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Bibliography on: covid-19

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ESP: PubMed Auto Bibliography 03 Apr 2020 at 01:36 Created: 

covid-19

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

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

Citations The Papers (from PubMed®)

RevDate: 2020-04-02

Saito M, Adachi E, Yamayoshi S, et al (2020)

Gargle lavage as a safe and sensitive alternative to swab samples to diagnose COVID-19: a case report in Japan.

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America pii:5815296 [Epub ahead of print].

RevDate: 2020-04-02

Qiu L, Liu X, Xiao M, et al (2020)

SARS-CoV-2 is not detectable in the vaginal fluid of women with severe COVID-19 infection.

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America pii:5815295 [Epub ahead of print].

BACKGROUND: Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) is mainly spread through respiratory droplets or direct contact. But the infection condition of genital system is still unknown. This study aimed to evaluate whether or not SARS-CoV-2 is found in the vaginal fluid of women with COVID-19 illness.

METHODS: 10 women with confirmed severe COVID-19 pneumonia admitted to in Tongji Zhongfa Hospital Intensive care union(ICU) ward from Feb 4, 2020 to Feb 24, 2020 were included. Clinical records, laboratory results, and computer tomography(CT)-scan examination were retrospectively reviewed. The evidence of genital infection potential was accessed by testing for the presence of SARS-CoV-2 in vaginal fluids obtained from vaginal swab samples. Reverse transcriptase polymerase chain reaction(RT-PCR) was used to confirm the SARS-CoV-2 infection in vaginal fluids.

RESULTS: The clinical characteristics of these ten women were similar to those reported severe COVID-19 patients. All ten patients were tested for SARS-CoV-2 in vaginal fluid, and all samples tested negative for the virus.

CONCLUSION: Findings from this small group of cases suggest that no SARS-CoV-2 virus existing in the vaginal fluids of severe COVID-19 patients.

RevDate: 2020-04-02

Yasaka TM, Lehrich BM, R Sahyouni (2020)

Peer-to-Peer Contact Tracing: A Privacy-Preserving Smartphone Application.

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

BACKGROUND: The novel coronavirus disease 2019 (COVID-19) pandemic is an urgent public health crisis, with epidemiologic models predicting severe consequences, including high death rates, if the virus is permitted to run its course without any intervention or response. Contact tracing using smartphone technology is a powerful tool which may be employed to limit disease transmission during an epidemic or pandemic, yet contact tracing applications present with significant privacy concerns regarding the collection of personal data such as location.

OBJECTIVE: To provide an effective contact tracing smartphone application that respects user privacy by not collecting location information or other personal data.

METHODS: We propose the use of an anonymized graph of interpersonal interactions to conduct a novel form of contact tracing, and develop a proof-of-concept smartphone application which implements this approach. Additionally, we develop a computer simulation model which demonstrates the impact of our proposal on epidemic or pandemic outbreak trajectories across multiple rates of adoption.

RESULTS: Our proof-of-concept smartphone application allows users to create "checkpoints" for contact tracing, check their risk level based on their past interactions, and anonymously self-report a positive status to their peer network. Our simulation results suggest that higher adoption rates of such an application may result in a better controlled epidemic or pandemic outbreak.

CONCLUSIONS: Our proposed smartphone-based contact tracing method presents a novel solution which preserves privacy while demonstrating the potential to suppress an epidemic or pandemic outbreak. This application could potentially be applied to the current COVID-19 pandemic as well as other epidemics or pandemics in the future, in order to achieve a middle ground between drastic isolation measures and unmitigated disease spread.

RevDate: 2020-04-02

Guest JL, Del Rio C, T Sanchez (2020)

The 3 Steps Needed to End the COVID-19 Pandemic: Bold Public Health Leadership, Rapid Innovations, and Courageous Political Will.

UNSTRUCTURED: The world is experiencing the expansive spread of the virus SARS-CoV-2 in a global pandemic that is placing strains on healthcare, economic and social systems. Commitment to implementing proven public health strategies will require bold public health leadership and courageous acts by politicians. Developing new innovative communication, mitigation and healthcare approaches, particularly in the era of social media is also clearly warranted. We believe that the best public health evidence must inform activities in three priority areas to stop this pandemic: 1) coordinated and consistent stay-at-home orders across multiple jurisdictions, including potential nation-wide mandates; 2) rapid scale-up of SARS-CoV-2 testing; and 3) improving healthcare capacity to respond. The editorial outlines those areas, the rationale behind them, and the call for innovation and the engagement of bold public health leadership to empower courageous political action to reduce the number of people who will die during this pandemic.

RevDate: 2020-04-02

Salman S, ML Salem (2020)

Routine childhood immunization may protect against COVID-19.

