we have examined the potential mechanism behind several complications that have been associated with COVID-19 and determined that a specific cytokine storm is leading to excessive neutrophil recruitment. These neutrophils are directly leading to thrombosis, organ damage, and complement activation via neutrophil extracellular trap release.

RevDate: 2020-11-26

Hurtado-Torres GF (2020)

Indirect Calorimetry in COVID-19 Critical Ill Patients, More Questions Than Answers.

RevDate: 2020-11-26

Islam N, Salameh JP, Leeflang MM, et al (2020)

Thoracic imaging tests for the diagnosis of COVID-19.

The Cochrane database of systematic reviews, 11:CD013639.

BACKGROUND: The respiratory illness caused by SARS-CoV-2 infection continues to present diagnostic challenges. Early research showed thoracic (chest) imaging to be sensitive but not specific in the diagnosis of coronavirus disease 2019 (COVID-19). However, this is a rapidly developing field and these findings need to be re-evaluated in the light of new research. This is the first update of this 'living systematic review'. This update focuses on people suspected of having COVID-19 and excludes studies with only confirmed COVID-19 participants.

OBJECTIVES: To evaluate the diagnostic accuracy of thoracic imaging (computed tomography (CT), X-ray and ultrasound) in people with suspected COVID-19.

SEARCH METHODS: We searched the COVID-19 Living Evidence Database from the University of Bern, the Cochrane COVID-19 Study Register, The Stephen B. Thacker CDC Library, and repositories of COVID-19 publications through to 22 June 2020. We did not apply any language restrictions.

SELECTION CRITERIA: We included studies of all designs that recruited participants of any age group suspected to have COVID-19, and which reported estimates of test accuracy, or provided data from which estimates could be computed. When studies used a variety of reference standards, we retained the classification of participants as COVID-19 positive or negative as used in the study.

DATA COLLECTION AND ANALYSIS: We screened studies, extracted data, and assessed the risk of bias and applicability concerns using the QUADAS-2 domain-list independently, in duplicate. We categorised included studies into three groups based on classification of index test results: studies that reported specific criteria for index test positivity (group 1); studies that did not report specific criteria, but had the test reader(s) explicitly classify the imaging test result as either COVID-19 positive or negative (group 2); and studies that reported an overview of index test findings, without explicitly classifying the imaging test as either COVID-19 positive or negative (group 3). We presented the results of estimated sensitivity and specificity using paired forest plots, and summarised in tables. We used a bivariate meta-analysis model where appropriate. We presented uncertainty of the accuracy estimates using 95% confidence intervals (CIs).

MAIN RESULTS: We included 34 studies: 30 were cross-sectional studies with 8491 participants suspected of COVID-19, of which 4575 (54%) had a final diagnosis of COVID-19; four were case-control studies with 848 cases and controls in total, of which 464 (55%) had a final diagnosis of COVID-19. Chest CT was evaluated in 31 studies (8014 participants, 4224 (53%) cases), chest X-ray in three studies (1243 participants, 784 (63%) cases), and ultrasound of the lungs in one study (100 participants, 31 (31%) cases). Twenty-six per cent (9/34) of all studies were available only as preprints. Nineteen studies were conducted in Asia, 10 in Europe, four in North America and one in Australia. Sixteen studies included only adults, 15 studies included both adults and children and one included only children. Two studies did not report the ages of participants. Twenty-four studies included inpatients, four studies included outpatients, while the remaining six studies were conducted in unclear settings. The majority of included studies had a high or unclear risk of bias with respect to participant selection, index test, reference standard, and participant flow. For chest CT in suspected COVID-19 participants (31 studies, 8014 participants, 4224 (53%) cases) the sensitivity ranged from 57.4% to 100%, and specificity ranged from 0% to 96.0%. The pooled sensitivity of chest CT in suspected COVID-19 participants was 89.9% (95% CI 85.7 to 92.9) and the pooled specificity was 61.1% (95% CI 42.3 to 77.1). Sensitivity analyses showed that when the studies from China were excluded, the studies from other countries demonstrated higher specificity compared to the overall included studies. When studies that did not classify index tests as positive or negative for COVID-19 (group 3) were excluded, the remaining studies (groups 1 and 2) demonstrated higher specificity compared to the overall included studies. Sensitivity analyses limited to cross-sectional studies, or studies where at least two reverse transcriptase polymerase chain reaction (RT-PCR) tests were conducted if the first was negative, did not substantively alter the accuracy estimates. We did not identify publication status as a source of heterogeneity. For chest X-ray in suspected COVID-19 participants (3 studies, 1243 participants, 784 (63%) cases) the sensitivity ranged from 56.9% to 89.0% and specificity from 11.1% to 88.9%. The sensitivity and specificity of ultrasound of the lungs in suspected COVID-19 participants (1 study, 100 participants, 31 (31%) cases) were 96.8% and 62.3%, respectively. We could not perform a meta-analysis for chest X-ray or ultrasound due to the limited number of included studies.

AUTHORS' CONCLUSIONS: Our findings indicate that chest CT is sensitive and moderately specific for the diagnosis of COVID-19 in suspected patients, meaning that CT may have limited capability in differentiating SARS-CoV-2 infection from other causes of respiratory illness. However, we are limited in our confidence in these results due to the poor study quality and the heterogeneity of included studies. Because of limited data, accuracy estimates of chest X-ray and ultrasound of the lungs for the diagnosis of suspected COVID-19 cases should be carefully interpreted. Future diagnostic accuracy studies should pre-define positive imaging findings, include direct comparisons of the various modalities of interest on the same participant population, and implement improved reporting practices. Planned updates of this review will aim to: increase precision around the accuracy estimates for chest CT (ideally with low risk of bias studies); obtain further data to inform accuracy of chest X-rays and ultrasound; and obtain data to further fulfil secondary objectives (e.g. 'threshold' effects, comparing accuracy estimates across different imaging modalities) to inform the utility of imaging along different diagnostic pathways.

RevDate: 2020-11-26

Fröding E, Edvinsson J, Mellqvist J, et al (2020)

[Patient safety in real time at covid-19 units in Region Jönköping County].

Lakartidningen, 117: pii:20118.

The adaptation of the healthcare needed in the covid-19 pandemic poses challenges to patient safety. Proactive patient safety work must continue even under conditions such as a pandemic. Methods are needed that assess and support patient safety as the work is carried out. Patient safety in real time appears to be such a useful method in which patient record review to identify patient harm is combined with interviews with patients and healthcare staff. The method was used in wards and intensive care units (ICU) for covid-19 patients in Region Jönköping County. Patient harm was found in ICU care. Patients were overall satisfied with the care, and in the interviews with healthcare staff areas for improvement were identified. Valid indicators for patient record review to evaluate patient harm in covid-19 need to be developed. To judge if patient harm in care of a Covid-19 is avoidable or not is difficult since the level of knowledge and treatment principles in the disease develops very fast.

RevDate: 2020-11-26

Andersson E, A Sönnerborg (2020)

[Future testing for SARS-CoV-2: not only more but smarter].

Lakartidningen, 117: pii:20180.

Sars-cov-2 PCR is a cornerstone of COVID-19 clinical diagnostics and epidemiological surveillance. Viral shedding in COVID-19, as measured by isolation of infectious virus, is most prominent around symptom onset. Sars-cov-2 PCR, however, may stay positive for months and thereby does not reflect infectiousness. PCR tests are both specific and sensitive but the performance in clinical diagnostics depends on sampling technique, sample material and disease stage. Self-sampling in individuals with mild symptoms aims rather to assess infectiousness and a lower sensitivity of the test can be accepted. False positive tests are a global problem and may have serious consequences for both the tested individuals and society. Awareness of contamination risks and continuous quality assurance is vital in all laboratories to ensure test reliability. Rapid, less sensitive sars-cov-2 antigen tests are potential new tools in infection control.

