RevDate: 2020-06-03

Nizzoli ME, Merati G, Tenore A, et al (2020)

Circulating endothelial cells in COVID-19.

RevDate: 2020-06-03

Bothra A, Das S, Singh M, et al (2020)

Retroauricular dermatitis with vehement use of ear loop face masks during COVID19 pandemic.

The COVID-19 pandemic forged theexponential use of masks of various kinds, not just by health workers but also by general population as a personal protective equipment (PPE). Although contact dermatitis due to PPE is well reported, mask induced dermatitis is a relatively unexplored phenomenon. In this article, we report a preliminary data of patients experiencing retroauricaular dermatitis due to ear loop face masks.

RevDate: 2020-06-03

Li L, Yang R, Wang J, et al (2020)

Feasibility of a Pilot Program for COVID-19 Convalescent Plasma Collection in Wuhan, China.

Transfusion [Epub ahead of print].

BACKGROUND: A novel coronavirus has caused an international outbreak. Currently, there are no specific therapeutic agents for coronavirus infections. Convalescent plasma (CP) therapy is a potentially effective treatment option.

METHODS: Patients who had recovered from COVID-19 and had been discharged from the hospital for more than two weeks were recruited. COVID-19 convalescent plasma (CCP)-specific donor screening and selection were performed based the following criteria: 1) aged 18-55 years; 2) eligible for blood donation; 3) diagnosed with COVID-19; 4) had two consecutive negative COVID-19 nasopharyngeal swab tests based on PCR (at least 24 h apart) prior to hospital discharge; 5) had been discharged from the hospital for more than 2 weeks; and 6) had no COVID-19 symptoms prior to convalescent plasma donation. In addition, preference was given to CCP donors who had a fever lasting more than 3 days or a body temperature exceeding 38.5 Celsius, and 4 weeks after the onset of symptoms. CCP collection was performed using routine plasma collection procedures via plasmapheresis. In addition to routine donor testing, the CCP donors' plasma was also tested for SARS-CoV-2 nucleic acid and S-RBD-specific IgG antibody.

RESULTS: Of the 81 potential CCP donors, 64 (79%) plasma products were collected. There were 18 female donors and 46 male donors. There were 34 first-time blood donors and 30 repeat donors. The average time between CCP collection and initial symptom onset was 49.1 days, and the average time between CCP collection and hospital discharge was 38.7 days. The average volume of CCP collected was 327.7 ml. All Alanine transaminase (ALT) testing results met blood donation requirements. HIV Ag/Ab, anti-HCV, anti-syphilis and HBsAg were all negative; NAT for HIV, HBV, and HCV were also negative. In addition, all of the CCP donors' plasma units were negative for SARS-CoV-2 RNA. Of the total 64 CCP donors tested, only one had an S-RBD-specific IgG titer of 1:160, all others had a titer of ≥1:320.

CONCLUSION: Based on a feasibility study of a pilot CCP program in Wuhan China, we demonstrated the success and feasibility of CCP collection. In addition, all of the CCP units collected had a titer of ≥ 1:160 for S-RBD-specific IgG antibody, which met the CCP quality control requirements based on the Chinese national guidelines for CCP. This article is protected by copyright. All rights reserved.

RevDate: 2020-06-03

Tutton MG (2020)

Colorectal cancer surgery during the COVID-19 pandemic.

RevDate: 2020-06-03

Fu D, Zhang P, Wang L, et al (2020)

Emergency abdominal surgery in COVID-19 patients: a note of caution from Wuhan.

RevDate: 2020-06-03

Zou Y, Wang BR, Sun L, et al (2020)

The issue of recurrently positive patients who recovered from COVID-19 according to the current discharge criteria: investigation of patients from multiple medical institutions in Wuhan, China.

The Journal of infectious diseases pii:5850850 [Epub ahead of print].

The current discharge criteria for COVID-19 require that patients have two consecutive negative results for RT-PCR detection. Here, we observed that recurrently positive RT-PCR test results in patients with three consecutive negative results (3xNegRPos, 5.4%) were significantly decreased compared with those in patients with two consecutive negative results (2xNegRPos, 20.6%); such patients reported positive RT-PCR test results within 1 to 12 days after meeting the discharge criteria. These results confirmed that many recovered patients could show a positive RT-PCR test result, and most of these patients could be identified by an additional RT-PCR test prior to discharge.

RevDate: 2020-06-03

Rod JE, Oviedo-Trespalacios O, J Cortes-Ramirez (2020)

A brief-review of the risk factors for covid-19 severity.

Revista de saude publica, 54:60.

The World Health Organization has emphasized that one of the most important questions to address regarding the covid-19 pandemic is to understand risk factors for disease severity. We conducted a brief review that synthesizes the available evidence and provides a judgment on the consistency of the association between risk factors and a composite end-point of severe-fatal covid-19. Additionally, we also conducted a comparability analysis of risk factors across 17 studies. We found evidence supporting a total of 60 predictors for disease severity, of which seven were deemed of high consistency, 40 of medium and 13 of low. Among the factors with high consistency of association, we found age, C-reactive protein, D-dimer, albumin, body temperature, SOFA score and diabetes. The results suggest that diabetes might be the most consistent comorbidity predicting disease severity and that future research should carefully consider the comparability of reporting cases, factors, and outcomes along the different stages of the natural history of covid-19.

RevDate: 2020-06-03

Ribeiro H, Santana KVS, Oliver SL, et al (2020)

Does Vitamin D play a role in the management of Covid-19 in Brazil?.

Revista de saude publica, 54:53.

The study discusses the possible role of adequate vitamin D status in plasma or serum for preventing acute respiratory infections during the Covid-19 pandemic. Our arguments respond to an article, published in Italy, that describes the high prevalence of hypovitaminosis D in older Italian women and raises the possible preventive and therapeutic role of optimal vitamin D levels. Based on literature review, we highlight the findings regarding the protective role of vitamin D for infectious diseases of the respiratory system. However, randomized controlled trials are currently lacking. Adequate vitamin D status is obtained from sun exposure and foods rich in vitamin D. Studies in Brazil have shown that hypovitaminosis D is quite common in spite of high insolation. Authors recommend ecological, epidemiological and randomized controlled trials studies to verify this hypothesis.

RevDate: 2020-06-03

Silva CMD, G Arbilla (2020)

COVID-19: challenges for a new epoch.

Revista da Sociedade Brasileira de Medicina Tropical, 53:e20200270.

RevDate: 2020-06-03

Zhu J, Zhou W, Zhou M, et al (2020)

Clinical characteristics and therapeutic procedure for a critical case of novel coronavirus pneumonia treated with glucocorticoids and non-invasive ventilator treatment.

Revista da Sociedade Brasileira de Medicina Tropical, 53:e20200227.

The novel coronavirus pneumonia (NCP) outbreak occurred in Wuhan, China at the end of 2019. Here, we report the clinical characteristics and therapeutic procedure for a case of severe NCP. The patient was started on glucocorticoids and non-invasive ventilator treatment. After treatment, the patient's symptoms improved, and the status was confirmed as NCP negative. Our results may provide clues for the treatment of NCP.

RevDate: 2020-06-03

Moreira BL, Santana PRP, Zanetti G, et al (2020)

COVID-19 and acute pulmonary embolism: what should be considered to indicate a computed tomography pulmonary angiography scan?.

Revista da Sociedade Brasileira de Medicina Tropical, 53:e20200267.

The full spectrum of COVID-19 is still emerging, although several studies have highlighted that patients infected with the novel coronavirus can potentially develop a hypercoagulable state. However, several aspects related to the incidence and pathophysiology of the association between COVID-19 and pulmonary embolism are not well established. Here, we present a case of a patient with COVID-19 who developed acute pulmonary embolism. Clinical and laboratory data and findings of non-enhanced CT indicate possibility of acute pulmonary embolism, and support the decision to proceed with computed tomography pulmonary angiography that can objectively identify filling defects in pulmonary arterial branches.

RevDate: 2020-06-03

Souza CDF (2020)

War economy and the COVID-19 pandemic: Inequalities in stimulus packages as an additional challenge for health systems.

Revista da Sociedade Brasileira de Medicina Tropical, 53:e20200245.

RevDate: 2020-06-03

Andrade LA, Gomes DS, Góes MAO, et al (2020)

Surveillance of the first cases of COVID-19 in Sergipe using a prospective spatiotemporal analysis: the spatial dispersion and its public health implications.

Revista da Sociedade Brasileira de Medicina Tropical, 53:e20200287.

INTRODUCTION: Coronavirus disease 2019 (COVID-19) has become a global public health emergency with lethality ranging from 1% to 5%. This study aimed to identify active high-risk transmission clusters of COVID-19 in Sergipe.

METHODS: We performed a prospective space-time analysis using confirmed cases of COVID-19 during the first 7 weeks of the outbreak in Sergipe.

RESULTS: The prospective space-time statistic detected "active" and emerging spatio-temporal clusters comprising six municipalities in the south-central region of the state.

CONCLUSIONS: The Geographic Information System (GIS) associated with spatio-temporal scan statistics can provide timely support for surveillance and assist in decision-making.

RevDate: 2020-06-03

Costa MF (2020)

Health belief model for coronavirus infection risk determinants.

Revista de saude publica, 54:47.

OBJECTIVE To use the advantages of a ratio scale with verbal anchors in order to measure the risk perception in the novel coronavirus infection, which causes covid-19, in a health belief model-based questionnaire, as well as its validity and reproducibility. METHOD We used the health belief model, which explores four dimensions: perceived susceptibility (five questions), perceived severity (five questions), perceived benefits (five questions), and perceived barriers (five questions). Additionally, we included a fifth dimension, called pro-health motivation (four questions). The questions composed an electronic questionnaire disseminated by social networks for an one-week period. Answers were quantitative values of subjective representations, obtained by a psychophysically constructed scale with verbal anchors ratio (CentiMax ®). Mean time for total filling was 12 minutes (standard deviation = 1.6). RESULTS We obtained 277 complete responses to the form. One was excluded because it belonged to a participant under 18 years old. Reproducibility measures were significant for 22 of the 24 questions in our questionnaire (Cronbach's α = 0.883). Convergent validity was attested by Spearman-Brown's split half reliability coefficient (r = 0.882). Significant differences among groups were more intense in perceived susceptibility and severity dimensions, and less in perceived benefits and barriers. CONCLUSION Our health belief model-based questionnaire using quantitative measures enabled the confirmation of popular beliefs about covid-19 infection risks. The advantage in our approach lays in the possibility of quickly, directly and quantitatively identifying individual belief profiles for each dimension in the questionnaire, serving as a great ally for communication processes and public health education.