RevDate: 2020-04-02

Banerjee D (2020)

The COVID-19 outbreak: Crucial role the psychiatrists can play.

RevDate: 2020-04-02

Chen Z, Fan H, Cai J, et al (2020)

High-resolution computed tomography manifestations of COVID-19 infections in patients of different ages.

European journal of radiology, 126:108972 pii:S0720-048X(20)30161-3 [Epub ahead of print].

PURPOSE: We aimed to compare chest HRCT lung signs identified in scans of differently aged patients with COVID-19 infections.

METHODS: Case data of patients diagnosed with COVID-19 infection in Hangzhou City, Zhejiang Province in China were collected, and chest HRCT signs of infected patients in four age groups (<18 years, 18-44 years, 45-59 years, ≥60 years) were compared.

RESULTS: Small patchy, ground-glass opacity (GGO), and consolidations were the main HRCT signs in 98 patients with confirmed COVID-19 infections. Patients aged 45-59 years and aged ≥60 years had more bilateral lung, lung lobe, and lung field involvement, and greater lesion numbers than patients <18 years. GGO accompanied with the interlobular septa thickening or a crazy-paving pattern, consolidation, and air bronchogram sign were more common in patients aged 45-59 years, and ≥60 years, than in those aged <18 years, and aged 18-44 years.

CONCLUSIONS: Chest HRCT manifestations in patients with COVID-19 are related to patient's age, and HRCT signs may be milder in younger patients.

RevDate: 2020-04-02

Liu N, Zhang F, Wei C, et al (2020)

Prevalence and predictors of PTSS during COVID-19 outbreak in China hardest-hit areas: Gender differences matter.

Psychiatry research, 287:112921 pii:S0165-1781(20)30545-X [Epub ahead of print].

The outbreak of COVID-19 in China in December 2019 has been identified as a pandemic and a health emergency of global concern. Our objective was to investigate the prevalence and predictors of posttraumatic stress symptoms (PTSS) in China hardest-hit areas during COVID-19 outbreak, especially exploring the gender difference existing in PTSS. One month after the December 2019 COVID-19 outbreak in Wuhan China, we surveyed PTSS and sleep qualities among 285 residents in Wuhan and surrounding cities using the PTSD Checklist for DSM-5 (PCL-5) and 4 items from the Pittsburgh Sleep Quality Index (PSQI). Hierarchical regression analysis and non-parametric test were used to analyze the data. Results indicated that the prevalence of PTSS in China hardest-hit areas a month after the COVID-19 outbreak was 7%. Women reported significant higher PTSS in the domains of re-experiencing, negative alterations in cognition or mood, and hyper-arousal. Participants with better sleep quality or less frequency of early awakenings reported lower PTSS. Professional and effective mental health services should be designed in order to aid the psychological wellbeing of the population in affected areas, especially those living in hardest-hit areas, females and people with poor sleep quality.

RevDate: 2020-04-02

Ilias I, L Zabuliene (2020)

Hyperglycemia and the novel Covid-19 infection: Possible pathophysiologic mechanisms.

RevDate: 2020-04-02

Peyrin-Biroulet L (2020)

Will the quality of research remain the same during the COVID-19 pandemic?.

RevDate: 2020-04-02

Ross SW, Lauer CW, Miles WS, et al (2020)

Maximizing the Calm Before the Storm: Tiered Surgical Response Plan for Novel Coronavirus (COVID-19).

Journal of the American College of Surgeons pii:S1072-7515(20)30263-5 [Epub ahead of print].

The novel coronavirus (COVID-19) was first diagnosed in Wuhan, China in December 2019 and has now spread throughout the world, being verified by the World Health Organization as a Pandemic on March 11th. This had led to the calling of a national emergency on March 13th in the United States. Many hospitals, healthcare networks, and specifically Departments of Surgery are asking the same questions of how to cope and plan for surge capacity, personnel attrition, novel infrastructure utilization, and resource exhaustion. Herein, we present a tiered plan for surgical department planning based on incident command levels. This includes Acute Care Surgeon deployment (given their critical care training and vertically integrated position in the hospital), recommended infrastructure and transfer utilization, triage principles, and faculty, resident and advanced care practitioner deployment.

RevDate: 2020-04-02

Montemurro N (2020)

The emotional impact of COVID-19: from medical staff to common people.

RevDate: 2020-04-02

Kang L, Ma S, Chen M, et al (2020)

Impact on Mental Health and Perceptions of Psychological Care among Medical and Nursing Staff in Wuhan during the 2019 Novel Coronavirus Disease Outbreak: a Cross-sectional Study.

Brain, behavior, and immunity pii:S0889-1591(20)30348-2 [Epub ahead of print].