RevDate: 2020-11-26

Suppan M, Catho G, Robalo Nunes T, et al (2020)

Development of Escape COVID-19, a Serious Game Designed to Promote Safe Behaviors Among Healthcare Workers During the COVID-19 Pandemic.

JMIR serious games [Epub ahead of print].

BACKGROUND: As many countries fear and even experience the emergence of a second wave of COVID-19, reminding healthcare workers (HCW) and other hospital employees of the critical role they play in avoiding SARS-CoV-2 transmission is more important than ever. Building and strengthening the intrinsic motivation of HCW to apply infection prevention and control (IPC) guidelines to avoid contaminating their colleagues, patients, friends and relatives is a goal that must be energetically pursued. A high rate of nosocomial infections during the first COVID-19 wave was detected by the IPC specialists and further cemented their belief in the need for an engaging intervention which could improve compliance with COVID-19 safe behaviors.

OBJECTIVE: Our aim was to develop a serious game which would promote IPC practices with a specific focus on COVID-19 among HCW and other hospital employees.

METHODS: The first three stages of the SERES framework were used to develop this serious game. A brainswarming session between developers and IPC specialists was used to identify the target audience and acquisition objectives. Nicholson's RECIPE mnemonic (reflection, engagement, choice, information, play, exposition) for meaningful gamification was used to guide the general design. A common and simple terminology was used to suit the broad target audience. The game was tested on various platforms (smartphones, tablets, laptops, desktop computers) by different users during each development loop and before its final release.

RESULTS: The game was designed to target all hospital staff who could be in direct contact with patients within the Geneva University Hospitals. Ten acquisition objectives were defined by IPC specialists and implemented into the game according to the principles of meaningful gamification. A simple storyboard was first created under Microsoft PowerPoint and progressively refined through multiple iteration loops. Articulate Storyline was then used to create two successive versions of the actual game. In the final version, a unique graphic atmosphere was created thanks to Eric Buche, a professional graphic designer. Feedback mechanisms were used extensively throughout the game to strengthen key IPC messages.

CONCLUSIONS: The SERES framework was successfully used to create "Escape COVID-19", a serious game designed to promote safe IPC practices among HCW and other hospital employees during the COVID-19 pandemic. This game can be obtained free of charge for research and educational purposes. A shareable content object reference model (SCORM) package is available to facilitate results and completion tracking on most current learning management systems.

RevDate: 2020-11-26

Alexandra Barley E, B Coghlan (2020)

Supporting recovery from COVID-19.

British journal of nursing (Mark Allen Publishing), 29(21):1272-1276.

COVID-19 is a new disease. Most research into the disease has focused on prevention of viral spread and treatment, but little is known about how patients recover. Nurses, whether in hospital, the community or in primary care, have a key role in supporting recovery from COVID-19. In this article, direct evidence from studies of COVID-19, and indirect evidence from studies of infections caused by other coronaviruses (eg SARS, MERS) and of the ICU experience are explored to identify the potential course of recovery and areas where nurses can help. Most people will have an uncomplicated recovery. However, it appears that a more complicated recovery is likely to be associated with severe disease. A minority, possibly those needing hospitalisation, and/or with pre-existing physical or psychological comorbidities, may experience long-term physical effects, fatigue and mental health difficulties. The support that nurses, as part of a multidisciplinary team, can provide to facilitate recovery is discussed.

RevDate: 2020-11-26

Thusini S (2020)

Critical care nursing during the COVID-19 pandemic: a story of resilience.

British journal of nursing (Mark Allen Publishing), 29(21):1232-1236.

In this article, an intensive care unit (ICU) nurse provides some reflections on caring for patients with COVID-19 and relates her lived experience to the concept of resilience. Similarities and differences to pre-pandemic understandings of resilience are drawn out and factors that mediate acute stress, resilience and psychological recovery during a pandemic are considered. Resources to support ICU nurses and other healthcare staff to manage stress and promote wellbeing are signposted, and important research directions that warrant attention are recommended. The story is one of learning and hope and, importantly, it captures key lessons that can equip healthcare staff with positive coping strategies in a time of unprecedented pressure.

RevDate: 2020-11-26

Foster S (2020)

Considering care in context.

British journal of nursing (Mark Allen Publishing), 29(21):1299.

Sam Foster, Chief Nurse, Oxford University Hospitals, reflects on the need for regulators to take into account the care context, particularly with some trusts under more pressure than others from a second wave of COVID-19.

RevDate: 2020-11-26

Markey K, Y Zhang (2020)

Demystifying, recognising and combating racism during the pandemic.

British journal of nursing (Mark Allen Publishing), 29(21):1266-1270.

The increased reports of escalation of social inequalities, xenophobic and racist ideologies during the COVID-19 pandemic presents a growing concern. Nurses are not immune to xenophobia and racism, both as perpetrators and as victims. Although COVID-19 brings a new wave of xenophobia and racism, healthcare organisations have been tackling discriminatory and racist practices for decades. However, racist practice quite often goes undetected or unchallenged due to its associated sensitivity and a lack of understanding of its complexity. There is a need for a more open and non-judgemental discourse around interpretations of racism and its predisposing factors as a means of combating the growing reports. This discussion paper proposes a practice-orientated conceptualisation of racism and outlines some particular and sustainable areas for consideration for nurses to use in their daily practice. Developing self-awareness and nurturing the courage, confidence and commitment to challenge self and others is critical for transforming ethnocentric and racist ideologies.

RevDate: 2020-11-26

Peate I (2020)

Marking World AIDS Day in a COVID-19 world.

British journal of nursing (Mark Allen Publishing), 29(21):1229.

RevDate: 2020-11-26

Li G, Wang J, He X, et al (2020)

An integrative analysis identifying transcriptional features and key genes involved in COVID-19.

Epigenomics [Epub ahead of print].

Aim: To elucidate the transcriptional characteristics of COVID-19. Materials & methods: We utilized an integrative approach to comprehensively analyze the transcriptional features of both COVID-19 patients and SARS-CoV-2 infected cells. Results: Widespread infiltration of immune cells was observed. We identified 233 genes that were codifferentially expressed in both bronchoalveolar lavage fluid and lung samples of COVID-19 patients. Functional analysis suggested upregulated genes were related to immune response such as neutrophil activation and antivirus response, while downregulated genes were associated with cell adhesion. Finally, we identified LCN2, STAT1 and UBE2L6 as core genes during SARS-CoV-2 infection. Conclusion: The identification of core genes involved in COVID-19 can provide us with more insights into the molecular features of COVID-19.

RevDate: 2020-11-26

Ap Dafydd D, O'Mahony M, Jhanji S, et al (2020)

The role of CT chest in screening for asymptomatic COVID-19 infection in self-isolating patients prior to elective oncological surgery: findings from a UK Cancer Hub.

The British journal of radiology [Epub ahead of print].

OBJECTIVES: In accordance with initial guidance from the Royal College of Surgeons and Royal College of Radiologists, we evaluated the utility of CT of the chest in the exclusion of asymptomatic COVID-19 infection prior to elective cancer surgery on self-isolating patients during the pandemic.

METHODS: All surgical referrals without symptoms of COVID-19 infection in April and May 2020 were included. Patient records were retrospectively reviewed. Screening included CT chest for major thoracic and abdominal surgery. CTs were reported according to British Society of Thoracic Imaging guidelines and correlated with reverse transcriptase polymerase chain reaction (RT-PCR) and surgical outcomes.