RevDate: 2020-06-03

Silva DARD, Pimentel RFW, MCD Merces (2020)

Covid-19 and the pandemic of fear: reflections on mental health.

Revista de saude publica, 54:46.

RevDate: 2020-06-03

Rezende LFM, Thome B, Schveitzer MC, et al (2020)

Adults at high-risk of severe coronavirus disease-2019 (Covid-19) in Brazil.

Revista de saude publica, 54:50.

OBJECTIVE To estimate the proportion and total number of the general adult population who may be at higher risk of severe Covid-19 in Brazil. METHODS We included 51,770 participants from a nationally representative, household-based health survey (PNS) conducted in Brazil. We estimated the proportion and number of adults (≥ 18 years) at risk of severe Covid-19 by sex, educational level, race/ethnicity, and state based on the presence of one or more of the following risk factors: age ≥ 65 years or medical diagnosis of cardiovascular disease, diabetes, hypertension, chronic respiratory disease, cancer, stroke, chronic kidney disease and moderate to severe asthma, smoking status, and obesity. RESULTS Adults at risk of severe Covid-19 in Brazil varied from 34.0% (53 million) to 54.5% (86 million) nationwide. Less-educated adults present a 2-fold higher prevalence of risk factors compared to university graduated. We found no differences by sex and race/ethnicity. São Paulo, Rio de Janeiro, Minas Gerais, and Rio Grande do Sul were the most vulnerable states in absolute and relative terms of adults at risk. CONCLUSIONS Proportion and total number of adults at risk of severe Covid-19 are high in Brazil, with wide variation across states and adult subgroups. These findings should be considered while designing and implementing prevention measures in Brazil. We argue that these results support broad social isolation measures, particularly when testing capacity for SARS-CoV-2 is limited.

RevDate: 2020-06-03

Morsch DS, Custódio ZAO, ZC Lamy (2020)

PSYCHO-EMOTIONAL CARE IN A NEONATAL UNIT DURING THE COVID-19 PANDEMIC.

Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo, 38:e2020119.

RevDate: 2020-06-03

Costa JA, Silveira JA, Santos SCMD, et al (2020)

Cardiovascular Implications in Patients Infected with Covid-19 and the Importance of Social Isolation to Reduce Dissemination of the Disease.

Arquivos brasileiros de cardiologia, 114(5):834-838.

Respiratory symptoms, especially the development of severe acute respiratory distress syndrome, dominate the discussion and initial concerns of the population and health professionals. However, the cardiovascular system is greatly affected by these conditions and is often responsible for complications and mortality of these patients. In order to show the cardiovascular implications in patients infected with COVID-19 and the importance of social isolation as an alternative to curb the spread of the disease, a literature review was carried out based on 37 articles, in English, Portuguese and Spanish, available on Scielo and PubMed. The findings showed that cardiac complications associated with COVID-19 infection are similar to those produced by: severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS) and influenza. However, COVID-19 has a much greater and faster contamination and, unlike influenza, there is no vaccine or treatment available yet. In view of this, social isolation becomes a tool that can reduce and flatten the curve of cases and thus protect the people at higher risk, decreasing the chances of serious conditions related to the disease, potential deaths and the collapse of the country's health system.

RevDate: 2020-06-03

Nascimento JHP, Gomes BFO, Carmo Júnior PRD, et al (2020)

COVID-19 and Hypercoagulable State: A New Therapeutic Perspective.

Arquivos brasileiros de cardiologia, 114(5):829-833.

RevDate: 2020-06-03

Askin L, Tanrıverdi O, HS Askin (2020)

The Effect of Coronavirus Disease 2019 on Cardiovascular Diseases.

Arquivos brasileiros de cardiologia, 114(5):817-822.

Coronavirus disease 2019 (COVID-19) is a global pandemic affecting the world, seen in more than 1,300,000 patients. COVID-19 acts through the angiotensin-converting enzyme 2 (ACE2) receptor. Cardiovascular comorbidities are more common with COVID-19, and nearly 10% of cases develop myocarditis (22% of critical patients). Further research is needed to continue or discontinue ACE inhibitors and angiotensin receptor blockers, which are essential in hypertension and heart failure in COVID-19. Intensive research is promising for the treatment and prevention of COVID-19.

RevDate: 2020-06-03

Matos MA (2020)

New Coronavirus (SARS-CoV-2): advances to flatten the curve the prison population.

Revista da Sociedade Brasileira de Medicina Tropical, 53:e20200219.

RevDate: 2020-06-03

Pititto BA, SRG Ferreira (2020)

Diabetes and covid-19: more than the sum of two morbidities.

Revista de saude publica, 54:54.

The coronavirus disease 2019 (covid-19) pandemic has caused a public health emergency worldwide. Risk, severity and mortality of the disease have been associated with non-communicable chronic diseases, such as diabetes mellitus. Accumulated evidence has caused great concern in countries with high prevalence of this morbidity, such as Brazil. This text shows the picture of diabetes in Brazil, followed by epidemiological data and explanatory hypothesis for the association between diabetes and covid-19. We emphasized how the burden of these two morbidities in a middle-income country has aggravated this pandemic scenario. The comprehension of this association and biological plausibility may help face this pandemic and future challenges.

RevDate: 2020-06-03

Telles LEB, Valença AM, Barros AJS, et al (2020)

Domestic violence in the COVID-19 pandemic: a forensic psychiatric perspective.

Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999) pii:S1516-44462020005015211 [Epub ahead of print].

RevDate: 2020-06-03

Ribeiro MAF, DE-Campos T, Lima DS, et al (2020)

The trauma and acute care surgeon in the COVID-19 pandemic era.

Revista do Colegio Brasileiro de Cirurgioes, 47:e20202576.

The World Health Organization recognized in March 2020 the existence of a pandemic for the new coronavirus that appeared in China, in late 2019, and whose disease was named COVID-19. In this context, the SBAIT (Brazilian Society of Integrated Care for Traumatized Patients) conducted a survey with 219 trauma and emergency surgeons regarding the availability of personal protective equipment (PPE) and the role of the surgeon in this pandemic by means of an electronic survey. It was observed that surgeons have been acting under inadequate conditions, with a lack of basic supplies as well as more specific equipment such as N95 masks and facial shields for the care of potential victims who may be contaminated. The latter increases the risk of contamination of professionals, resulting in potential losses in the working teams. Immediate measures must be taken to guarantee access to safety equipment throughout the country, since all trauma victims and/or patients with emergency surgical conditions must be treated as potential carriers of COVID-19.

RevDate: 2020-06-03

Castro REV, Garcez FB, TJ Avelino-Silva (2020)

Patient care during the COVID-19 pandemic: do not leave delirium behind.

Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999) pii:S1516-44462020005014203 [Epub ahead of print].

RevDate: 2020-06-03

Emparan JPO, Sardi-Correa C, López-Ulloa JA, et al (2020)

COVID-19 and the eye: how much do we really know? A best evidence review.

Arquivos brasileiros de oftalmologia, 83(3):250-261.

To identify and classify available information regarding COVID-19 and eye care according to the level of evidence, within four main topics of interest: evidence of the virus in tears and the ocular surface, infection via the conjunctival route, ocular manifestations, and best practice recommendations. A structured review was conducted in PubMed, ScienceDirect, LILACS, SciELO, the Cochrane Library and Google Scholar on COVID-19 and ophthalmology. The Oxford Centre for Evidence Based Medicine 2011 Levels of Evidence worksheet was used for quality assessments. 1018 items were identified in the search; 26 records were included in the qualitative synthesis, which encompassed 6 literature reviews, 10 case series or cross-sectional studies, 4 case reports, and 6 intervention descriptions. Seventeen out of 26 records (65%) were categorized as level 5 within the Oxford CBME methodology grading system, the rest were level 4. The evidence generated on COVID-19 and ophthalmology to date is limited, although this is understandable given the circumstances. Both the possible presence of viral particles in tears and conjunctiva, and the potential for conjunctival transmission remain controversial. Ocular manifestations are not frequent and could resemble viral infection of the ocular surface. Most recommendations are based on the strategies implemented by Asian countries during previous coronavirus outbreaks. There is a need for substantive studies evaluating these strategies in the setting of SARS-CoV-2. In the meantime, plans for applying these measures must be implemented with caution, taking into account the context of each individual country, and undergo regular evaluation.

RevDate: 2020-06-03

Munhoz RP, Pedroso JL, Nascimento FA, et al (2020)

Neurological complications in patients with SARS-CoV-2 infection: a systematic review.

Arquivos de neuro-psiquiatria, 78(5):290-300.

BACKGROUND: As the COVID-19 pandemic unfolds worldwide, different forms of reports have described its neurologic manifestations.

OBJECTIVE: To review the literature on neurological complications of SARS-CoV-2 infection.

METHODS: Literature search performed following systematic reviews guidelines, using specific keywords based on the COVID-19 neurological complications described up to May 10th, 2020.

RESULTS: A total of 43 articles were selected, including data ranging from common, non-specific symptoms, such as hyposmia and myalgia, to more complex and life-threatening conditions, such as cerebrovascular diseases, encephalopathies, and Guillain-Barré syndrome.

CONCLUSION: Recognition of neurological manifestations of SARS-CoV-2 should be emphasized despite the obvious challenges faced by clinicians caring for critical patients who are often sedated and presenting other concurrent systemic complications.

RevDate: 2020-06-03

Monteiro RAA, Duarte-Neto AN, Silva LFFD, et al (2020)

Ultrasound-guided minimally invasive autopsies: A protocol for the study of pulmonary and systemic involvement of COVID-19.

Clinics (Sao Paulo, Brazil), 75:e1972.

RevDate: 2020-06-03

Puech-Leão P, César LAM, N De Luccia (2020)

COVID-19, Vascular Diseases, and Vascular Services.

Clinics (Sao Paulo, Brazil), 75:e1979.

RevDate: 2020-06-03

Denadai R (2020)

COVID-19 Pandemic as a Driver for Spreading Virtual Care Globally: The Future Starts Now.

Clinics (Sao Paulo, Brazil), 75:e1967.

RevDate: 2020-06-03

Breithaupt-Faloppa AC, Correia CJ, Prado CM, et al (2020)

17β-Estradiol, a potential ally to alleviate SARS-CoV-2 infection.