The severe 2019 outbreak of novel coronavirus disease (COVID-19), which was first reported in Wuhan, would be expected to impact the mental health of local medical and nursing staff and thus lead them to seek help. However, those outcomes have yet to be established using epidemiological data. To explore the mental health status of medical and nursing staff and the efficacy, or lack thereof, of critically connecting psychological needs to receiving psychological care, we conducted a quantitative study. This is the first paper on the mental health of medical and nursing staff in Wuhan. Notably, among 994 medical and nursing staff working in Wuhan, 36.9% had subthreshold mental health disturbances (mean PHQ-9: 2.4), 34.4% had mild disturbances (mean PHQ-9: 5.4), 22.4% had moderate disturbances (mean PHQ-9: 9.0), and 6.2% had severe disturbance (mean PHQ-9: 15.1) in the immediate wake of the viral epidemic. The noted burden fell particularly heavily on young women. Of all participants, 36.3% had accessed psychological materials (such as books on mental health), 50.4% had accessed psychological resources available through media (such as online push messages on mental health self-help coping methods), and 17.5% had participated in counseling or psychotherapy. Trends in levels of psychological distress and factors such as exposure to infected people and psychological assistance were identified. Although staff accessed limited mental healthcare services, distressed staff nonetheless saw these services as important resources to alleviate acute mental health disturbances and improve their physical health perceptions. These findings emphasize the importance of being prepared to support frontline workers through mental health interventions at times of widespread crisis.

RevDate: 2020-04-02

Wu Y, Xu X, Chen Z, et al (2020)

Nervous system involvement after infection with COVID-19 and other coronaviruses.

Brain, behavior, and immunity pii:S0889-1591(20)30357-3 [Epub ahead of print].

Viral infections have detrimental impacts on neurological functions, and even to cause severe neurological damage. Very recently, coronaviruses (CoV), especially severe acute respiratory syndrome CoV 2 (SARS-CoV-2), exhibit neurotropic properties and may also cause neurological diseases. It is reported that CoV can be found in the brain or cerebrospinal fluid. The pathobiology of these neuroinvasive viruses is still incompletely known, and it is therefore important to explore the impact of CoV infections on the nervous system. Here, we review the research into neurological complications in CoV infections and the possible mechanisms of damage to the nervous system.

RevDate: 2020-04-02

Calton B, Abedini N, M Fratkin (2020)

Telemedicine in the Time of Coronavirus.

Journal of pain and symptom management pii:S0885-3924(20)30170-6 [Epub ahead of print].

Within weeks, COVID-19 has transformed our practice of palliative care and clinical medicine as we know it. Telemedicine has emerged as a critical technology to bring medical care to patients while attempting to reduce the transmission of COVID-19 among patients, families, and clinicians. It is also increasingly necessary to preserve scarce resources like personal protective equipment. In this article, we share just-in-time tips to support palliative care clinicians and program leaders in providing the best care possible by telemedicine. These quick, practical tips cover telemedicine set-up, patient considerations, and clinician considerations. Next steps include ensuring equitable access to affordable telemedicine technology for vulnerable populations through creative solutions and financing, and dedicated attention to telemedicine evaluation and quality improvement.

RevDate: 2020-04-02

Porzio G, Cortellini A, Bruera E, et al (2020)

Home care for cancer patients during COVID-19 pandemic: the "double triage" protocol.

Journal of pain and symptom management pii:S0885-3924(20)30172-X [Epub ahead of print].

Cancer patients have an increased risk of developing severe forms of COVID-19, and advanced cancer patients who are followed at home, represent a particularly frail population. Although with substantial differences, the challenges which cancer care professionals have to face with during a pandemic are quite similar to those posed by natural disasters. Some of us have already managed the oncological home care service after the 2009 earthquake in L'Aquila (middle Italy). With this letter, we want to share with the medical community the procedures and tools that we have started using at the home care service of the Tuscany Tumor Association during the COVID-19 pandemic.

RevDate: 2020-04-02

Fausto J, Hirano L, Lam D, et al (2020)

Creating a Palliative Care Inpatient Response Plan for COVID19 - The UW Medicine Experience.

Journal of pain and symptom management pii:S0885-3924(20)30176-7 [Epub ahead of print].

INTRODUCTION: The COVID-19 pandemic is stressing healthcare systems throughout the world. Significant numbers of patients are being admitted to the hospital with severe illness, often in the setting of advanced age and underlying co-morbidities. Therefore, palliative care is an important part of the response to this pandemic. The Seattle area and UW Medicine have been on the forefront of the pandemic in the US.

METHODS: UW Medicine developed a strategy to implement a palliative care response for a multi-hospital healthcare system that incorporates conventional capacity, contingency capacity, and crisis capacity. The strategy was developed by our palliative care programs with input from the healthcare system leadership.