RESULTS: The prevalence of RT-PCR confirmed COVID-19 infection in our screened population was 0.7% (5/681). 240 pre-operative CTs were performed. 3.8% (9/240) of CTs were reported as abnormal, only one of which was RT-PCR positive. 2% (5/240) of cases had surgery postponed based on CT results. All nine patients with CTs reported as abnormal have had surgery, all without complication.

CONCLUSION: The prevalence of asymptomatic COVID-19 infection in our screened population was low. The pre-test probability of CT chest in asymptomatic, self-isolating patients is consequently low. CT can produce false positives in this setting, introducing unnecessary delay in surgery for a small proportion of cases.

ADVANCES IN KNOWLEDGE: Self-isolation, clinical assessment and RT-PCR are effective at minimising COVID-19 related surgical risk. The addition of CT chest is unhelpful. Our data have particular relevance during the second wave of infection and in the recovery phase.

RevDate: 2020-11-26

Lombardi AF, Afsahi AM, Gupta A, et al (2020)

Severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), influenza, and COVID-19, beyond the lungs: a review article.

La Radiologia medica pii:10.1007/s11547-020-01311-x [Epub ahead of print].

BACKGROUND: In the past 20 years four major viral infectious diseases outbreaks caused hundreds of thousands of deaths worldwide: SARS, Influenza H1N1, MERS, and COVID-19. They all present clinically initially as upper and lower respiratory tract infections and may progress to multi-organ failure.

METHODS: This study was a systematic review of literature conducted in September 2020 to study extra-pulmonary complications of SARS, FLU, MERS, and current COVID-19. We carried out a systematic search using the keywords in online databases of PubMed, EMBASE, and Google Scholar until June 2020.

OBJECTIVE: This article aims to review the most common extra-pulmonary manifestations of SARS, Influenza, MERS, and COVID-19.

DISCUSSION: Several studies have reported extra-pulmonary conditions in patients diagnosed with SARS, Influenza, MERS, and COVID-19, either by direct viral injury or from the systemic response to the initial infection.

CONCLUSION: SARS, Influenza, MERS, and COVID-19 have all been associated with dysfunction of kidneys, endocrine system, neuromuscular symptoms, perinatal complications, and myocardial injury. Progression from pulmonary disease to a systemic condition has a poor outcome and can result in multi-organ failure.

RevDate: 2020-11-26

Padron-Regalado E (2020)

Correction to: Vaccines for SARS-CoV-2: Lessons from Other Coronavirus Strains.

The correct affiliation has been given in this paper.

RevDate: 2020-11-26

Erro R, Scannapieco S, Russo M, et al (2020)

Impact of COVID-19 on neurological patients attending a botulinum toxin service.

RevDate: 2020-11-26

Jammu AS, Chasen MR, Lofters AK, et al (2020)

Systematic rapid living review of the impact of the COVID-19 pandemic on cancer survivors: update to August 27, 2020.

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer pii:10.1007/s00520-020-05908-w [Epub ahead of print].

BACKGROUND: The COVID-19 pandemic has resulted in drastic changes in the global healthcare delivery landscape and has had practical repercussions for cancer survivors. This systematic rapid living review has been undertaken to synthesise the available knowledge regarding the impact of the COVID-19 pandemic in a timely manner. This initial rapid review will present the findings of literature published up to August 27, 2020.

DESIGN: A systematic search of PubMed, Scopus and Google Scholar databases was conducted to identify all articles, available in English language, regarding the impact of the COVID-19 pandemic on cancer survivors published between December 2019 and August 27, 2020. The search strategy employed the following search strings: "covid-19 OR coronavirus OR sars-cov-2" with "cancer survivors OR cancer survivorship".

RESULTS: The database search yielded 1639 articles, of which 19 were included. Of the 19 selected articles, there were 12 expert opinion articles, two literature reviews, two prospective cohort studies, one retrospective cohort study, one descriptive study and one pooled meta-analysis that comment on the impact of the COVID-19 pandemic on the physical wellbeing (16 articles), psychosocial wellbeing (15 articles) and financial wellbeing of cancer survivors (3 articles).

CONCLUSIONS: Limited definitive evidence exists regarding the impact of the COVID-19 pandemic on cancer survivors. Currently available literature provides preliminary indications of wide-ranging impacts of the pandemic on cancer survivors with respect to the requirement to adapt to new means of healthcare delivery as well as their physical, psychosocial and economic wellbeing. The pandemic has left survivors dealing with the consequences of rigorous cancer treatment in the context of new challenges related to social isolation, financial hardship and uncertainty with respect to their ongoing care. Additional rigorously designed research initiatives are required to elucidate the impact of the pandemic on cancer survivors.

RevDate: 2020-11-26

da Rosa Mesquita R, Francelino Silva Junior LC, Santos Santana FM, et al (2020)

Clinical manifestations of COVID-19 in the general population: systematic review.

Wiener klinische Wochenschrift pii:10.1007/s00508-020-01760-4 [Epub ahead of print].

Clinical manifestations of COVID-19 are varied in the general population. This study aimed to systematize the literature regarding clinical manifestations of patients with confirmed COVID-19. A systematic review of the literature was conducted. A total of 8070 scientific productions were found in the databases. Among the studies, 184 met the initial inclusion criteria, with a total of 114,046 patients. After complete reading, 32 studies that did not report clinical manifestations were excluded. The 152 publications finally included a total of 41,409 individuals from at least 23 countries and 26 different clinical manifestations were reported. In percentage terms, 6 symptoms had a general prevalence greater than or equal to 25%, namely, fever (58.66%), cough (54.52%), dyspnea (30.82%), malaise (29.75%), fatigue (28.16%) and sputum/secretion (25.33%). Neurological symptoms (20.82%), dermatological manifestations (20.45%), anorexia (20.26%), myalgia (16.9%), sneezing (14.71%), sore throat (14.41%), rhinitis (14.29%), goosebumps (13.49%), headache (12.17%), chest pain (11.49%) and diarrhea (9.59%) were other common symptoms. Only one study reported dermatological manifestations. The least frequent sign/symptom was hemoptysis (1.65%). In studies with more than 100 patients, the 3 main symptoms were fever (57.93%), cough (54.21%), and dyspnea (30.64%). Dermatological manifestations do not appear among the main symptoms. The identification of all clinical manifestations of COVID-19 is essential for an early diagnosis and the adoption of preventive measures.

RevDate: 2020-11-26

Zeyfang A, Zeeh J, Bahrmann A, et al (2020)

[Diabetes mellitus in old age].

Zeitschrift fur Gerontologie und Geriatrie pii:10.1007/s00391-020-01815-1 [Epub ahead of print].

In the treatment of diabetes in old age cognitive, functional and constitutional resources of the individual must be taken into account. Purely glycated hemoglobin (HbA1c)-oriented treatment goals are less relevant. The primary focus should be freedom from symptoms while avoiding hypoglycemia and maintaining the quality of life. The geriatric assessment helps to clarify the current functional, psychological and cognitive status as well as the need for support in multimorbid older people and to define appropriate treatment strategies. With drug treatment of diabetes in old age, particular attention must be paid to renal insufficiency and dehydration as well as slow dose adjustments. According to the Robert Koch Institute (RKI), diabetes patients belong to the risk group for a severe course of the coronavirus disease 2019 (COVID-19); further risk factors are high blood pressure, underlying oncological diseases, cerebrovascular and coronary heart diseases.

RevDate: 2020-11-26

Cirks BT, Geracht JC, Jones OY, et al (2020)

Multisystem Inflammatory Syndrome in Children during the COVID-19 Pandemic: A Case Report on Managing the Hyperinflammation.

Military medicine pii:6006784 [Epub ahead of print].