Clinics (Sao Paulo, Brazil), 75:e1980.

Considering that female sexual hormones may modulate the inflammatory response and also exhibit direct effects on the cells of the immune system, herein, we intend to discuss the sex differences and the role of estradiol in modulating the lung and systemic inflammatory response, focusing on its possible application as a treatment modality for SARS-CoV-2 patients. COVID-19 patients develop severe hypoxemia early in the course of the disease, which is silent most of the time. Small fibrinous thrombi in pulmonary arterioles and a tumefaction of endothelial were observed in the autopsies of fatal COVID-19 cases. Studies showed that the viral infection induces a vascular process in the lung, which included vasodilation and endothelial dysfunction. Further, the proportions of CD4+ T and CD8+ T lymphocytes were strongly reduced in patients with severe SARS-CoV-2 infection. Estradiol is connected with CD4+ T cell numbers and increases T-reg cell populations, affecting immune responses to infection. It is known that estradiol exerts a protective effect on endothelial function, activating the generation of nitric oxide (NO) via endothelial nitric oxide synthase. Estrogen attenuates the vasoconstrictor response to various stimuli and induces vasodilation in the pulmonary vasculature during stress situations like hypoxia. It exerts a variety of rapid actions, which are initiated after its coupling with membrane receptors, which in turn, may positively modulate vascular responses in pulmonary disease and help to maintain microvascular flow. Direct and indirect mechanisms underlying the effects of estradiol were investigated, and the results point to a possible protective effect of estradiol against COVID-19, indicating that it may be considered as an adjuvant therapeutic element for the treatment of patients affected by the novel coronavirus.

RevDate: 2020-06-03

Samano MN, PM Pêgo-Fernandes (2020)

Lung transplantation during the COVID-19 pandemic.

Clinics (Sao Paulo, Brazil), 75:e1978.

RevDate: 2020-06-03

Artese F (2020)

Covid-19: The aftermath for orthodontics.

Dental press journal of orthodontics, 25(2):7-8.

RevDate: 2020-06-03

Pedrozo-Pupo JC, Pedrozo-Cortés MJ, A Campo-Arias (2020)

Perceived stress associated with COVID-19 epidemic in Colombia: an online survey.

Cadernos de saude publica, 36(5):e00090520.

This study aimed to assess the prevalence and variables related to perceived stress associated with the COVID-19 pandemic in a sample of Colombian adults using a designed online cross-sectional survey. Adults answered a version of the Perceived Stress Scale (PSS-10) modified for COVID-19 (PSS-10-C), with Cronbach alpha equal to 0.86. In total, 406 individuals aged between 19 and 88 years (M = 43.9; SD = 12.4) agreed to participate in the survey: 61.8% were females, 90.6% had a university degree, 44.1% were health professionals, and 45.7% considered public health policies for preventing the spread of the disease inconsistent with scientific recommendations. PSS-10-C scores ranged from 0 to 36 (M = 16.5; SD = 7.3); 58 individuals (14.3%) scored for high perceived stress (cut-off point = 25). The inconsistency between policies and scientific evidence was significantly related to high perception of stress associated with COVID-19 (OR = 2.36; 95%CI: 1.32-4.20), after adjusting for gender. We concluded that the study group presented the prevalence of perceived stress associated with COVID-19 at high levels, arising from the inconsistent strategies developed by health authorities in view of scientific recommendations. Further researches must address the psychosocial aspects of epidemics.

RevDate: 2020-06-03

Silva Filho OJD, NN Gomes Júnior (2020)

The future at the kitchen table: COVID-19 and the food supply.

Cadernos de saude publica, 36(5):e00095220.

RevDate: 2020-06-03

Caetano R, Silva AB, Guedes ACCM, et al (2020)

Challenges and opportunities for telehealth during the COVID-19 pandemic: ideas on spaces and initiatives in the Brazilian context.

Cadernos de saude publica, 36(5):e00088920.

COVID-19 has created enormous challenges for health systems worldwide, with the rapidly growing number of deaths and critical patients with pneumonia requiring ventilatory support. Alternative methods to control the spread of the disease such as social isolation, extreme quarantine measures, and contact tracing have been used around the world. However, these measures may not be totally effective to fight COVID-19, in step with the necessary national preparations to meet the new patient care demands. A wide range of digital technologies can be used to enhance these public health strategies, and the pandemic has sparked increasing use of telehealth. This field has grown considerably in Brazil in recent years. Still, despite the intense proliferation of recommendations and rules, until the current pandemic the country still lacked a fully consolidated regulatory framework. The emergence of COVID-19 marks a key moment in the expansion of applications and use of telehealth for improving the health system's response to the current crisis. The article discusses telehealth's contribution to the fight against COVID-19 and the recent initiatives triggered in Brazil as opportunities for the consolidation of telemedicine and improvement of the Brazilian Unified National Health System. The authors conclude that telehealth offers capabilities for remote screening, care and treatment, and assists monitoring, surveillance, detection, prevention, and mitigation of the impacts on healthcare indirectly related to COVID-19. The initiatives triggered in this process can reshape the future space of telemedicine in health services in the territory.

RevDate: 2020-06-03

Jasinowodolinski D, Filisbino MM, BG Baldi (2020)

COVID-19 pneumonia: a risk factor for pulmonary thromboembolism?.

Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia, 46(4):e20200168.

RevDate: 2020-06-03

Silva FVD (2020)

Nursing to combat the COVID-19 pandemic.

Revista brasileira de enfermagem, 73 Suppl 2:e2020sup2.

RevDate: 2020-06-03

Carvalho EA, MVB Oliveira (2020)

Safety model for chest drainage in pandemic by COVID-19.

Revista do Colegio Brasileiro de Cirurgioes, 47:e20202568.

Over one million cases of the SARS-CoV-2 virus have been confirmed worldwide, with the death toll exceeding 50,000 people. An important issue to be addressed concerns the exposure of health professionals to this new virus. The first reports from Wuhan province, China, described infection rates of up to 29% among healthcare professionals before the use of personal protective equipment (PPE) was fully regulated. There are several protocols on the correct use of PPE during aerosol-generating procedures. However, there is no specific guidance on how to proceed in cases of need for chest tubes in patients with positive COVID-19 active air leak. The objective of this work is to assist surgeons of the most diverse specialties during the chest drainage of a patient with COVID-19 and to avoid a risk of contamination to the professional and the environment.

RevDate: 2020-06-03

Barros BCS, Maia AB, Marques MA, et al (2020)

The role of Angiology and Vascular Surgery in the COVID-19 pandemic.

Revista do Colegio Brasileiro de Cirurgioes, 47:e20202595.

The New Coronavirus Epidemic (2019-nCoV), discovered in the city of Wuhan, China, in December 2019, presents mainly with pulmonary pneumonia that is preceded by fever, cough and myalgia. However, as the disease spread globally and the number of hospitalizations increased exponentially, it was noted that most serious patients hospitalized by COVID-19 have laboratory changes worthy of attention, such as lymphopenia, neutrophilia, increased time of prothrombin and increased levels of D-dimer. Due to these changes proving to be crucial for the mortality and morbidity rates in this subset of infected people, several studies focusing on the pathophysiology, mainly hematological, of the disease appear every day. Deepening these studies, several published works have shown SarsCoV-2 infection to the installation of a prothrombotic state in hospitalized patients, which leads to the potential occurrence of thrombotic or arterial events in this cohort. Thus, in order to understand how the departments of Angiology and Vascular Surgery are acting in the context of the COVID-19 pandemic, this work aims to gather studies that reveal from protocols applied in vascular services in the current situation, until to the role of vascular surgeons and angiologists in the clinical and surgical management of patients infected or not, as a way of helping and clarifying this specialty during the context of a pandemic due to the new coranavirus. For the selection of works, the following search criteria were used: "Coronavirus and venous thrombosis", "Coronavirus and thrombosis", "COVID-19 and venous thrombosis" and "COVID-19 Coronavirus and thrombosis".

RevDate: 2020-06-03

Antunes BBP, Peres IT, Baião FA, et al (2020)

Progression of confirmed COVID-19 cases after the implementation of control measures.

Revista Brasileira de terapia intensiva pii:S0103-507X2020005001201 [Epub ahead of print].

OBJECTIVE: To analyse the measures adopted by countries that have shown control over the transmission of coronavirus disease 2019 (COVID-19) and how each curve of accumulated cases behaved after the implementation of those measures.

METHODS: The methodology adopted for this study comprises three phases: systemizing control measures adopted by different countries, identifying structural breaks in the growth of the number of cases for those countries, and analyzing Brazilian data in particular.

RESULTS: We noted that China (excluding Hubei Province), Hubei Province, and South Korea have been effective in their deceleration of the growth rates of COVID-19 cases. The effectiveness of the measures taken by these countries could be seen after 1 to 2 weeks of their application. In Italy and Spain, control measures at the national level were taken at a late stage of the epidemic, which could have contributed to the high propagation of COVID-19. In Brazil, Rio de Janeiro and São Paulo adopted measures that could be effective in slowing the propagation of the virus. However, we only expect to see their effects on the growth of the curve in the coming days.

CONCLUSION: Our results may help decisionmakers in countries in relatively early stages of the epidemic, especially Brazil, understand the importance of control measures in decelerating the growth curve of confirmed cases.

RevDate: 2020-06-03

Biembengut ÍV, TACB de Souza (2020)

Coagulation modifiers targeting SARS-CoV-2 main protease Mpro for COVID-19 treatment: an in silico approach.

Memorias do Instituto Oswaldo Cruz, 115:e200179.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection depends on viral polyprotein processing, catalysed by the main proteinase (Mpro). The solution of the SARS-CoV-2 Mpro structure allowed the investigation of potential inhibitors. This work aims to provide first evidences of the applicability of commercially approved drugs to treat coronavirus disease-19 (COVID-19). We screened 4,334 compounds to found potential inhibitors of SARS-CoV-2 replication using an in silico approach. Our results evidenced the potential use of coagulation modifiers in COVID-19 treatment due to the structural similarity of SARS-CoV-2 Mpro and human coagulation factors thrombin and Factor Xa. Further in vitro and in vivo analysis are needed to corroborate these results.

RevDate: 2020-06-03

Duruk G, Gümüşboğa ZŞ, C Çolak (2020)

Investigation of Turkish dentists' clinical attitudes and behaviors towards the COVID-19 pandemic: a survey study.

Brazilian oral research, 34:e054.