RESULTS: In this publication, we share our multi-faceted strategy to implement high-quality palliative care in the context of the COVID-19 pandemic that incorporates conventional, contingency, and crisis capacity and focuses on the areas of the hospital caring for the most patients: the emergency department, the intensive care units, and the acute care services. The strategy focuses on key content areas including identifying and addressing goals of care, addressing moderate and severe symptoms, and supporting family members.

CONCLUSIONS: Strategy planning for delivery of high-quality palliative care in the context of the COVID-19 pandemic represents an important area of need for our healthcare systems. We share our experiences developing such a strategy to help other institutions conduct and adapt such strategies more quickly.

RevDate: 2020-04-02

Weaver MS, L Wiener (2020)

Applying Palliative Care Principles to Communicate with Children about COVID-19.

Journal of pain and symptom management pii:S0885-3924(20)30171-8 [Epub ahead of print].

Children are seeing rapid changes to their routines and facing an unpredictable future. Palliative care teams may consider expanding their communication training and skillsets to help families consider caring ways to communicate with their children and grandchildren about the coronavirus. Palliative care teams are wise to encourage families to ground their communication with children on key values: honesty and trust, self-compassion, safety, sensitivity, connection, preparedness, community-building, recognition of death as a part of the lifecycle, and legacy.

RevDate: 2020-04-02

Wang R, Liao C, He H, et al (2020)

COVID-19 in Hemodialysis Patients: A Report of 5 Cases.

In December 2019, an outbreak of coronavirus disease (COVID-19) due to the novel SARS-CoV-2 virus began in China and spread rapidly worldwide. It is unknown whether hemodialysis patients represent a distinct group of patients with certain characteristics that may make them susceptible to infection or severe disease. In this Case Report, we describe the clinical and epidemiological features of COVID-19 in 201 maintenance hemodialysis patients in Zhongnan Hospital of Wuhan university, including 5 maintenance hemodialysis patients who contracted COVID-19 disease. Of the 5 patients with COVID-19, one had a definite history of contact with an infected person. The age range of the patients was 47-67 years. Diarrhea (80%), fever (60%), and fatigue (60%) were the most common symptoms. Lymphopenia occurred in all patients.Chest computerized tomography (CT) scans showed ground glass opacity in the lungs of all patients. Up to February 13, 2020, none of the patients had developed severe complications (acute respiratory distress syndrome, shock, multiple organ dysfunction) or died.

RevDate: 2020-04-02

Wang L, He W, Yu X, et al (2020)

Coronavirus Disease 2019 in elderly patients: characteristics and prognostic factors based on 4-week follow-up.

The Journal of infection pii:S0163-4453(20)30146-8 [Epub ahead of print].

OBJECTIVE: To investigate the characteristics and prognostic factors in the elderly patients with COVID-19.

METHODS: Consecutive cases over 60 years old with COVID-19 in Renmin Hospital of Wuhan University from Jan 1 to Feb 6, 2020 were included. The primary outcomes were death and survival till March 5. Data of demographics, clinical features, comorbidities, laboratory tests and complications were collected and compared for different outcomes. Cox regression was performed for prognostic factors.

RESULTS: 339 patients with COVID-19 (aged 71±8 years,173 females (51%)) were enrolled, including 80 (23.6%) critical, 159 severe (46.9%) and 100 moderate (29.5%) cases. Common comorbidities were hypertension (40.8%), diabetes (16.0%) and cardiovascular disease (15.7%). Common symptoms included fever (92.0%), cough (53.0%), dyspnea (40.8%) and fatigue (39.9%). Lymphocytopenia was a common laboratory finding (63.2%). Common complications included bacterial infection (42.8%), liver enzyme abnormalities (28.7%) and acute respiratory distress syndrome (21.0%). Till Mar 5, 2020, 91 cases were discharged (26.8%), 183 cases stayed in hospital (54.0%) and 65 cases (19.2%) were dead. Shorter length of stay was found for the dead compared with the survivors (5 (3-8) vs. 28 (26-29), P < 0.001). Symptoms of dyspnea (HR 2.35, P = 0.001), comorbidities including cardiovascular disease (HR 1.86, P = 0.031) and chronic obstructive pulmonary disease (HR 2.24, P = 0.023), and acute respiratory distress syndrome (HR 29.33, P < 0.001) were strong predictors of death. And a high level of lymphocytes was predictive of better outcome (OR = 0.10, P < 0.001).

CONCLUSIONS: High proportion of severe to critical cases and high fatality rate were observed in the elderly COVID-19 patients. Rapid disease progress was noted in the dead with a median survival time of 5 days after admission. Dyspnea, lymphocytopenia, comorbidities including cardiovascular disease and chronic obstructive pulmonary disease, and acute respiratory distress syndrome were predictive of poor outcome. Close monitoring and timely treatment should be performed for the elderly patients at high risk.