The novel human coronavirus of 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has quickly swept throughout the entire world. As the ongoing pandemic has spread, recent studies have described children presenting with a multisystem inflammatory disorder sharing the features of Kawasaki disease (KD) and toxic shock syndrome, now named Multisystem Inflammatory Syndrome in Children (MIS-C). These cases report a similar phenotype of prolonged fever, multisystem involvement, and biomarkers demonstrating marked hyperinflammation that occurs temporally in association with local community spread of SARS-CoV-2. Herein, we describe the presentation, clinical characteristics, and management of an 11-year-old boy with prolonged fever, strikingly elevated inflammatory markers, and profound, early coronary artery aneurysm consistent with a hyperinflammatory, multisystem disease temporally associated with coronavirus disease 2019. We highlight our multidisciplinary team's management with intravenous immunoglobulin, methylprednisolone, and an interleukin-1 receptor antagonist, anakinra, as a strategy to manage this multisystem, hyperinflammatory disease process.

RevDate: 2020-11-26

Elena B, Francesca A, Federica V, et al (2020)

Coronavirus Disease-2019 and dental practice: A project on the use of ozonized water in the water circuit of the dental armchair.

Stomatologija, 21(2):35-38.

A novel coronavirus (2019-nCoV) is associated with human-to-human transmission. From its beginning in December 2019, the coronavirus disease 2019 (COVID-19) outbreak has spread globally from Wuhan and is now declared a pandemic by the World Health Organization (WHO). The person-to-person transmission routes of 2019-nCoV includes direct transmission, such as cough, sneeze, droplet inhalation transmission, and contact transmission, such as the contact with oral, nasal and eye mucous membranes. The participants in dental practice are exposed to a severe risk of 2019-nCoV infections because of the face-to-face communication and the exposure to saliva, blood, and other body fluids. Dental professionals play great roles in preventing the transmission of 2019-nCoV. Since ozone has a proven anti-viral action, we present a project on the use of ozonized water in the water circuit of the dental armchair, in order to lower the viral load during dental practice in dental clinics and hospitals.

RevDate: 2020-11-26

Linssen J, Ermens A, Berrevoets M, et al (2020)

A novel haemocytometric COVID-19 prognostic score developed and validated in an observational multicentre European hospital-based study.

eLife, 9: pii:63195 [Epub ahead of print].

COVID-19 induces haemocytometric changes. Complete blood count changes, including new cell activation parameters, from 982 confirmed COVID-19 adult patients from 11 European hospitals were retrospectively analysed for distinctive patterns based on age, gender, clinical severity, symptom duration and hospital days. The observed haemocytometric patterns formed the basis to develop a multi-haemocytometric-parameter prognostic score to predict, during the first three days after presentation, which patients will recover without ventilation or deteriorate within a two-week timeframe, needing intensive care or with fatal outcome. The prognostic score, with ROC curve AUC at baseline of 0.753 (95% CI 0.723-0.781) increasing to 0.875 (95% CI 0.806-0.926) on day 3, was superior to any individual parameter at distinguishing between clinical severity. Findings were confirmed in a validation cohort. Aim is that the score and haemocytometry results are simultaneously provided by analyser software, enabling wide applicability of the score as haemocytometry is commonly requested in COVID-19 patients.

RevDate: 2020-11-26

Arezzo A, Vignali A, Ammirati CA, et al (2020)

Is it possible to continue academic teaching in surgery during the COVID pandemic era?.

Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy [Epub ahead of print].

In the era of the novel coronavirus (COVID-19) pandemic, we critically appraised the literature by means of a systematic review on surgical education and propose an educational curriculum with the aid of available technologies. We performed a literature search on 10 May 2020 of Medline/PubMed, Embase, Google Scholar and major journals with specific COVID-19 sections. Articles eligible for inclusion contained the topic of education in surgery in the context of COVID-19. Specific questions we aimed to answer were: Is there any difference in surgical education from pre-COVID-19 to now? How does technology assist us in teaching? Can we better harness technology to augment resident training? Two-hundred and twenty-six articles were identified, 21 relevant for our aim: 14 case studies, three survey analyses, three reviews and one commentary. The collapse of the traditional educational system due to social distancing caused a fragmentation of knowledge, a reduced acquisition of skills and a decreased employment of surgical trainees. These problems can be partially overcome by using new technologies and arranging 2-weeks rotation shifts, alternating clinical activities with learning. While medical care will remain largely based on the interaction with patients, students' adaptability to innovation will be a characteristic of post-COVID classes.

RevDate: 2020-11-26

Richardson DL, Duncan MJ, Clarke ND, et al (2020)

The influence of COVID-19 measures in the United Kingdom on physical activity levels, perceived physical function and mood in older adults: A survey-based observational study.

Journal of sports sciences [Epub ahead of print].

In March 2020, the spreading Coronavirus (COVID-19) prompted the United Kingdom government to introduce a societal shutdown, accompanied by self-isolation and social-distancing measures to reduce virus transmission. In doing so, opportunities for physical activity were likely reduced, potentially causing detrimental effects to older adults. Therefore, the present study investigated the influence of the initial six weeks of lockdown on physical activity levels, perceived physical function and mood in older adults. A cross-sectional, mixed-methods, observational study was conducted using self-administered, fortnightly online surveys throughout the UK between 21st March-4 May 2020. A total of 117 participants (52 males [age: 76 ± 4 years] and 65 females [age: 76 ± 4 years]) completed all surveys. Despite lockdown restrictions, this group of older adults maintained their pre-lockdown physical activity levels, but also increased their self-reported sedentary time. Subsequently, perception of physical function was maintained across lockdown. With regards to mood; the only strong evidence for an increase in depression was for males (ps = 95.35%; >0.3 AU), although self-reported levels of depression were similar between sexes at week six. Given the link between sedentary behaviour and negative health outcomes in older adults, strategies to reduce sedentariness during the COVID-19 pandemic are required.

RevDate: 2020-11-26

Höglund P, Ljunggren HG, R Jonsson (2020)

Covid-19, SSI 50 years and Nobel: Three immunological reasons to remember 2020.

Scandinavian journal of immunology, 92(6):e12997.

RevDate: 2020-11-26

Tolentino JC, Gjorup ALT, Schmidt GJ, et al (2020)

Early attention impairment in a patient with COVID-19.

RevDate: 2020-11-26

Hariyanto TI, A Kurniawan (2020)

Tocilizumab administration is associated with reduction in biomarkers of coronavirus disease 2019 (COVID-19) infection.

Journal of medical virology [Epub ahead of print].

BACKGROUND AND AIMS: Coronavirus disease 2019 (COVID-19) has caused a significant impact on all aspects of life with the number of death cases is still increasing. Therefore, identification of potential treatment for reducing the severity of the disease is important. Currently, the data regarding the effectivity of tocilizumab as treatment agents for COVID-19 infection is still conflicting. This study aims to give clear evidence regarding the potential benefit of tocilizumab in reducing the biomarkers of COVID-19 infection.

METHODS: We systematically searched the PubMed Central database using specific keywords related to our aims until July 24th , 2020. All articles published on COVID-19 and tocilizumab were retrieved.

RESULTS: A total of 9 studies with a total of 577 patients were included in our analysis. Our meta-analysis showed that tocilizumab treatment is associated with reduction of CRP [MD -106.69 mg/L (95% CI -146.90, -66.49 mg/L), p < 0.00001; I2 = 98%, random-effect modelling], D-Dimer [MD -3.06 mg/L (95% CI -5.81, -0.31 mg/L), p = 0.03; I2 = 98%, random-effect modelling], Ferritin [MD -532.80 ng/mL (95% CI -810.93, -254.67 ng/mL), p = 0.0002; I2 = 25%, random-effect modelling], PCT [MD -0.67 ng/mL (95% CI -1.13, -0.22 ng/mL), p = 0.004; I2 = 92%, random-effect modelling], and increment in the levels of Lymphocyte count [MD 0.36 x 103 /μL (95% CI 0.18, 0.54 x 103 /μL), p < 0.0001; I2 = 88%, random-effect modelling].