Currently, the whole world is under the threat of the COVID-19 pandemic, and dentists are at high risk. The aim of this study was to investigate what kind of precautions Turkish dentists take in dental clinics during the COVID-19 pandemic. The study population consisted of dentists in Turkey. An online questionnaire (23 questions-57 items) was sent to a sample of Turkish dentists from March 16 to March 20, 2020. The questionnaire comprised a series of questions about dentists' demographic characteristics, their concerns, and the measures taken in dental clinics against COVID-19. This study included a total of 1,958 Turkish dentists. A total of 1,274 (65.1%) were general dentists, and 684 (34.9%) were specialists. Five hundred twenty-two (26.7%) dentists attended an informational meeting on COVID-19. Of these dentists, 69.8% were aware of COVID-19 according to their self-assessed knowledge scores. More than 90% of the dentists were concerned about themselves and their families. Only 12% of the dentists wore an N95 mask. Although Turkish dentists took some precautionary measures, they did not take enough precautions to protect themselves, the dental staff, and other patients from COVID-19. As the number of COVID-19 cases increased, the measures taken slightly increased in dental clinics as well. Dentists are strongly recommended to take maximum precautions in the clinical setting. The guidelines about the COVID-19 pandemic should be sent to all dentists by the regional and national dental associations.

RevDate: 2020-06-03

Savioli F (2020)

Is there a rationale for heparin use among severe COVID-19 patients?.

Einstein (Sao Paulo, Brazil), 18:eED5758.

RevDate: 2020-06-03

Masterson AN, Liyanage T, Berman C, et al (2020)

A novel liquid biopsy-based approach for highly specific cancer diagnostics: mitigating false responses in assaying patient plasma-derived circulating microRNAs through combined SERS and plasmon-enhanced fluorescence analyses.

The Analyst [Epub ahead of print].

Studies have shown that microRNAs, which are small noncoding RNAs, hold tremendous promise as next-generation circulating biomarkers for early cancer detection via liquid biopsies. A novel, solid-state nanoplasmonic sensor capable of assaying circulating microRNAs through a combined surface-enhanced Raman scattering (SERS) and plasmon-enhanced fluorescence (PEF) approach has been developed. Here, the unique localized surface plasmon resonance properties of chemically-synthesized gold triangular nanoprisms (Au TNPs) are utilized to create large SERS and PEF enhancements. With careful modification to the surface of Au TNPs, this sensing approach is capable of quantifying circulating microRNAs at femtogram/microliter concentrations. Uniquely, the multimodal analytical methods mitigate both false positive and false negative responses and demonstrate the high stability of our sensors within bodily fluids. As a proof of concept, microRNA-10b and microRNA-96 were directly assayed from the plasma of six bladder cancer patients. Results show potential for a highly specific liquid biopsy method that could be used in point-of-care clinical diagnostics to increase early cancer detection or any other diseases including SARS-CoV-2 in which RNAs can be used as biomarkers.

RevDate: 2020-06-03

McRae MP, Simmons GW, Christodoulides NJ, et al (2020)

Clinical decision support tool and rapid point-of-care platform for determining disease severity in patients with COVID-19.

Lab on a chip [Epub ahead of print].

SARS-CoV-2 is the virus that causes coronavirus disease (COVID-19) which has reached pandemic levels resulting in significant morbidity and mortality affecting every inhabited continent. The large number of patients requiring intensive care threatens to overwhelm healthcare systems globally. Likewise, there is a compelling need for a COVID-19 disease severity test to prioritize care and resources for patients at elevated risk of mortality. Here, an integrated point-of-care COVID-19 Severity Score and clinical decision support system is presented using biomarker measurements of C-reactive protein (CRP), N-terminus pro B type natriuretic peptide (NT-proBNP), myoglobin (MYO), D-dimer, procalcitonin (PCT), creatine kinase-myocardial band (CK-MB), and cardiac troponin I (cTnI). The COVID-19 Severity Score combines multiplex biomarker measurements and risk factors in a statistical learning algorithm to predict mortality. The COVID-19 Severity Score was trained and evaluated using data from 160 hospitalized COVID-19 patients from Wuhan, China. Our analysis finds that COVID-19 Severity Scores were significantly higher for the group that died versus the group that was discharged with median (interquartile range) scores of 59 (40-83) and 9 (6-17), respectively, and area under the curve of 0.94 (95% CI 0.89-0.99). Although this analysis represents patients with cardiac comorbidities (hypertension), the inclusion of biomarkers from other pathophysiologies implicated in COVID-19 (e.g., D-dimer for thrombotic events, CRP for infection or inflammation, and PCT for bacterial co-infection and sepsis) may improve future predictions for a more general population. These promising initial models pave the way for a point-of-care COVID-19 Severity Score system to impact patient care after further validation with externally collected clinical data. Clinical decision support tools for COVID-19 have strong potential to empower healthcare providers to save lives by prioritizing critical care in patients at high risk for adverse outcomes.

RevDate: 2020-06-03

Mackey T, Purushothaman V, Li J, et al (2020)

Machine Learning to Detect Self-Reporting of Symptoms, Testing Access and Recovery Associated with COVID-19 on Twitter: A Retrospective Big-Data Infoveillance Study.

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

BACKGROUND: The coronavirus (COVID-19) pandemic is a global health emergency with over 6 million cases worldwide as of the beginning of June 2020. Importantly, the pandemic is historic in scope and precedent given its emergence in an increasing digital era. Importantly, there have been concerns about the accuracy of COVID-19 case counts due to issues such as lack of access to testing and difficulty in measuring recoveries.

OBJECTIVE: The aims of this study were to detect and characterize user-generated conversations that could be associated with COVID-19-related symptoms, experiences with access to testing, and mentions of disease recovery using an unsupervised machine learning approach.

METHODS: Tweets were collected from the Twitter public streaming API from March 3-20, 2020, filtered for general COVID-19-related keywords and then further filtered for terms that could be related to COVID-19 symptoms as self-reported by users. Tweets were analyzed using an unsupervised machine learning approach called the biterm topic model (BTM), where groups of tweets containing the same word-related themes were separated into topic clusters that included conversations about symptoms, testing, and recovery. Tweets in these clusters were then extracted and manually annotated for content analysis and also assessed for their statistical and geographic characteristics.

RESULTS: A total of 4,492,954 tweets were collected that contained terms that could be related to COVID-19 symptoms. After using BTM to identify relevant topic clusters and removing duplicate tweets, we identified a total of 3,465 (<1%) tweets that included user generated conversations about experiences that users associated with possible COVID-19 symptoms and other disease experiences. These tweets were grouped into five main categories including first and second-hand reports of symptoms, symptom reporting concurrent with lack of testing, discussion of recovery, confirmation of negative COVID-19 diagnosis after receiving testing, and users recalling symptoms and questioning whether they might have been previously infected with COVID-19. Co-occurrence of tweets for these themes were statistically significant for users reporting symptoms with lack of testing and with discussion of recovery. Sixty-three percent (n=1112) of tweets were located in the United States.

CONCLUSIONS: This study used unsupervised machine learning for the purposes of characterizing self-reporting of symptoms, experiences with testing, and mentions of recovery related to COVID-19. Many users reported symptoms they thought were related to COVID-19, but also were not able to get tested to confirm their concerns. In the absence of testing availability and confirmation, accurate case estimations for this period of the outbreak may never be known. Future studies should continue to explore the utility of infoveillance approaches to estimate COVID-19 disease severity.

RevDate: 2020-06-03

van Agteren J, Bartholomaeus J, Fassnacht D, et al (2020)

Using Internet-based psychological measurement to capture the deteriorating community mental health profile during COVID-19: An observational study.

JMIR mental health [Epub ahead of print].

BACKGROUND: COVID-19 is expected to have widespread and pervasive implications for mental health in terms of deteriorating outcomes and increased health service utilization, leading to calls for empirical research on mental health during the pandemic. Internet-based psychological measurement can play an important role in collecting imperative data, assisting to guide evidence-based decision making in practice and policy, and subsequently facilitating immediate reporting of measurement results to participants.

OBJECTIVE: To use an internet-based mental health measurement platform to compare the mental health profile of community members during COVID-19 with community members assessed before the pandemic.

METHODS: This study used an Internet-based self-assessment tool to collect data on psychological distress, mental wellbeing, and resilience in community cohorts during (n=673), and prior to the pandemic (two cohorts, n=1264 and n=340).

RESULTS: Results demonstrated significantly worst outcomes on all mental health measures for participants measured during COVID-19 compared to those measured before, P<.001 for all outcomes, effect sizes ranging between d=0.32 to d=0.81. Participants who demonstrated problematic scores for at least one of the mental health outcomes increased from 58% before COVID-19 to 79% during COVID-19, leading to only 21% of measured participants displaying good mental health during the pandemic.

CONCLUSIONS: The results clearly demonstrate a deterioration in mental health outcomes during COVID-19. While further research is needed, findings support the serious mental health implications of the pandemic and highlights the utility of internet-based data collection tools in providing evidence to innovate and strengthen practice and policy during and after the pandemic.

CLINICALTRIAL: N.a.

RevDate: 2020-06-03

Kim KH, Bae YS, Jeong CW, et al (2020)

Information technology-based management of clinically healthy COVID-19 patients: Lessons from the Living and Treatment Support Center operated by Seoul National University Hospital.

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

BACKGROUND: South Korea took preemptive action against COVID-19 through extensive testing, thorough epidemiological investigation, strict social distancing, and quick treatment of patients according to severity. The Korean government entrusted large scale hospitals to operate living and treatment support centers for the management for clinically healthy COVID-19 patients.

OBJECTIVE: We introduce our experience implementing information and communication technology based remote patient management systems especially for a COVID-19 living and treatment support center.

METHODS: We adopted new electronic health record templates, hospital information system dashboards, cloud based medical image sharing, mobile application, and smart vital sign monitoring devices.

RESULTS: Enhancements were made to the hospital information system to assist in the workflow and care of patients in the living and treatment support center. A dashboard was created for the medical staff to view the vital signs and symptoms of all patients. Patients used a mobile application to consult with their physician or nurse, answer questionnaires, and input self-measured vital signs; the results were uploaded to the hospital information system in real-time. Cloud-based image sharing enabled interoperability between medical institutions. Korea's strategy of aggressive mitigation has 'flattened the curve' of the rate of infection. A multidisciplinary approach was integral to develop systems supporting patient care and management at the living and treatment support center as quickly as possible.