RevDate: 2020-04-02

Verity R, Okell LC, Dorigatti I, et al (2020)

Estimates of the severity of coronavirus disease 2019: a model-based analysis.

The Lancet. Infectious diseases pii:S1473-3099(20)30243-7 [Epub ahead of print].

BACKGROUND: In the face of rapidly changing data, a range of case fatality ratio estimates for coronavirus disease 2019 (COVID-19) have been produced that differ substantially in magnitude. We aimed to provide robust estimates, accounting for censoring and ascertainment biases.

METHODS: We collected individual-case data for patients who died from COVID-19 in Hubei, mainland China (reported by national and provincial health commissions to Feb 8, 2020), and for cases outside of mainland China (from government or ministry of health websites and media reports for 37 countries, as well as Hong Kong and Macau, until Feb 25, 2020). These individual-case data were used to estimate the time between onset of symptoms and outcome (death or discharge from hospital). We next obtained age-stratified estimates of the case fatality ratio by relating the aggregate distribution of cases to the observed cumulative deaths in China, assuming a constant attack rate by age and adjusting for demography and age-based and location-based under-ascertainment. We also estimated the case fatality ratio from individual line-list data on 1334 cases identified outside of mainland China. Using data on the prevalence of PCR-confirmed cases in international residents repatriated from China, we obtained age-stratified estimates of the infection fatality ratio. Furthermore, data on age-stratified severity in a subset of 3665 cases from China were used to estimate the proportion of infected individuals who are likely to require hospitalisation.

FINDINGS: Using data on 24 deaths that occurred in mainland China and 165 recoveries outside of China, we estimated the mean duration from onset of symptoms to death to be 17·8 days (95% credible interval [CrI] 16·9-19·2) and to hospital discharge to be 24·7 days (22·9-28·1). In all laboratory confirmed and clinically diagnosed cases from mainland China (n=70 117), we estimated a crude case fatality ratio (adjusted for censoring) of 3·67% (95% CrI 3·56-3·80). However, after further adjusting for demography and under-ascertainment, we obtained a best estimate of the case fatality ratio in China of 1·38% (1·23-1·53), with substantially higher ratios in older age groups (0·32% [0·27-0·38] in those aged <60 years vs 6·4% [5·7-7·2] in those aged ≥60 years), up to 13·4% (11·2-15·9) in those aged 80 years or older. Estimates of case fatality ratio from international cases stratified by age were consistent with those from China (parametric estimate 1·4% [0·4-3·5] in those aged <60 years [n=360] and 4·5% [1·8-11·1] in those aged ≥60 years [n=151]). Our estimated overall infection fatality ratio for China was 0·66% (0·39-1·33), with an increasing profile with age. Similarly, estimates of the proportion of infected individuals likely to be hospitalised increased with age up to a maximum of 18·4% (11·0-7·6) in those aged 80 years or older.

INTERPRETATION: These early estimates give an indication of the fatality ratio across the spectrum of COVID-19 disease and show a strong age gradient in risk of death.

FUNDING: UK Medical Research Council.

RevDate: 2020-04-02

Giulio M, Maggioni D, Montroni I, et al (2020)

Being a doctor will never be the same after the COVID-19 pandemic.

RevDate: 2020-04-02

Wang H, Li T, Barbarino P, et al (2020)

Dementia care during COVID-19.

RevDate: 2020-04-02

Green CA, Quraishi MN, Shabir S, et al (2020)

Screening faecal microbiota transplant donors for SARS-CoV-2 by molecular testing of stool is the safest way forward.

RevDate: 2020-04-02

The Lancet Oncology (2020)

COVID-19: global consequences for oncology.

The Lancet. Oncology, 21(4):467.

RevDate: 2020-04-02

Akiyama MJ, Spaulding AC, JD Rich (2020)

Flattening the Curve for Incarcerated Populations - Covid-19 in Jails and Prisons.

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

RevDate: 2020-04-02

Keesara S, Jonas A, K Schulman (2020)

Covid-19 and Health Care's Digital Revolution.

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

RevDate: 2020-04-02

Haffajee RL, MM Mello (2020)

Thinking Globally, Acting Locally - The U.S. Response to Covid-19.

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

RevDate: 2020-04-02

Casanova M, Bagliacca EP, Silva M, et al (2020)

How young patients with cancer perceive the Covid-19 (coronavirus) epidemic in Milan, Italy: is there room for other fears?.

Pediatric blood & cancer [Epub ahead of print].

The rapid spread of COVID-19 epidemic in Italy, in particular in the Milan focal point, required drastic measures and led to panic in the population. While in our centre we did not change our approach to the treatment of our young cancer patients, we developed a qualitative survey to assess their perception of the risk and level of stress. The survey showed that a relatively large proportion of them felt personally at risk of severe complications. We believe that we need to adequately inform our patients, focusing on hygienic measures and personal protection and prompt reporting of any suspicious symptoms. This article is protected by copyright. All rights reserved.