CONCLUSION: Administration of tocilizumab is effective in reducing the biomarkers of the COVID-19 infection. This article is protected by copyright. All rights reserved.

RevDate: 2020-11-26

Kulkarni JA, Thomson SB, Zaifman J, et al (2020)

Spontaneous, solvent-free entrapment of siRNA within lipid nanoparticles.

Nanoscale [Epub ahead of print].

Lipid nanoparticle (LNP) formulations of nucleic acid are leading vaccine candidates for COVID-19, and enabled the first approved RNAi therapeutic, Onpattro. LNPs are composed of ionizable cationic lipids, phosphatidylcholine, cholesterol, and polyethylene glycol (PEG)-lipids, and are produced using rapid-mixing techniques. These procedures involve dissolution of the lipid components in an organic phase and the nucleic acid in an acidic aqueous buffer (pH 4). These solutions are then combined using a continuous mixing device such as a T-mixer or microfluidic device. In this mixing step, particle formation and nucleic acid entrapment occur. Previous work from our group has shown that, in the absence of nucleic acid, the particles formed at pH 4 are vesicular in structure, a portion of these particles are converted to electron-dense structures in the presence of nucleic acid, and the proportion of electron-dense structures increases with nucleic acid content. What remained unclear from previous work was the mechanism by which vesicles form electron-dense structures. In this study, we use cryogenic transmission electron microscopy and dynamic light scattering to show that efficient siRNA entrapment occurs in the absence of ethanol (contrary to the established paradigm), and suggest that nucleic acid entrapment occurs through inversion of preformed vesicles. We also leverage this phenomenon to show that specialized mixers are not required for siRNA entrapment, and that preformed particles at pH 4 can be used for in vitro transfection.

RevDate: 2020-11-26

Brimblecombe P, Y Lai (2020)

Diurnal and weekly patterns of primary pollutants in Beijing under COVID-19 restrictions.

Faraday discussions [Epub ahead of print].

Restrictions on movement in Beijing to limit the COVID-19 epidemic tended to reduce the emissions of primary pollutants. However, changes in pollutant concentrations are also affected by chemical transformation and meteorology. Decreases in concentrations were also not as obvious in Beijing when compared with Hubei Province, where lockdown was especially strict. Declines in concentrations between 2019 and 2020 are evident for both NO2 (37.0 to 26.2 μg m-3) and SO2 (5.86 to 4.15 μg m-3), but there was little evidence of change for PM2.5 (50.0 to 53.8 μg m-3) and CO (0.71 to 0.74 mg m-3). Despite this, Fourier analysis revealed that the weekly cycle of PM2.5 evident in 2019 was not apparent in 2020. In 2019, CO showed both diurnal and weekly signals, but these were absent under the restrictions of 2020. This suggests that while concentrations may remain relatively constant, the temporal distribution of pollutants can show subtle changes under restrictions imposed in attempts to limit the spread of the coronavirus.

RevDate: 2020-11-26

Landoni G, Maimeri N, Fedrizzi M, et al (2020)

Why are Asian countries outperforming the Western world in controlling COVID-19 pandemic?.

Pathogens and global health [Epub ahead of print].

COVID-19 already caused more than 1,260,000 deaths around the world. However, mortality rates are not equal amongst the different countries. Mortality rates are ranging from less than 1 death per million in Taiwan, Vietnam and Thailand to 1,112 deaths per million in Belgium. In the present article, we report a striking difference in mean per million mortality between Asian and European countries (2.7 vs 197 deaths per million population, p < 0.001). In addition, we confirmed that the later a specific country was hit by the epidemic, the milder the impact on mortality during the first 50 days was. We analyzed several factors that may have contributed to this discrepancy including population age, previous experience of epidemics in the modern era, social acceptance of physical distancing and face masks, percentage of active smokers and lastly genetic prothrombotic mutations.

RevDate: 2020-11-26

Martinez KF, JB Morrow (2020)

Lessons learned in managing risk: Tools and strategies for confident operations from the CLEAN 2020 Summit.

Toxicology and industrial health, 36(9):736-742.

Risk mitigation of COVID-19 in the indoor environment requires an articulated strategy for creating a bridge between science and the business community that focuses on knitting together four core capabilities-environmental microbiology, transmission science, building science, and social science-advancing scientific knowledge. The purpose of this article is to share insights from the CLEAN 2020 Summit, which assembled leaders from business, policy, standards development, science, and engineering working to mitigate risk of transmission in the built environment. The Summit worked to assess current challenges and pain points felt by industries from around the globe as well as innovative solutions applied to meet these challenges. Although SARS-CoV-2 and the COVID-19 diseases are unique, the foundation of knowledge to assess and mitigate the risk of viral transmission in the built environment is robust. There are opportunities to improve science and engineering technology solutions, processes, and procedures to better meet the dynamic needs of the evolving pandemic.

RevDate: 2020-11-26

Gibbs JL, MW Nonnenmann (2020)

OSHA Voluntary Respirator Use: Challenges incurred with use of N95 filtering facepiece respirators during the COVID-19 pandemic.

Toxicology and industrial health, 36(9):681-688.

This article discusses several lessons learned in dealing with the interpretation of the Occupational Health and Safety Administration (OSHA) Voluntary Use provision of the Respiratory Health Standard at health-care facilities during the COVID-19 pandemic in the United States. This includes (but is not limited to) (a) confusion about OSHA policy and procedures when health-care workers brought outside personal protective equipment (PPE; N95 filtering facepiece respirators) into the workplace; (b) challenges in adhering to guidelines stated in Appendix D of the Respiratory Protection Standard; (c) difficulty in achieving respirator fit testing for workers; and (d) vague or inconsistent determination of "non-hazardous" environments (concerning COVID-laden droplets and aerosols). The purpose was to identify gaps in knowledge to help policy makers, enforcement personnel, safety managers, and health-care workers in the United States prepare for similar future events involving PPE shortages.

RevDate: 2020-11-26

Nembhard MD, Burton DJ, JM Cohen (2020)

Ventilation use in nonmedical settings during COVID-19: Cleaning protocol, maintenance, and recommendations.

Toxicology and industrial health, 36(9):644-653.

Coronavirus disease 2019, otherwise referred to as COVID-19, started in China and quickly became a worldwide pandemic. Beginning in March 2020, nonessential businesses in the United States were closed, and many communities were under shelter-in-place orders. As of May 2020, some business sectors started reopening, even amidst concerns of worker health as the pandemic continued. In addition to physical distancing, cleaning and disinfection routines, and using face coverings, building ventilation can also be an important risk mitigation measure for controlling exposure to SARS-CoV-2 indoors. A number of studies to date, however, have focused on ventilation in medical facilities (e.g. hospitals) as the risk of transmission of SARS-CoV-2 is higher there (because of the close proximity of workers to patients who have the disease and their treatment procedures). Few studies have focused on ventilation use in nonmedical settings (e.g. office buildings and school classrooms), despite the large population of workers and community members in these facilities. In this article, we review the role that building ventilation can play in minimizing the risk of SARS-CoV-2 transmission in nonmedical environments and some recommended protocols to follow for its proper use, including cleaning and maintaining mechanical ventilation systems for businesses, schools, and homes.

RevDate: 2020-11-26

Dotson GS, Lotter JT, Zisook RE, et al (2020)

Setting occupational exposure limits for antimicrobial agents: A case study based on a quaternary ammonium compound-based disinfectant.

Toxicology and industrial health, 36(9):619-633.