CONCLUSIONS: Faced with a novel infectious disease, we describe the implementation and experience of applying an information and communication technology based patient management system in the living and treatment support center by Seoul National University Hospital. Information and communication technology based tools and applications are increasingly gaining importance in healthcare and we hope that our experience can provide insight into future technology-based infectious disease responses.

RevDate: 2020-06-03

Tosi D, Verde A, M Verde (2020)

COVID-19 Fatality Rate and Performed Swabs in Italy: a Misleading Perception.

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

BACKGROUND: CoronaVirus Disease 2019 (COVID-19) fatality rate in Italy is controversial and is largely affecting discussion on the impact of containment measures that are straining the world's social and economic fabric, such as large-scale use of isolation and quarantine, closing borders, imposing limits on public gatherings, and implementing nationwide lockdowns.

OBJECTIVE: The scientific community, citizens, politicians and mass media are arguing over data that seem to suggest that Italy has a significantly higher number of COVID-19-related deaths than in the rest of the world. Moreover, Italian citizens have a misleading perception related to the number of actually performed swab tests. Citizens and mass media denounce that the coverage obtained by COVID-19 swab testing in Italy is not in line with other countries all over the world.

METHODS: In this paper, we try to clarify, with a set of statistical analysis conducted world-wide, both aspects by highlighting the actual numbers and by comparing them with the official data available.

RESULTS: The analysis clearly shows that the Italian COVID-19 fatality and mortality rate are in line with the official world scenario, and these findings are true also for the number of COVID-19 swabs performed in Italy and in Lombardy Region.

CONCLUSIONS: Up-to-date analysis of this type may simplify the understanding of the pandemic evolution.

RevDate: 2020-06-03

Wang PW, Lu WH, Ko NY, et al (2020)

COVID-19-Related Information Sources and Their Relationships with Confidence of People in Coping with COVID-19: A Facebook Survey Study in Taiwan.

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

BACKGROUND: People obtain information on coronavirus disease 2019 (COVID-19) from the Internet and other sources. Understanding the factors related to such information sources aids health professionals in educating individuals.

OBJECTIVE: This study used data collected from the Online Survey Study on COVID-19 in Taiwan to examine what major COVID-19 information sources are available and which sources are significantly related to the self-confidence of people in coping with COVID-19 in Taiwan.

METHODS: A total of 1904 participants (1270 non-health-care workers and 634 health care workers) were recruited from the Facebook advertisement. Their major sources of information about COVID-19, the relationships between the sources and demographic factors, and the relationships between the sources and the self-confidence in coping with COVID-19 were surveyed.

RESULTS: Most Taiwanese people relied on the Internet for COVID-19 information (80.6%). Many respondents also used a variety of sources of information on COVID-19, where such variety was associated with sex, age, whether one was a health care worker, and level of worry toward COVID-19. For health care workers, the use of formal lessons as an information source was significantly associated with better self-confidence in coping with COVID-19. The significant association between receiving information from more sources and greater self-confidence was found only in health care workers but not in non-health care workers.

CONCLUSIONS: Medical professionals should consider subgroups of the population when establishing the various means to deliver information on COVID-19.

RevDate: 2020-06-03

Ufuk F (2020)

Radiological approach to COVID-19 pneumonia: Attention should be paid to pulmonary embolism and radiation exposure.

Diagnostic and interventional radiology (Ankara, Turkey) [Epub ahead of print].

RevDate: 2020-06-03

Luo N, Zhang H, Zhou Y, et al (2020)

Utility of chest CT in diagnosis of COVID-19 pneumonia.

Diagnostic and interventional radiology (Ankara, Turkey) [Epub ahead of print].

PURPOSE: We aimed to explore the imaging findings of computed tomography (CT) in diagnosing coronavirus disease 2019 (COVID-19) and its clinical value for further evaluation of suspected cases.

METHODS: Files of 155 patients visiting the fever clinics at our hospital and affiliated hospitals from January 20th to February 9th, 2020 were searched. Among them, 140 cases (including 82 males and 58 females) were included as suspected COVID-19 cases based on clinical and epidemiological history; the CT image features of 70 cases with suggestive findings on CT, confirmed by positive nucleic acid test were analyzed and evaluated. The sensitivity and specificity of CT in diagnosing COVID-19 were evaluated in patients with epidemiological history.

RESULTS: Of the 70 patients, 84.3% showed bilateral lung involvement on CT; 27 cases (38.6%) showed ground-glass opacity (GGO), which was mostly distributed in the subpleural area (55.7%), and this sign was mainly observed in early COVID-19 patients. In addition, 41 cases (58.6%) manifested GGO combined with focal consolidation opacity, 2 (2.8%) had flake-like consolidation opacity, with involvements of the periphery of lung field and the central zone (44.3%), and this sign was mostly observed in severe or critical patients. Concomitant signs such as pleural effusion and mediastinal lymph node enlargement were rare. Among patients with epidemiological history, the sensitivity of CT in diagnosing COVID-19 was 89.7% (70/78), and the specificity was 88.7% (55/62).

CONCLUSION: CT shows high sensitivity and specificity in diagnosing COVID-19. CT is an important examination method in evaluation of suspected cases and assessment of disease severity.

RevDate: 2020-06-03

Savaş R (2020)

Alternative strategies for CT unit management during the COVID-19 pandemic: a single center experience.

Diagnostic and interventional radiology (Ankara, Turkey) [Epub ahead of print].

RevDate: 2020-06-03

Roffi M, Capodanno D, Windecker S, et al (2020)

Impact of the COVID-19 pandemic on interventional cardiology practice: results of the EAPCI survey.

EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology pii:EIJ-D-20-00528 [Epub ahead of print].

RevDate: 2020-06-03

Mathews BK, Koenig S, Kurian L, et al (2020)

Clinical Progress Note: Point-of-Care Ultrasound Applications in COVID-19.

Journal of hospital medicine pii:jhm.3454 [Epub ahead of print].

RevDate: 2020-06-03

Cho HJ, Feldman LS, Keller S, et al (2020)

Choosing Wisely in the COVID-19 Era: Preventing Harm to Healthcare Workers.

Journal of hospital medicine pii:jhm.3457 [Epub ahead of print].

RevDate: 2020-06-03

Westafer LM, Elia T, Medarametla V, et al (2020)

A Transdisciplinary COVID-19 Early Respiratory Intervention Protocol: An Implementation Story.

Journal of hospital medicine pii:jhm.3456 [Epub ahead of print].

RevDate: 2020-06-03

Gandhi TK, H Singh (2020)

Reducing the Risk of Diagnostic Error in the COVID-19 Era.

Journal of hospital medicine pii:jhm.3461 [Epub ahead of print].

RevDate: 2020-06-03

Kinnear B, Kelleher M, Olson AP, et al (2020)

Developing Trust With Early Medical School Graduates During the COVID-19 Pandemic.

Journal of hospital medicine pii:jhm.3463 [Epub ahead of print].

RevDate: 2020-06-03

Riley-Smith Qc T, Heppinstall A, F Foster (2020)

Is Covid-19 sowing the seeds for future litigation?.

The Medico-legal journal [Epub ahead of print].

We consider various types of litigation that may follow the Covid-19 pandemic, including: claims against National Health Service (NHS) Trusts by patients who have contracted the coronavirus (or by their bereaved families), claims by NHS staff against their employer for a failure to provide any or adequate personal protective equipment or testing, commercial claims arising from the procurement of medical supplies, the potential liabilities to those who suffer adverse reactions to any vaccine and the guidance issued by the regulators in relation to subsequent disciplinary action.

RevDate: 2020-06-03

Kirtipal N, S Bharadwaj (2020)

Interleukin 6 polymorphisms as an indicator of COVID-19 severity in humans.

RevDate: 2020-06-03

Gelman R, Bayatra A, Kessler A, et al (2020)

Targeting SARS-CoV-2 Receptors as a Means for Reducing Infectivity and Improving Antiviral and Immune Response: An Algorithm-based Method For Overcoming Resistance To Antiviral Agents.

Emerging microbes & infections [Epub ahead of print].

The ongoing severe acute respiratory syndrome pandemic caused by the novel coronavirus 2 (SARS-CoV-2) is associated with high morbidity and mortality rates, and it has created a pressing global need for effective antiviral therapies against it. COVID-19 disease pathogenesis is characterized by an initial virus-mediated phase, followed by inappropriate hyperactivation of the immune system leading to organ damage. Targeting of the SARS-CoV-2 viral receptors is being explored as a therapeutic option for these patients. In this paper, we summarize several potential receptors associated with the infectivity of SARS-CoV-2 and discuss their association with the immune-mediated inflammatory response. The potential for the development of resistance towards antiviral drugs is also presented. An algorithm-based platform to improve the efficacy of and overcome resistance to viral receptor blockers through the introduction of personalized variability is described. This method is designed to ensure sustained antiviral effectiveness when using SARS-CoV-2 receptor blockers.

RevDate: 2020-06-03

Evren C, Evren B, Dalbudak E, et al (2020)

Measuring anxiety related to COVID-19: A Turkish validation study of the Coronavirus Anxiety Scale.

Death studies [Epub ahead of print].

The aim of the current study is to validate the Turkish version of the Coronavirus Anxiety Scale (CAS). Participants were assessed across the CAS, Obsession with COVID-19 Scale (OCS) and Fear of COVID-19 Scale. We surveyed 1023 Turkish native speakers who participated online. Confirmatory factor analysis showed that the factor structure of the CAS was satisfactory. The scale was internally consistent with a Cronbach's alpha of 0.80. Positive correlations of the CAS with the OCS and the Fear of COVID-19 Scale demonstrated adequate convergent validity. These findings suggest that the CAS is a valid and reliable measure to assess the severity of dysfunctional coronavirus related anxiety.

RevDate: 2020-06-03

Maiese A, Passaro G, Matteis A, et al (2020)

Thromboinflammatory response in SARS-CoV-2 sepsis.

The Medico-legal journal [Epub ahead of print].

Viral sepsis is rare, and its real incidence is not known. SARS-CoV-2 infection causes the release of a significant amount of pro-inflammatory cytokines that aggravates interstitial pneumonia and evolves in viral sepsis with prominent hypercoagulability. We believe it is useful and advisable to establish early immunomodulator therapy and the prophylaxis anticoagulant therapy should be rethought.

RevDate: 2020-06-03

Pan Z, Lu J, Wang N, et al (2020)

Development of a TaqMan-probe-based multiplex real-time PCR for the simultaneous detection of emerging and reemerging swine coronaviruses.