RevDate: 2020-04-02

Wong HK, CK Lee (2020)

Pivotal Role of Convalescent Plasma in Managing Emerging Infectious Diseases.

Vox sanguinis [Epub ahead of print].

Infectious diseases remain one of the top 10 global health threats as announced by the World Health Organization [1]. The emergence of new pathogens for which there is no effective treatment has redrawn the attention to the usefulness of convalescent plasma. Indeed, convalescent plasma can be an alternate and fast therapeutic option in outbreaks of infectious diseases such as Middle East Respiratory Syndrome, Severe Acute Respiratory Syndrome (SARS), Chikungunya, Ebola and Zika [2-4]. The recent Coronavirus Disease 2019 (COVID-19) pandemic caused by SARS-CoV-2 has prompted not only a search for effective anti-viral treatment and spread control measures, but also a reconsideration of the use of convalescent plasma for COVID-19 treatment [5, 6].

RevDate: 2020-04-02

Tiberghien P, de Lambalerie X, Morel P, et al (2020)

Collecting and evaluating convalescent plasma for COVID-19 treatment: why and how.

Vox sanguinis [Epub ahead of print].

Plasma provided by COVID-19 convalescent patients may provide therapeutic relief as the number CODID-19 cases escalate steeply world-wide. Prior findings in various viral respiratory diseases including SARS-CoV related pneumonia suggest that convalescent plasma can reduce mortality, although formal proof of efficacy is still lacking. By reducing viral spread early on, such an approach may possibly downplay subsequent immunopathology. Identifying, collecting, qualifying and preparing plasma from convalescent patients with adequate SARS-CoV-2 neutralizing Ab titers in an acute crisis setting may be challenging, although well within the remit of most blood establishments. Careful clinical evaluation should allow to quickly establish whether such passive immunotherapy, administered at early phases of the disease in patients at high risk of deleterious evolution may reduce the frequency of patient deterioration, and thereby COVID-19 mortality.

RevDate: 2020-04-02

Franchini M, Farrugia A, Velati C, et al (2020)

The impact of the SARS-CoV-2 outbreak on the safety and availability of blood transfusions in Italy.

Vox sanguinis [Epub ahead of print].

Coronaviruses are enveloped single-stranded RNA viruses belonging to the family of Coronaviridae. While initial research focused on their ability to cause enzootic infections, infections which have emerged in the past two decades demonstrate their ability to cross the species barrier and infect humans [1,2]. The ensuing epidemics have included Severe Acute Respiratory Syndrome (SARS) in 2002 and the more recent Middle East Respiratory Syndrome (MERS) in 2012, and have resulted in severe disease burden, mortality and economic disruption [3]. A novel flu-like coronavirus, emerging towards the end of 2019 and subsequently named SARS-CoV-2, has been associated with an epidemic initially focused in Wuhan, China.

RevDate: 2020-04-02

Kwon SY, Kim EJ, Jung YS, et al (2020)

Post-donation COVID-19 identification in blood donors.

Vox sanguinis [Epub ahead of print].

The coronavirus disease 19 (COVID-19) outbreak, which was characterized as a pandemic on 11 March 2020 by the WHO, started in December 2019 with the emergence of pneumonia cases of unknown cause in Wuhan, Hubei, China [1]. SARS-CoV-2, the causative agent of COVID-19, are enveloped, non-segmented, single stranded positive sense RNA viruses and are classified as a sister clade to the prototype human and bat severe acute respiratory syndrome coronaviruses (SARS-CoVs) of the species Severe acute respiratory syndrome-related coronavirus [2]. So far, no respiratory virus, including SARS-CoV and the Middle East Respiratory Syndrome (MERS)-CoV, has been confirmed as transfusion-transmissible [3,4].

RevDate: 2020-04-02

Mungmunpuntipantip R, V Wiwanitkit (2020)

Uncertainty in using chest computed tomography in early coronavirus disease (COVID-19).

RevDate: 2020-04-02

Meng L, Qiu F, S Sun (2020)

Providing pharmacy services at cabin hospitals at the coronavirus epicenter in China.

International journal of clinical pharmacy pii:10.1007/s11096-020-01020-5 [Epub ahead of print].

In the Chinese coronavirus epicenter, Wuhan, 16 cabin hospitals were built to admit patients with confirmed coronavirus infection (COVID-19). These cabin hospitals serve the role of effectively quarantine and treat mild cases of patients infected with COVID-19. Each cabin hospital has pharmacists to provide services and pharmaceutical care to patients. Pharmacists also provide assistance to cabin hospitals through remote internet platforms across China. In this commentary, we describe pharmacy services at cabin hospitals to share our experiences with the international pharmacy community.