Antimicrobial agents have become an essential tool in controlling the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and guidelines on their use have been issued by various public health agencies. Through its Emerging Viral Pathogen Guidance for Antimicrobial Pesticides, the US Environmental Protection Agency has approved numerous surface disinfectant products for use against SARS-CoV-2. Despite their widespread use and range of associated health hazards, the majority of active ingredients in antimicrobial products, such as surface disinfectants, lack established occupational exposure limits (OELs) to assist occupational health professionals in characterizing risks from exposures to these chemicals. Based on established approaches from various organizations, a framework for deriving OELs specific to antimicrobial agents was developed that relies on a weight-of-evidence evaluation of the available data. This framework involves (1) a screening-level toxicological assessment based on a review of the existing literature and recommendations, (2) identification of the critical adverse effect(s) and dose-response relationship(s), (3) identification of alternative health-based exposure limits (HBELs), (4) derivation of potential OELs based on identified points of departure and uncertainty factors and/or modification of existing alternative HBELs, and (5) selection of an appropriate OEL. To demonstrate the use of this framework, a case study is described for selection of an OEL for a disinfectant product containing quaternary ammonium compounds (quats). Three potential OELs were derived for this product based on irritation toxicity data, developmental and reproductive toxicity (DART) data, and modification of an existing HBEL. The final selected OEL for the quats-containing product was 0.1 mg/m3, derived from modification of an existing HBEL. This value represented the lowest resulting value of the three approaches, and thus, was considered protective of irritation and potential DART.

RevDate: 2020-11-26

Brewster RK, Sundermann A, C Boles (2020)

Lessons learned for COVID-19 in the cruise ship industry.

Toxicology and industrial health, 36(9):728-735.

The coronavirus disease 2019 (COVID-19) pandemic has created widespread disruption in individuals' personal and occupational lives all around the world. Vacationers and tourism, recreation, and leisure employees were among those who experienced substantial disruption. Cruise ships, especially, faced turmoil on a global scale for both their customers and workers. COVID-19 outbreaks were reported on cruise ships beginning in February 2020, presenting new and unique challenges for the industry. Conditions on cruise ships, including close and frequent contact between passengers and crew members, use of common areas, the confined nature of the vessels, and gathering of passengers from different countries, aided in transmitting the disease both onboard and in the community. As the pandemic evolved, federal and state governments and industries worldwide, including cruise ship companies, developed response plans. In this article, we provide a high-level overview of the US government and cruise ship industry's response to the COVID-19 pandemic, as well as a brief commentary on lessons learned, and recommendations for the cruise ship sector going forward. The outlined suggestions may be used as a starting point to increase emergency preparedness and to inform outbreak response plans in the event of future infectious disease outbreaks.

RevDate: 2020-11-26

Roberts JD, Dickinson KL, Koebele E, et al (2020)

Clinicians, cooks, and cashiers: Examining health equity and the COVID-19 risks to essential workers.

Toxicology and industrial health, 36(9):689-702.

In Spring/Summer 2020, most individuals living in the United States experienced several months of social distancing and stay-at-home orders because of the coronavirus (COVID-19) pandemic. Clinicians, restaurant cooks, cashiers, transit operators, and other essential workers (EWs), however, continued to work outside the home during this time in order to keep others alive and maintain a functioning society. In the United States, EWs are often low-income persons of color who are more likely to face socioeconomic vulnerabilities, systemic racism, and health inequities. To assess the various impacts of COVID-19 on EWs, an online survey was distributed to a representative sample of individuals residing in six states during May/June 2020. The sample included 990 individuals who identified as EWs and 736 nonessential workers (NWs). We assessed differences between EW and NW respondents according to three categories related to health equity and social determinants of health: (1) demographics (e.g. race/ethnicity); (2) COVID-19 exposure risk pathways (e.g. ability to social distance); and (3) COVID-19 risk perceptions (e.g. perceived risk of contracting COVID-19). EWs were more likely to be Black or Hispanic than NWs and also had lower incomes and education levels on average. Unsurprisingly, EWs were substantially more likely to report working outside the home and less likely to report social distancing and wearing masks indoors as compared to NWs. EWs also perceived a slightly greater risk of contracting COVID-19. These findings, which we discuss in the context of persistent structural inequalities, systemic racism, and health inequities within the United States, highlight ways in which COVID-19 exacerbates existing socioeconomic vulnerabilities faced by EWs.

RevDate: 2020-11-26

Yong JH, Mainprize JG, Yaffe MJ, et al (2020)

The impact of episodic screening interruption: COVID-19 and population-based cancer screening in Canada.

Journal of medical screening [Epub ahead of print].

BACKGROUND: Population-based cancer screening can reduce cancer burden but was interrupted temporarily due to the COVID-19 pandemic. We estimated the long-term clinical impact of breast and colorectal cancer screening interruptions in Canada using a validated mathematical model.

METHODS: We used the OncoSim breast and colorectal cancers microsimulation models to explore scenarios of primary screening stops for 3, 6, and 12 months followed by 6-24-month transition periods of reduced screening volumes. For breast cancer, we estimated changes in cancer incidence over time, additional advanced-stage cases diagnosed, and excess cancer deaths in 2020-2029. For colorectal cancer, we estimated changes in cancer incidence over time, undiagnosed advanced adenomas and colorectal cancers in 2020, and lifetime excess cancer incidence and deaths.

RESULTS: Our simulations projected a surge of cancer cases when screening resumes. For breast cancer screening, a three-month interruption could increase cases diagnosed at advanced stages (310 more) and cancer deaths (110 more) in 2020-2029. A six-month interruption could lead to 670 extra advanced cancers and 250 additional cancer deaths. For colorectal cancers, a six-month suspension of primary screening could increase cancer incidence by 2200 cases with 960 more cancer deaths over the lifetime. Longer interruptions, and reduced volumes when screening resumes, would further increase excess cancer deaths.

CONCLUSIONS: Interruptions in cancer screening will lead to additional cancer deaths, additional advanced cancers diagnosed, and a surge in demand for downstream resources when screening resumes. An effective strategy is needed to minimize potential harm to people who missed their screening.

RevDate: 2020-11-26

Baccellieri D, Bertoglio L, Apruzzi L, et al (2020)

Incidence of deep venous thrombosis in COVID-19 hospitalized patients during the first peak of the Italian outbreak.

Phlebology [Epub ahead of print].

OBJECTIVES: A high rate of thrombotic events has been reported in COVID-19 population. The study aims to assess the incidence of deep vein thrombosis (DVT) in COVID-19 patients admitted to a single tertiary hospital.

METHODS: From April 2nd to April 18th, 2020, hospitalized patients with SARS-CoV-2 infection were screened by lower limb duplex ultrasound (DUS). Patients were on (low molecular weight heparin) LMWH prophylaxis in medical wards, and on therapeutic anticoagulation in intensive care unit (ICU). DVT risk factors, reported by the Padua prediction score and blood tests, were retrieved from institutional electronic charts. The study primary endpoint was the incidence of DVT in the in-hospital COVID-19 population and its association with clinical and laboratory risk factors. The secondary endpoint was the association of DVT with mortality.

RESULTS: Two hundred patients (median age 62 years, 72% male, 40 in ICU) received DUS screening. DVT was observed in 29 patients (14.5%), with proximal extension in 16 patients, and in association with symptoms in four patients. The DVT rate was similar in ICU (12.5%) and non-ICU patients (15%). Eighty-seven patients underwent a computed tomography angiography (CTA) that showed pulmonary embolism in 35 patients (40.2%) not associated with DVT in 25/35 cases (71.4%). DVT in the ten patients with pulmonary embolism were symptomatic in four and with a proximal localization in eight cases. A D-dimer level ≥5 mg/l at admission was predictive of DVT (OR 1.02; IC95% 1.03-1.16; p = .003). At the multivariate analysis in-hospital mortality was predicted by age (OR 1.06; 95% CI 0.02-1.15; p = .004) and by being an ICU patient (OR 1.23; 95% CI 0.30-2.25; p = .01).