Virulence, 11(1):707-718.

With the outbreak of the recent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in 2019, coronaviruses have become a global research hotspot in the field of virology. Coronaviruses mainly cause respiratory and digestive tract diseases, several coronaviruses are responsible for porcine diarrhea, such as porcine epidemic diarrhea virus (PEDV), porcine deltacoronavirus (PDCoV), and emerging swine acute diarrhea syndrome coronavirus (SADS-CoV). Those viruses have caused huge economic losses and are considered as potential public health threats. Porcine torovirus (PToV) and coronaviruses, sharing similar genomic structure and replication strategy, belong to the same order Nidovirales. Here, we developed a multiplex TaqMan-probe-based real-time PCR for the simultaneous detection of PEDV, PDCoV, PToV, and SADS-CoV for the first time. Specific primers and TaqMan fluorescent probes were designed targeting the ORF1a region of PDEV, PToV, and SADS-CoV and the ORF1b region of PDCoV. The method showed high sensitivity and specificity, with a detection limit of 1 × 102 copies/μL for each pathogen. A total of 101 clinical swine samples with signs of diarrhea were analyzed using this method, and the result showed good consistency with conventional reverse transcription PCR (RT-PCR). This method improves the efficiency for surveillance of these emerging and reemerging swine enteric viruses and can help reduce economic losses to the pig industry, which also benefits animal and public health.

RevDate: 2020-06-03

Perrone G, Zerbo S, Bilotta C, et al (2020)

Telemedicine during Covid-19 pandemic: Advantage or critical issue?.

The Medico-legal journal [Epub ahead of print].

Telemedicine offers a support to traditional medicine, delivering clinical services when distance is a critical factor. Although this tool does not replace a medical examination, during Covid-19 pandemic, it reduces the spread of infection and avoids the need for a patient's visit. It is useful in the management of chronic disorders or for patients undergoing palliative treatment. The University Hospital of Palermo has applied this in cases of chronic illness caring for patients who cannot stop their treatment, such as Department of Onco-Haematology, Internal Medicine, Dermatology, etc. The Department of Legal Medicine of Palermo, in particular, is also using telemedicine to manage medico-legal sudden natural death investigations and dealing with the Public Prosecutor's office of Palermo. Even after the Covid-19 emergency, telemedicine will be essential to streamline outpatient visits, while at the same time limiting costs, with significant benefits for the Italian National Public Health Service budget. In conclusion, telemedicine can offer a valuable support to the doctor's activity by streamlining and facilitating their work. In this sense, the Covid-19 pandemic represents a positive input for the acceleration and enhancement of these tools.

RevDate: 2020-06-03

Turk C, Turk S, Temirci ES, et al (2020)

In vitro analysis of the renin-angiotensin system and inflammatory gene transcripts in human bronchial epithelial cells after infection with severe acute respiratory syndrome coronavirus.

Journal of the renin-angiotensin-aldosterone system : JRAAS, 21(2):1470320320928872.

INTRODUCTION: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a recently identified coronavirus family member that triggers a respiratory disease similar to severe acute respiratory syndrome coronavirus (SARS-CoV). SARS-CoV and SARS-CoV-2 are very similar to each other in many respects, such as structure, genetics, and pathobiology. We hypothesized that coronaviruses could affect pulmonary tissues via integration with the critical immune genes after their interaction with renin-angiotensin system (RAS) elements. The aim of the present bioinformatics study was to assess expression changes of the RAS and non-RAS genes, particularly immune response genes, in the lung epithelial cells after infection with SARS-CoV.

METHODS: Linear regression, hierarchical clustering, pathway analysis, and network analysis were performed using the E-GEOD-17400 data set.

RESULTS: The whole-genome expression data of the lung epithelial cells infected with SARS-CoV for 12, 24, and 48 hours were analyzed, and a total of 15 RAS family and 29 immune genes were found to be highly correlated with the exposure time to the virus in the studied groups.

CONCLUSION: RAS genes are important at the initiation of the infections caused by coronavirus family members and may have a strong relationship with the exchange of immune genes in due course following the infection.

RevDate: 2020-06-03

Tullio V, Perrone G, Bilotta C, et al (2020)

Psychological support and psychotherapy via digital devices in Covid-19 emergency time: Some critical issues.

The Medico-legal journal [Epub ahead of print].

The Covid-19 pandemic and the resulting fear, quarantine and lockdown measures implemented in Italy and other countries to contain the risk of contagion have seriously impacted the mental health of a large number of people. The need to offer psychological and psychotherapeutic support to these people, while respecting the government's pressing calls to "stay home", have led many psychologists and psychotherapists, both in the public and private sectors, to provide their professional services via teleconference, telephone, smartphone, etc. The aim of this work is to highlight some critical issues related to the sudden switch from the traditional method of providing psychological services to the digital one in Italy.

RevDate: 2020-06-03

Yıldırım M, Geçer E, Ö Akgül (2020)

The impacts of vulnerability, perceived risk, and fear on preventive behaviours against COVID-19.

Psychology, health & medicine [Epub ahead of print].

The world has been under the negative effect of the COVID-19 pandemic for the last few months. While people may take many preventive behaviours to minimize the risk, very little is known about the factors that can increase preventive behaviours during the COVID-19 pandemic. This study examined the effects of vulnerability, perceived risk, and fear on preventive behaviours of COVID-19. The study used a sample of 4,536 Turkish adults (M = 30.33 ± 10.95 years) recruited from 17 March through 1 April 2020. Vulnerability, perceived risk, fear, and preventive behaviours were measured with self-rating scales. Participants mostly engaged in avoidance of public transportation and frequent handwashing as preventive behaviours. Women had a significantly higher vulnerability to, perceived risk, and fear of new coronavirus compared to men. Correlation results indicated that age, gender, education level, vulnerability, perceived risk, and fear were related to preventive behaviours. Regression results demonstrated that vulnerability, perceived risk, and fear accounted for a significant amount of variance in preventive behaviours over and above the effects of demographic variables. The results suggest that vulnerability, perceived risk, and fear can significantly increase engagement in preventive behaviours during the novel coronavirus pandemic. The results have important implications for research and practice.

RevDate: 2020-06-03

Li J, Li M, Zheng S, et al (2020)

Plasma albumin levels predict risk for nonsurvivors in critically ill patients with COVID-19.

Biomarkers in medicine [Epub ahead of print].

Aim: We aimed to explore the biomarkers for disease progression or the risk of nonsurvivors. Materials & methods: This study included 134 hospitalized patients with confirmed COVID-19 infection. The outcome of moderate versus severe versus critically ill patients and survivors versus nonsurvivors were compared. Results: An increase in the severity of COVID-19 pneumonia was positively associated with lower levels of platelets and albumin (all p < 0.05). In the critical group, the plasma levels of albumin continued to have a significant association for the risk of nonsurvivors (p < 0.05), even after adjusting for confounding factors. Conclusion: Albumin levels could be used as an independent predictor of the risk of nonsurvivors in critically ill patients with COVID-19.

RevDate: 2020-06-03

Medetalibeyoğlu A, Şenkal N, Çapar G, et al (2020)

Characteristics of the initial patients hospitalized for COVID-19: a single-center report.

Turkish journal of medical sciences [Epub ahead of print].

BACKGROUND: Novel coronavirus 19 infection (COVID-19) has become a global pandemic and Turkey had the first coronavirus patient tested positive in 10 March 2020.

AIMS: In this analysis we have discussed the characteristics of Turkish patients who have been hospitalized for COVID-19 infection.

STUDY DESIGN: Cross sectional study Methods: This retrospective study included all the patients who have been hospitalized for novel coronavirus at blinded for peer review -Department of Internal Medicine between 15th March 2020 and 28th March 2020. Patients were screened with real time PCR (2019nCoV), chest X-ray and computer tomography. Also, their demographic characteristics including sex, age, occupation, comorbid disease etc. were recorded.

RESULTS: There were 70 patients for analysis. Thirty-seven patients (52.9 %) tested positive for coronavirus infection with PCR. Mean age was 55.8 (min 24- max 87). There were 49 men (70.0%). Two patients (2%) were sent home and eleven patients (15.7%) were transferred to intensive care unit (ICU). Patients in ICU had statistically higher, pulse rate, respiratory rate, aspartate aminotransferase, lactate dehydrogenase, c-reactive protein, d-dimer, fibrinogen, activated partial thromboplastin time, troponin and procalcitonin compared to patients followed in clinics.

CONCLUSION: Turkey has avoided the disease for some time but as inevitable as it is, our country has been added to the countries which are infected.

RevDate: 2020-06-03

Ufuk F, Savaş R, T Hazirolan (2020)

Letter to the Editor: Radiological approaches to COVID-19 pneumonia.

Turkish journal of medical sciences [Epub ahead of print].

Dear editor, We read with great interest the article titled ?Radiological approaches to COVID-19 pneumonia? by Akcay S. et al. in the latest issue of Turk J Med Sci [1]. The authors provided a review of the radiological findings of novel coronavirus disease (COVID-19) pneumonia. We would like to highlight some missing radiological findings in this article, and we want to contribute to some critical radiological findings.

RevDate: 2020-06-03

Akçay MŞ (2020)

Response to letter to the editor: radiological approaches to COVID-19 pneumonia.

Turkish journal of medical sciences [Epub ahead of print].

This is a letter to response to "letter to the editor" about our review article entitled "Radiological approaches to COVID-19 pneumonia". Abstract is not required in this format.

RevDate: 2020-06-03

Villani A, Annunziata MC, Abategiovanni L, et al (2020)

Teledermatology for acne patients: how to reduce face-to-face visits during COVID-19 pandemic.

From the outbreak in Wuhan, China, in December 2019, the coronavirus disease 2019 (COVID-19) pandemic, called Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) has spread all over the world causing a global public health emergency1 . Since then, preventive measures, such as the use of protective equipement, social distance and disinfection procedures, have been adopted in order to reduce the risk of COVID-19 transmission. Regarding Dermatology departments, the majority of them have been reorganized and all dermatological procedures have been postponed, except for the emergencies and the oncological ones2 .

RevDate: 2020-06-03

Mills WR, Sender S, Lichtefeld J, et al (2020)

Supporting individuals with intellectual and developmental disability during the first 100 days of the COVID-19 outbreak in the USA.

Journal of intellectual disability research : JIDR [Epub ahead of print].