RevDate: 2020-04-02

Zhou M, Zhang X, J Qu (2020)

Coronavirus disease 2019 (COVID-19): a clinical update.

Frontiers of medicine pii:10.1007/s11684-020-0767-8 [Epub ahead of print].

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has posed a significant threat to global health. It caused a total of 80 868 confirmed cases and 3101 deaths in Chinese mainland until March 8, 2020. This novel virus spread mainly through respiratory droplets and close contact. As disease progressed, a series of complications tend to develop, especially in critically ill patients. Pathological findings showed representative features of acute respiratory distress syndrome and involvement of multiple organs. Apart from supportive care, no specific treatment has been established for COVID-19. The efficacy of some promising antivirals, convalescent plasma transfusion, and tocilizumab needs to be investigated by ongoing clinical trials.

RevDate: 2020-04-02

Turer RW, Jones I, Rosenbloom ST, et al (2020)

Electronic Personal Protective Equipment: A Strategy to Protect Emergency Department Providers in the Age of COVID-19.

Journal of the American Medical Informatics Association : JAMIA pii:5815267 [Epub ahead of print].

Emergent policy changes related to telemedicine and the Emergency Medical Treatment and Labor Act (EMTALA) during the novel coronavirus pandemic (COVID-19) have created opportunities for technology-based clinical evaluation, which serves to conserve personal protective equipment (PPE) and protect emergency providers. We define electronic personal protective equipment (ePPE) as an approach using telemedicine tools to perform electronic medical screening exams while satisfying EMTALA. We discuss the safety, legal, and technical factors necessary for implementing such a pathway. This approach has the potential to conserve PPE and protect providers while maintaining safe standards for medical screening exams in the ED for low risk patients in whom COVID-19 is suspected.

RevDate: 2020-04-02

Volkow ND (2020)

Collision of the COVID-19 and Addiction Epidemics.

Annals of internal medicine pii:2764313 [Epub ahead of print].

RevDate: 2020-04-02

Becker WC, DA Fiellin (2020)

When Epidemics Collide: Coronavirus Disease 2019 (COVID-19) and the Opioid Crisis.

Annals of internal medicine pii:2764312 [Epub ahead of print].

RevDate: 2020-04-02

Scott SE, Zabel K, Collins J, et al (2020)

First Mildly Ill, Non-Hospitalized Case of Coronavirus Disease 2019 (COVID-19) Without Viral Transmission in the United States - Maricopa County, Arizona, 2020.

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America pii:5815221 [Epub ahead of print].

BACKGROUND: Coronavirus disease 2019 (COVID-19) causes a range of illness severity. Mild illness has been reported, but whether illness severity correlates with infectivity is unknown. We describe the public health investigation of a mildly ill, non-hospitalized COVID-19 case who traveled to China.

METHODS: The case was a Maricopa County resident with multiple severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive specimens collected on January 22, 2020. Contacts were persons exposed to the case on or after the day before case diagnostic specimen collection. Contacts were monitored for 14 days after last known exposure. High-risk contacts had close, prolonged case contact (≥10 minutes within 2 meters). Medium-risk contacts wore all U.S. Centers for Disease Control and Prevention (CDC)-recommended personal protective equipment during interactions. Nasopharyngeal and oropharyngeal (NP/OP) specimens were collected from the case and high-risk contacts and tested for SARS-CoV-2.

RESULTS: Paired case NP/OP specimens were collected for SARS-CoV-2 testing at 11 time points. In 8 pairs (73%), ≥1 specimen tested positive or indeterminate, and in 3 pairs (27%) both tested negative. Specimens collected 18 days after diagnosis tested positive. Sixteen contacts were identified; 11 (69%) had high-risk exposure, including 1 intimate contact, and 5 (31%) had medium-risk exposure. In total, 35 high-risk contact NP/OP specimens were collected for SARS-CoV-2 testing; all 35 pairs (100%) tested negative.

CONCLUSIONS: This report demonstrates that SARS-CoV-2 infection can cause mild illness and result in positive tests for up to 18 days after diagnosis, without evidence of transmission to close contacts. These data might inform public health strategies to manage individuals with asymptomatic infection or mild illness.

RevDate: 2020-04-02

Alexander GC, Stoller KB, Haffajee RL, et al (2020)

An Epidemic in the Midst of a Pandemic: Opioid Use Disorder and COVID-19.

Annals of internal medicine pii:2764311 [Epub ahead of print].

RevDate: 2020-04-02

Back A, Tulsky JA, RM Arnold (2020)

Communication Skills in the Age of COVID-19.

Annals of internal medicine pii:2764314 [Epub ahead of print].