CONCLUSIONS: Despite LMWH prophylaxis or full anticoagulant therapy, the incidence of DVT, mainly asymptomatic, in hospitalized COVID-19 patients was 14.5%. Further research should focus on the appropriate antithrombotic therapy for COVID-19 patients.

RevDate: 2020-11-26

Wang ZJ, Zhang HJ, Lu J, et al (2020)

Low Toxicity and High Immunogenicity of an Inactivated Vaccine Candidate against COVID-19 in different animal models.

Emerging microbes & infections [Epub ahead of print].

The ongoing COVID-19 pandemic is causing huge impact on health, life and global economy which is characterized by rapid spreading of SARS-CoV-2, high number of confirmed cases and a fatality/case rate worldwide reported by WHO. The most effective intervention measure will be to develop safe and effective vaccines to protect the population from the disease and limit the spread of the virus. An inactivated, whole virus vaccine candidate of SARS-CoV-2 has been developed by Wuhan Institute of Biological Products and Wuhan Institute of Virology. The low toxicity, immunogenicity and immune persistence were investigated in preclinical studies using 7 different species of animals. The results showed that the vaccine candidate was well tolerated and stimulated high levels of specific IgG and neutralizing antibodies. Low or no toxicity in three species of animals was also demonstrated in preclinical study of the vaccine candidate. Biochemical analysis of structural proteins and purity analysis were performed. The inactivated, whole virion vaccine was characterized with safe double-inactivation, no use of DNases and high purity. Dosages, boosting times, adjuvants, and immunization schedules were shown to be important for stimulating a strong humoral immune response in animals tested. Preliminary observation in ongoing phase I and II clinical trials of the vaccine candidate in Wuzhi County, Henan Province, showed that the vaccine is well tolerant. The results were characterized by very low proportion and low degree of side effects, high levels of neutralizing antibodies and seroconversion. These results consistent with the results obtained from preclinical data on the safety.

RevDate: 2020-11-26

Hussain A, Ike DI, Durand-Hill M, et al (2020)

Sternal wound infections during the COVID-19 pandemic: an unexpected benefit.

Asian cardiovascular & thoracic annals [Epub ahead of print].

BACKGROUND: The novel coronavirus, now termed SARS-CoV-2, has had a significant impact on cardiac surgical services globally. Although drastically reduced, our institution has maintained a significant level of cardiac surgical activity during the pandemic. Rigorous COVID-19 guidelines have been instituted to mitigate the risk of viral transmission. We observed a reduction in sternal wound infections since the institution of new perioperative surgical guidelines.

METHODS: We performed a retrospective analysis of all patients who underwent cardiac surgery at our institution since a national lockdown was declared in March 2020. A retrospective analysis of all patients who underwent cardiac surgery in the 12 months preceding the national lockdown, as a baseline cohort group, was also performed.

RESULTS: A total of 2600 patients (493 during the COVID-19 pandemic) were included in this study. Urgent/emergency procedures accounted for more than 60% of procedures performed during the lockdown compared to 39% previously. During the COVID-19 pandemic, there were 4 sternal wound infections with an overall incidence of 0.8%. In comparison, the incidence of sternal wound infections was significantly higher at 3.0% in the 12-month period prior to lockdown with 63 sternal wound infections (p = 0.006).

CONCLUSION: This report suggests a significant role of iatrogenic causes in sternal wound infections prior to the pandemic. The strict implementation of guidelines in the perioperative period suggests that sternal wound infections can be prevented. We propose that the now widespread COVID-19 guidelines to reduce transmission risk be adapted to help reduce the incidence of sternal wound infections.

RevDate: 2020-11-26

Levin AB, Ball CM, PJ Featherstone (2020)

From cholera to COVID-19: How pandemics have shaped the development of anaesthesia and intensive care medicine.

Anaesthesia and intensive care [Epub ahead of print].

The infectious pandemics and epidemics of the past 200 years have caused millions of deaths. However, these devastating events have also led to creative thinking, imaginative experimentation and the evolution of medical care. As a result, the history of critical care medicine is entwined with the story of these global disasters. This article will take case studies from recent pandemics and epidemics and examine their impact on the development of anaesthesia and intensive care medicine.

RevDate: 2020-11-26

Qin X, Huang C, Wu K, et al (2020)

Anti-coronavirus disease 2019 (COVID-19) targets and mechanisms of puerarin.

Journal of cellular and molecular medicine [Epub ahead of print].

The present study aimed to uncover the pharmacological function and underlying mechanism of puerarin as a potential treatment for COVID-19, using an in silico methodology, including network pharmacology and molecular docking. The pivotal targets of puerarin to treat COVID-19 were identified and included the epidermal growth factor receptor (EGFR), tumour necrosis factor (TNF), tumour protein p53 (TP53), caspase 3 (CASP3), RELA proto-oncogene (RELA), Fos proto-oncogene (FOS), caspase 8 (CASP8), prostaglandin-endoperoxide synthase 2 (PTGS2), interleukin 2 (IL2), protein kinase CB (PRKCB), B cell lymphoma/leukaemia gene-2 (BCL2), protein kinase CA (PRKCA), nitric oxide synthase 3 (NOS3) and peroxisome proliferator-activated receptor gamma (PPARG). Functionally, the anti-COVID-19 action of puerarin was associated with the suppression of oxidative stress and inflammatory cascades, and cell apoptosis. The signalling pathways of puerarin to treat COVID-19 included modulation of the pathways of apoptosis, IL-17 signalling, mitogen-activated protein kinase (MAPK) signalling and TNF signalling. Molecular docking data illustrated the binding capacity of puerarin with COVID-19 and the effective anti-COVID-19 activity of puerarin. Taken together, our current network pharmacology-based findings revealed the pharmacological role of puerarin in the treatment of COVID-19. Furthermore, the bioinformatic findings elucidated that some of these pivotal targets might serve as potential molecular markers for detecting COVID-19.

RevDate: 2020-11-26

Sivaraman M, Virues-Ortega J, H Roeyers (2020)

Telehealth mask wearing training for children with autism during the COVID-19 pandemic.

Journal of applied behavior analysis [Epub ahead of print].

SARS-CoV-2 is the virus causing COVID-19 and is spread through close person-to-person contact. The use of face masks has been described as an important strategy to slow its transmission. We evaluated the effects of coaching caregivers via telehealth technologies to teach face mask wearing to children with autism spectrum disorder. Six participants with a history of challenging behavior associated with mask wearing were recruited from different parts of the world, and trained using graduated exposure, shaping, and contingent reinforcement. By the end of the intervention, all participants wore a face mask for a period of 10 min without exhibiting challenging behavior. The skills generalized to a novel mask or a community setting. Mask wearing did not affect the percentage of oxyhemoglobin saturation of participants, and caregivers found the intervention useful. The findings support previous tolerance training treatment evaluations in children with developmental disorders exhibiting resistance to healthcare routines.

RevDate: 2020-11-26

Mamun MA (2020)

The first COVID-19 triadic (homicide!)-suicide pact: Do economic distress, disability, sickness, and treatment negligence matter?.

Perspectives in psychiatric care [Epub ahead of print].

INTRODUCTION: Dyadic suicide-pact is rare but possible incidence in the COVID-19 time. No prior evidences available on triadic suicide-pact, which is presented herein for the first-time.

CASE PRESENTATION: An Indian family consisting of three members, committed suicide. There is no evidence of homicide-suicide, which suggests the cases to be mutual suicide-pact. However, the suicide risk factors can be evidently noted as (i) economic distress, (ii) feeling burden of disability and sick people, and (iii) being stubborn as of not getting hospital treatment. Poisoning is reported for the suicide method; besides, the victims left a suicide note.