BACKGROUND: It is unknown how the novel Coronavirus SARS-CoV-2, the cause of the current acute respiratory illness COVID-19 pandemic that has infected millions of people, affects people with intellectual and developmental disability (IDD). The aim of this study is to describe how individuals with IDD have been affected in the first 100 days of the COVID-19 pandemic.

METHODS: Shortly after the first COVID-19 case was reported in the USA, our organisation, which provides continuous support for over 11 000 individuals with IDD, assembled an outbreak committee composed of senior leaders from across the health care organisation. The committee led the development and deployment of a comprehensive COVID-19 prevention and suppression strategy, utilising current evidence-based practice, while surveilling the global and local situation daily. We implemented enhanced infection control procedures across 2400 homes, which were communicated to our employees using multi-faceted channels including an electronic resource library, mobile and web applications, paper postings in locations, live webinars and direct mail. Using custom-built software applications enabling us to track patient, client and employee cases and exposures, we leveraged current public health recommendations to identify cases and to suppress transmission, which included the use of personal protective equipment. A COVID-19 case was defined as a positive nucleic acid test for SARS-CoV-2 RNA.

RESULTS: In the 100-day period between 20 January 2020 and 30 April 2020, we provided continuous support for 11 540 individuals with IDD. Sixty-four per cent of the individuals were in residential, community settings, and 36% were in intermediate care facilities. The average age of the cohort was 46 ± 12 years, and 60% were male. One hundred twenty-two individuals with IDD were placed in quarantine for exhibiting symptoms and signs of acute infection such as fever or cough. Sixty-six individuals tested positive for SARS-CoV-2, and their average age was 50. The positive individuals were located in 30 different homes (1.3% of total) across 14 states. Fifteen homes have had single cases, and 15 have had more than one case. Fifteen COVID-19-positive individuals were hospitalised. As of 30 April, seven of the individuals hospitalised have been discharged back to home and are recovering. Five remain hospitalised, with three improving and two remaining in intensive care and on mechanical ventilation. There have been three deaths. We found that among COVID-19-positive individuals with IDD, a higher number of chronic medical conditions and male sex were characteristics associated with a greater likelihood of hospitalisation.

CONCLUSIONS: In the first 100 days of the COVID-19 outbreak in the USA, we observed that people with IDD living in congregate care settings can benefit from a coordinated approach to infection control, case identification and cohorting, as evidenced by the low relative case rate reported. Male individuals with higher numbers of chronic medical conditions were more likely to be hospitalised, while most younger, less chronically ill individuals recovered spontaneously at home.

RevDate: 2020-06-03

Paton C (2020)

Insouciance and inexperience: A deadly combination when dealing with COVID-19.

The International journal of health planning and management [Epub ahead of print].

This article gives key reasons for the UK's tardy and confused attempts to react to the COVID-19 pandemic. It explains very poor outcomes in the UK (in terms of the spread of the virus and high mortality, already striking at the time of writing), in terms of an initial lack of political will to prioritise public health, itself a product of a strong Prime Minister who made the "wrong call". It also highlights a failure to "follow the science", except in so far as the "science" had already accepted some dubious political judgements and the lack of capacity to test as the starting-point.

RevDate: 2020-06-03

Kluger N (2020)

Pitfalls of possible reporting of same patients with COVID-19 in dermatology journals.

The Editor in chief and Deputy Editors of the JAMA recently shared their concern regarding possible reporting of patients in more than one manuscript, while this has not been clearly indicated in the submission [1]. Although the unprecedented context of the COVID-19 outbreak justifies efforts for rapid dissemination of knowledge, such practice may be responsible for inaccurate interpretation and overestimation of published data [1]. Similar concern applies to dermatology. In Spain, the national COVID Piel study have reported 372 patients with skin manifestations related with COVID-19, including 71 patients with pseudo-chilblains, from April 3rd to April 16th [2].

RevDate: 2020-06-03

Nagaraja BS, Ramesh KN, Dhar D, et al (2020)

HyPE study: hydroxychloroquine prophylaxis-related adverse events' analysis among healthcare workers during COVID-19 pandemic: a rising public health concern.

Journal of public health (Oxford, England) pii:5850534 [Epub ahead of print].

BACKGROUND: The rising burden of Coronavirus disease (COVID-19) has led to the mass use of hydroxychloroquine by healthcare workers (HCWs). Adverse event profile of this drug when used as prophylaxis is not well known in the literature.

METHODS: A retrospective, cross-sectional study was conducted across the country using semi-structured web-based questionnaire among COVID-19 negative and asymptomatic healthcare workers, taking hydroxychloroquine prophylaxis. Descriptive and multivariate logistic-regression models were applied for analysis.

RESULTS: Of the 166 participants, at least one adverse event was experienced by 37.9% participants, gastrointestinal being the most common (30.7%). Risk was higher in participants <40 years age (odd's ratio (OR): 2.44, 95% confidence interval (CI): 1.18-5.05) and after first dose of hydroxychloroquine (51.2%, OR: 2.38, 95%CI: 1.17-4.84). Hydroxychloroquine prophylaxis was initiated without electrocardiography by 80.1% of HCWs. Only 21.6% of those with cardiovascular disease could get prior ECG.

CONCLUSIONS: A higher incidence of adverse events was observed when results were compared with studies involving patients on long-term hydroxychloroquine therapy. Younger age and first dose were associated with greater incidence of adverse events though all were self-limiting. Monitoring prior and during prophylaxis was inadequate even among those with cardiovascular disease and risk-factors. However, no serious cardiovascular events were reported.

RevDate: 2020-06-03

Shanks GD (2020)

COVID-19 versus the 1918 influenza pandemic: different virus, different age mortality patterns.

Journal of travel medicine pii:5850342 [Epub ahead of print].

RevDate: 2020-06-03

García-García S, Cepeda S, Arrese I, et al (2020)

Letter: Hemorrhagic Conditions Affecting the Central Nervous System in COVID-19 Patients.

Neurosurgery pii:5850759 [Epub ahead of print].

RevDate: 2020-06-03

Alobuia WM, Dalva-Baird NP, Forrester JD, et al (2020)

Racial disparities in knowledge, attitudes and practices related to COVID-19 in the USA.

Journal of public health (Oxford, England) pii:5850538 [Epub ahead of print].

BACKGROUND: Recent reports indicate racial disparities in the rates of infection and mortality from the 2019 novel coronavirus (coronavirus disease 2019 [COVID-19]). The aim of this study was to determine whether disparities exist in the levels of knowledge, attitudes and practices (KAPs) related to COVID-19.

METHODS: We analyzed data from 1216 adults in the March 2020 Kaiser Family Foundation 'Coronavirus Poll', to determine levels of KAPs across different groups. Univariate and multivariate regression analysis was used to identify predictors of KAPs.

RESULTS: In contrast to White respondents, Non-White respondents were more likely to have low knowledge (58% versus 30%; P < 0.001) and low attitude scores (52% versus 27%; P < 0.001), but high practice scores (81% versus 59%; P < 0.001). By multivariate regression, White race (odds ratio [OR] 3.06; 95% confidence interval [CI]: 1.70-5.50), higher level of education (OR 1.80; 95% CI: 1.46-2.23) and higher income (OR 2.06; 95% CI: 1.58-2.70) were associated with high knowledge of COVID-19. Race, sex, education, income, health insurance status and political views were all associated with KAPs.

CONCLUSIONS: Racial and socioeconomic disparity exists in the levels of KAPs related to COVID-19. More work is needed to identify educational tools that tailor to specific racial and socioeconomic groups.

RevDate: 2020-06-03

Abdul-Baki MN, Dhemesh Y, Alasadi L, et al (2020)

The substantial awareness role of web-based and social media platforms in developing countries during a pandemic scenario: the example of COVID-19.

Journal of public health (Oxford, England) pii:5850532 [Epub ahead of print].

BACKGROUND: During the outbreak of coronavirus COVID-19, social media platforms have shown effectiveness in information dissemination. Delivering evidence-based medical knowledge and trustworthy recommendations is a difficult mission for classical entities, especially in a war-torn country with a fragile health system. In this context, the role of non-governmental scientific organizations was proven, filling the gap between original scientific sources and a non-English speaking population.

METHODS: We reviewed an example of an organization named Syrian Researchers, which publishes based-on-reliable-sources of scientific content and has massive reachability across Middle East and beyond.

RESULTS: We strongly believe that this model is a simple and suitable approach that may be helpful for other low-income or war-torn countries in the context of health-related disasters.

CONCLUSIONS: This subject is of high importance and we believe that this approach may ameliorate public health knowledge, thus, participate in defying the COVID-19 consequences.

RevDate: 2020-06-03

Yolcu M, Gunesdogdu F, Bektas M, et al (2020)

Coronavirus disease 2019 (COVID-19) and simultaneous acute anteroseptal and inferior ST-segment elevation myocardial infarction.

Coronavirus disease 2019 (COVID-19) is a recently recognised pandemic spreading rapidly from Wuhan, Hubei, to other provinces in China and to many countries around the world. The number of COVID-19-related deaths is steadily increasing. Acute ST-segment elevation myocardial infarction (STEMI) is a disease with high morbidity and mortality rates, and primary percutaneous coronary intervention is usually recommended for the treatment. A patient with diabetes mellitus and hypertension for five years was admitted to the emergency unit with symptoms of fever, cough and dyspnoea. These symptoms were consistent with viral pneumonia and a COVID PCR test was performed, which tested positive three days later. The patient had chest pain on the eighth day of hospitalisation. On electrocardiography, simultaneous acute inferior and anterior STEMI were identified. High levels of stress and increased metabolic demand in these patients may lead to concomitant thrombosis of different coronary arteries, presenting with two different STEMIs.

RevDate: 2020-06-03

Weatherby S, Seddon JM, P Ceroni (2020)

Luminescent silicon nanostructures and COVID-19.

This Faraday Discussion volume is unique in the hundred plus year history of the Faraday Discussion series, being produced at a time of unprecedented circumstances worldwide and without the preceding Faraday Discussion conference having taken place.

RevDate: 2020-06-03

Mao D, Zhou N, Zheng D, et al (2020)

Guide to forensic pathology practice for death cases related to coronavirus disease 2019 (COVID-19) (Trial draft).

Forensic sciences research, 5(1):1-7 pii:1744400.