PRACTICAL IMPLICATIONS: The present case highlights the possibilities of further suicide-pacts in economically unprivileged family, whereas having disabled and/or sick people may add extra burdens in taking such extreme decision.

RevDate: 2020-11-26

Pj A, Pironi L, F J, et al (2020)

An international survey of clinicians' experience caring for patients on home parenteral nutrition for chronic intestinal failure during the COVID-19 pandemic.

JPEN. Journal of parenteral and enteral nutrition [Epub ahead of print].

BACKGROUND AND AIMS: This survey of centres caring for patients on home parenteral nutrition (HPN) was conducted to assess the impact of the COVID-19 crisis on the management of these patients in terms of provision of care, monitoring, regular follow-up and any changes to service infrastructure.

METHODS: A survey was devised and publically published on the REDCap database management system with individual centres responding to a public link.

RESULTS: 78 adult and paediatric centres worldwide contributed to the survey, representing at least 3500 patients' experience. Centres (n/78 unless otherwise specified, %) reported infrastructure maintenance for PN bag deliveries to patients (60, 76.92%) or delivery of ancillary items (dressing packs, gloves, bungs) (57, 73.08%) home delivery and HPN administration (65, 83.33%) but homecare nurse shortages (25, 32.05%). Follow up of routine HPN patients changed to either all telemed or mixed with emergency clinic review (70, 89.74%). In 26 centres (33.33%), new discharges on HPN for benign conditions were reduced or stopped. Based on clinical history the centres reported psychological distress for patients (52, 66.67%) with anxiety, worry, concern and apprehension reported most frequently (37/52, 71.15%) but also fear (10/52, 19.23%), depression (5/52, 9.62%) and issues related to isolation/confinement (12/52, 23.08%).

CONCLUSIONS: The COVID-19 pandemic was reported by clinicians to have had a far reaching adverse impact on patients on home parenteral nutrition, especially their safety in terms of provision of PPE, PN bags, available nursing staff and psychological well-being. Healthcare systems responded to the challenge presented with new ways of working. This article is protected by copyright. All rights reserved.

RevDate: 2020-11-26

Gordon WJ, Henderson D, DeSharone A, et al (2020)

Remote Patient Monitoring Program for Hospital Discharged COVID-19 Patients.

Applied clinical informatics, 11(5):792-801.

OBJECTIVE: We deployed a Remote Patient Monitoring (RPM) program to monitor patients with coronavirus disease 2019 (COVID-19) upon hospital discharge. We describe the patient characteristics, program characteristics, and clinical outcomes of patients in our RPM program.

METHODS: We enrolled COVID-19 patients being discharged home from the hospital. Enrolled patients had an app, and were provided with a pulse oximeter and thermometer. Patients self-reported symptoms, O2 saturation, and temperature daily. Abnormal symptoms or vital signs were flagged and assessed by a pool of nurses. Descriptive statistics were used to describe patient and program characteristics. A mixed-effects logistic regression model was used to determine the odds of a combined endpoint of emergency department (ED) or hospital readmission.

RESULTS: A total of 295 patients were referred for RPM from five participating hospitals, and 225 patients were enrolled. A majority of enrolled patients (66%) completed the monitoring period without triggering an abnormal alert. Enrollment was associated with a decreased odds of ED or hospital readmission (adjusted odds ratio: 0.54; 95% confidence interval: 0.3-0.97; p = 0.039). Referral without enrollment was not associated with a reduced odds of ED or hospital readmission.

CONCLUSION: RPM for COVID-19 provides a mechanism to monitor patients in their home environment and reduce hospital utilization. Our work suggests that RPM reduces readmissions for patients with COVID-19 and provides scalable remote monitoring capabilities upon hospital discharge. RPM for postdischarge patients with COVID-19 was associated with a decreased risk of readmission to the ED or hospital, and provided a scalable mechanism to monitor patients in their home environment.

RevDate: 2020-11-26

Soheilifar S, Fathi H, N Naghdi (2020)

Photobiomodulation therapy as a high potential treatment modality for COVID-19.

Lasers in medical science pii:10.1007/s10103-020-03206-9 [Epub ahead of print].

COVID-19 is now a worldwide concern, causing an unprecedented pandemic. The infected cases show different symptoms based on the severity of the disease. In asymptomatic and non-severe symptomatic cases, the host immune system can successfully eliminate the virus and its effects. In severe cases, however, immune system impairment causes cytokine release syndrome which eventually leads to acute respiratory distress syndrome (ARDS). In recent years, photobiomodulation (PBM) has shown promising results in reducing acute pulmonary inflammation. Considering the high potential impact of PBM on immune responses, we hypothesized that using PBM could be an effective treatment modality for ARDS management in COVID-19 patients.

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ESP Quick Facts

ESP Origins

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.

ESP Support

In 1995, Robbins became the VP/IT of the Fred Hutchinson Cancer Research Center in Seattle, WA. Soon after arriving in Seattle, Robbins secured funding, through the ELSI component of the US Human Genome Project, to create the original ESP.ORG web site, with the formal goal of providing free, world-wide access to the literature of classical genetics.

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Although the methods of molecular biology can seem almost magical to the uninitiated, the original techniques of classical genetics are readily appreciated by one and all: cross individuals that differ in some inherited trait, collect all of the progeny, score their attributes, and propose mechanisms to explain the patterns of inheritance observed.

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In reading the early works of classical genetics, one is drawn, almost inexorably, into ever more complex models, until molecular explanations begin to seem both necessary and natural. At that point, the tools for understanding genome research are at hand. Assisting readers reach this point was the original goal of The Electronic Scholarly Publishing Project.

ESP Usage

Usage of the site grew rapidly and has remained high. Faculty began to use the site for their assigned readings. Other on-line publishers, ranging from The New York Times to Nature referenced ESP materials in their own publications. Nobel laureates (e.g., Joshua Lederberg) regularly used the site and even wrote to suggest changes and improvements.

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When the site began, no journals were making their early content available in digital format. As a result, ESP was obliged to digitize classic literature before it could be made available. For many important papers — such as Mendel's original paper or the first genetic map — ESP had to produce entirely new typeset versions of the works, if they were to be available in a high-quality format.

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Early support from the DOE component of the Human Genome Project was critically important for getting the ESP project on a firm foundation. Since that funding ended (nearly 20 years ago), the project has been operated as a purely volunteer effort. Anyone wishing to assist in these efforts should send an email to Robbins.

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With the development of methods for adding typeset side notes to PDF files, the ESP project now plans to add annotated versions of some classical papers to its holdings. We also plan to add new reference and pedagogical material. We have already started providing regularly updated, comprehensive bibliographies to the ESP.ORG site.

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With the world now in the middle of a new and rapidly spreading pandemic, now is the time to read this book, originally published in 2012, that describes animal infections and the next human pandemic (that's actually the book's subtitle). You would be hard pressed to find a more relevant explanation of how this got started and why there will be more after this one. R. Robbins

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Papers in Classical Genetics

The ESP began as an effort to share a handful of key papers from the early days of classical genetics. Now the collection has grown to include hundreds of papers, in full-text format.

Digital Books

Along with papers on classical genetics, ESP offers a collection of full-text digital books, including many works by Darwin (and even a collection of poetry — Chicago Poems by Carl Sandburg).

Timelines

ESP now offers a much improved and expanded collection of timelines, designed to give the user choice over subject matter and dates.

Biographies

Biographical information about many key scientists.

Selected Bibliographies

Bibliographies on several topics of potential interest to the ESP community are now being automatically maintained and generated on the ESP site.

ESP Picks from Around the Web (updated 07 JUL 2018 )