Autopsy is of great significance for elucidating the pathological changes, pathogenesis and cause of death of Coronavirus Disease 2019 (COVID-19) and can provide a theoretical basis for scientific and accurate prevention and control of its outbreak. Based on related laws and regulations, such as the Law of the People's Republic of China on Prevention and Control of Infectious Diseases, clinical manifestations and epidemiological characteristics of COVID-19 and guidelines on the prevention and control of this epidemic, combined with the practical work of forensic pathology examinations, we developed the Guide to Forensic Pathology Practice for Death Cases Related to Coronavirus Disease 2019 (COVID-19) (Trial Draft). This guide describes the background investigation of the death cases, autopsy room requirements, personal prevention and protections, external examinations, autopsy practices and auxiliary examinations, and thus offers a reference for forensic and pathological examination institutions and staff.

RevDate: 2020-06-03

Costantino C, D Fiacchini (2020)

Rationale of the WHO document on Risk Communication and Community Engagement (RCCE) readiness and response to the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and of the Italian Decalogue for Prevention Departments.

Journal of preventive medicine and hygiene, 61(1):E1-E2.

RevDate: 2020-06-03

Wang L, Liu Y, Zhang T, et al (2020)

Differentiating Between 2019 Novel Coronavirus Pneumonia and Influenza Using a Nonspecific Laboratory Marker-Based Dynamic Nomogram.

Open forum infectious diseases, 7(5):ofaa169 pii:ofaa169.

Background: There is currently a lack of nonspecific laboratory indicators as a quantitative standard to distinguish between the 2019 coronavirus disease (COVID-19) and an influenza A or B virus infection. Thus, the aim of this study was to establish a nomogram to detect COVID-19.

Methods: A nomogram was established using data collected from 457 patients (181 with COVID-19 and 276 with influenza A or B infection) in China. The nomogram used age, lymphocyte percentage, and monocyte count to differentiate COVID-19 from influenza.

Results: Our nomogram predicted probabilities of COVID-19 with an area under the receiver operating characteristic curve of 0.913 (95% confidence interval [CI], 0.883-0.937), greater than that of the lymphocyte:monocyte ratio (0.849; 95% CI, 0.812-0.880; P = .0007), lymphocyte percentage (0.808; 95% CI, 0.768-0.843; P < .0001), monocyte count (0.780; 95% CI, 0.739-0.817; P < .0001), or age (0.656; 95% CI, 0.610-0.699; P < .0001). The predicted probability conformed to the real observation outcomes of COVID-19, according to the calibration curves.

Conclusions: We found that age, lymphocyte percentage, and monocyte count are risk factors for the early-stage prediction of patients infected with the 2019 novel coronavirus. As such, our research provides a useful test for doctors to differentiate COVID-19 from influenza.

RevDate: 2020-06-03

Gharebaghi R, Desuatels J, Moshirfar M, et al (2020)

COVID-19: Preliminary Clinical Guidelines for Ophthalmology Practices.

Medical hypothesis, discovery & innovation ophthalmology journal, 9(2):149-158.

The zoonotic Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and its resultant human coronavirus disease (COVID-19) recently appeared as a global health threat that can cause severe respiratory infection and terminal respiratory distress. By the first week of April, more than 1.3 million people had been globally infected and more than 70,000 had lost their lives to this contagious virus. Clinical manifestations occur shortly after exposure, or a few days later. There is controversy regarding the transmission of the virus through the tear and conjunctiva; however, there are reports that the ocular surface might be a potential target for COVID-19. The ease of transmission of this virus at close proximity presents a risk to eyecare workers. Several recommendations have been issued by local and national organizations to address the issue of safe ophthalmic practice during the ongoing COVID-19 pandemic. These guidelines have numerous similarities; however, subtle differences exist. The purpose of this paper was to discuss measures, with a specific focus on standard precautions, to prevent further dissemination of COVID-19 at Eye Clinics. We have proposed procedures to triage suspected cases of COVID-19, considering emergency conditions.

RevDate: 2020-06-03

Reviglio VE, Osaba M, Reviglio V, et al (2020)

COVID-19 and Ophthalmology: A New Chapter in an Old Story.

Medical hypothesis, discovery & innovation ophthalmology journal, 9(2):71-73.

RevDate: 2020-06-03

Guo Y, Hu X, Yu F, et al (2020)

Abdomen CT findings in a COVID-19 patient with intestinal symptoms and possibly false negative RT-PCR before initial discharge.

Quantitative imaging in medicine and surgery, 10(5):1158-1161.

RevDate: 2020-06-03

Xu C, Xu Q, Du C, et al (2020)

Radiological follow-up of twelve COVID-19 patients with initially normal chest CT.

Quantitative imaging in medicine and surgery, 10(5):1153-1157.

RevDate: 2020-06-03

Zeng Y, Fu J, Yu X, et al (2020)

Should computed tomography (CT) be used as a screening or follow-up tool for asymptomatic patients with SARS-CoV-2 infection?.

Quantitative imaging in medicine and surgery, 10(5):1150-1152.

RevDate: 2020-06-03

Tang L, Cheng X, Tian C, et al (2020)

Computed tomography (CT) intestinal alterations of Coronavirus Disease 2019 (COVID-19) from the imaging perspective: a case description.

Quantitative imaging in medicine and surgery, 10(5):1145-1149.

RevDate: 2020-06-03

Zhang L, Li C, Zhou Y, et al (2020)

Persistent viral shedding lasting over 60 days in a mild COVID-19 patient with ongoing positive SARS-CoV-2.

Quantitative imaging in medicine and surgery, 10(5):1141-1144.

RevDate: 2020-06-03

Deng L, Ji L, Meng Z, et al (2020)

Family cluster of asymptomatic infections with COVID-19: a case series of 4 patients.

Quantitative imaging in medicine and surgery, 10(5):1127-1132.

RevDate: 2020-06-03

Lei S, Wu Y, Dong C, et al (2020)

Early minimal lesions of COVID-19 pneumonia with interstitial lung abnormality: a case description.

Quantitative imaging in medicine and surgery, 10(5):1121-1126.

RevDate: 2020-06-03

Sun Z, Zhang N, Li Y, et al (2020)

A systematic review of chest imaging findings in COVID-19.

Quantitative imaging in medicine and surgery, 10(5):1058-1079.

Chest computed tomography (CT) is frequently used in diagnosing coronavirus disease 2019 (COVID-19) for detecting abnormal changes in the lungs and monitoring disease progression during the treatment process. Furthermore, CT imaging appearances are correlated with patients presenting with different clinical scenarios, such as early versus advanced stages, asymptomatic versus symptomatic patients, and severe versus nonsevere situations. However, its role as a screening and diagnostic tool in COVID-19 remains to be clarified. This article provides a systematic review and meta-analysis of the current literature on chest CT imaging findings with the aim of highlighting the contribution and judicious use of CT in the diagnosis of COVID-19. A search of PubMed/Medline, Web of Science, ScienceDirect, Google Scholar and Scopus was performed to identify studies reporting chest imaging findings in COVID-19. Chest imaging abnormalities associated with COVID-19 were extracted from the eligible studies and diagnostic value of CT in detecting these abnormal changes was compared between studies consisting of both COVID-19 and non-COVID-19 patients. A random-effects model was used to perform meta-analysis for calculation of pooled mean values and 95% confidence intervals (95% CI) of abnormal imaging findings. Fifty-five studies met the selection criteria and were included in the analysis. Pulmonary lesions more often involved bilateral lungs (78%, 95% CI: 45-100%) and were more likely to have a peripheral (65.35%, 95% CI: 25.93-100%) and peripheral plus central distribution (31.12%, 95% CI: 1.96-74.07%), but less likely to have a central distribution (3.57%, 95% CI: 0.99-9.80%). Ground glass opacities (GGO) (58.05%, 95% CI: 16.67-100%), consolidation (44.18%, 95% CI: 1.61-71.46%) and GGO plus consolidation (52.99%, 95% CI: 19.05-76.79%) were the most common findings reported in 94.5% (52/55) of the studies, followed by air bronchogram (42.50%, 95% CI: 7.78-80.39%), linear opacities (41.29%, 95% CI: 7.44-65.06%), crazy-paving pattern (23.57%, 95% CI: 3.13-91.67%) and interlobular septal thickening (22.91%, 95% CI: 0.90-80.49%). CT has low specificity in differentiating pneumonia-related lung changes due to significant overlap between COVID-19 and non-COVID-19 patients with no significant differences in most of the imaging findings between these two groups (P>0.05). Furthermore, normal CT (13.31%, 95% CI: 0.74-38.36%) was reported in 26 (47.3%) studies. Despite widespread use of CT in the diagnosis of COVID-19 patients based on the current literature, CT findings are not pathognomonic as it lacks specificity in differentiating imaging appearances caused by different types of pneumonia. Further, there is a relatively high percentage of normal CT scans. Use of CT as a first-line diagnostic or screening tool in COVID-19 is not recommended.

RevDate: 2020-06-03

Zhu Y, He Y, Wang Z, et al (2020)

Chinese Society of Interventional Radiology Expert Consensus on the prevention and control of COVID-19 in interventional radiology procedures (first edition).

Quantitative imaging in medicine and surgery, 10(5):1045-1057.

The COVID-19 pandemic seriously threatens the lives of the general public and poses momentous challenges to all medical workers, including those engaged in interventional radiology, who play an important role in the diagnosis and treatment of various diseases. To further standardize the prevention and control of nosocomial infections and ensure the safety of doctors and patients, the Chinese Society of Interventional Radiology (CSIR) organized multidisciplinary experts in the field of interventional radiology in China to prepare an "Expert Consensus" elaborating and summarizing the protective strategies and suggestions for medical workers in the field of interventional radiology when they engage in interventional diagnosis and treatment activities against the background of novel coronavirus infection control. The aim is to provide a reference for interventional procedures in hospitals and other medical institutions at all levels in China and worldwide. The key points include the following: (I) non-emergency interventional diagnosis and treatment should be suspended while work is ongoing to prevent and control the spread of COVID-19; (II) protective measures should be taken according to the appropriate level designated for COVID-19 infection prevention and control; (III) patients should take measures to protect themselves when they want to see a doctor, including accessing outpatient services online and other relevant channels of consultation.

RevDate: 2020-06-03

Thienemann F, Pinto F, Grobbee DE, et al (2020)

World Heart Federation Briefing on Prevention: Coronavirus Disease 2019 (COVID-19) in Low-Income Countries.

Global heart, 15(1):31.

In December 2019, the novel coronavirus Coronavirus Disease 2019 (COVID-19) outbreak started in Wuhan, the capital of Hubei province in China. Since then it has spread to many other regions, including low-income countries.

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