RevDate: 2020-04-02

Gane SB, Kelly C, C Hopkins (2020)

Isolated sudden onset anosmia in COVID-19 infection. A novel syndrome?.

Rhinology pii:2449 [Epub ahead of print].

BACKGROUND: The amelioration of the current COVID pandemic relies on swift and efficient case finding as well as stringent social distancing measures. Current advice suggests that fever or new onset dry cough are the commonest presenting complaints.

METHODOLOGY: We present a case report and case series as well as other evidence that there is an important fourth presenting syndrome, namely isolated sudden onset anosmia (ISOA), which should be considered highly suspicious for SARS-CoV-2.

RESULTS: A patient presenting with ISOA who went on to test positive for infection with COVID-19 and did not develop any further symptoms as well as a case series of similar patients although limited by the lack of reliable testing at the moment.

CONCLUSIONS: We posit the existence of a fourth common syndrome of COVID-19 infection: isolated sudden onset anosmia (ISOA) and urge the international community to consider this presentation in current management advice.

RevDate: 2020-04-02

Kimball A, Hatfield KM, Arons M, et al (2020)

Asymptomatic and Presymptomatic SARS-CoV-2 Infections in Residents of a Long-Term Care Skilled Nursing Facility - King County, Washington, March 2020.

MMWR. Morbidity and mortality weekly report, 69(13):377-381.

Older adults are susceptible to severe coronavirus disease 2019 (COVID-19) outcomes as a consequence of their age and, in some cases, underlying health conditions (1). A COVID-19 outbreak in a long-term care skilled nursing facility (SNF) in King County, Washington that was first identified on February 28, 2020, highlighted the potential for rapid spread among residents of these types of facilities (2). On March 1, a health care provider at a second long-term care skilled nursing facility (facility A) in King County, Washington, had a positive test result for SARS-CoV-2, the novel coronavirus that causes COVID-19, after working while symptomatic on February 26 and 28. By March 6, seven residents of this second facility were symptomatic and had positive test results for SARS-CoV-2. On March 13, CDC performed symptom assessments and SARS-CoV-2 testing for 76 (93%) of the 82 facility A residents to evaluate the utility of symptom screening for identification of COVID-19 in SNF residents. Residents were categorized as asymptomatic or symptomatic at the time of testing, based on the absence or presence of fever, cough, shortness of breath, or other symptoms on the day of testing or during the preceding 14 days. Among 23 (30%) residents with positive test results, 10 (43%) had symptoms on the date of testing, and 13 (57%) were asymptomatic. Seven days after testing, 10 of these 13 previously asymptomatic residents had developed symptoms and were recategorized as presymptomatic at the time of testing. The reverse transcription-polymerase chain reaction (RT-PCR) testing cycle threshold (Ct) values indicated large quantities of viral RNA in asymptomatic, presymptomatic, and symptomatic residents, suggesting the potential for transmission regardless of symptoms. Symptom-based screening in SNFs could fail to identify approximately half of residents with COVID-19. Long-term care facilities should take proactive steps to prevent introduction of SARS-CoV-2 (3). Once a confirmed case is identified in an SNF, all residents should be placed on isolation precautions if possible (3), with considerations for extended use or reuse of personal protective equipment (PPE) as needed (4).

RevDate: 2020-04-02

CDC COVID-19 Response Team (2020)

Preliminary Estimates of the Prevalence of Selected Underlying Health Conditions Among Patients with Coronavirus Disease 2019 - United States, February 12-March 28, 2020.

MMWR. Morbidity and mortality weekly report, 69(13):382-386.

On March 11, 2020, the World Health Organization declared Coronavirus Disease 2019 (COVID-19) a pandemic (1). As of March 28, 2020, a total of 571,678 confirmed COVID-19 cases and 26,494 deaths have been reported worldwide (2). Reports from China and Italy suggest that risk factors for severe disease include older age and the presence of at least one of several underlying health conditions (3,4). U.S. older adults, including those aged ≥65 years and particularly those aged ≥85 years, also appear to be at higher risk for severe COVID-19-associated outcomes; however, data describing underlying health conditions among U.S. COVID-19 patients have not yet been reported (5). As of March 28, 2020, U.S. states and territories have reported 122,653 U.S. COVID-19 cases to CDC, including 7,162 (5.8%) for whom data on underlying health conditions and other known risk factors for severe outcomes from respiratory infections were reported. Among these 7,162 cases, 2,692 (37.6%) patients had one or more underlying health condition or risk factor, and 4,470 (62.4%) had none of these conditions reported. The percentage of COVID-19 patients with at least one underlying health condition or risk factor was higher among those requiring intensive care unit (ICU) admission (358 of 457, 78%) and those requiring hospitalization without ICU admission (732 of 1,037, 71%) than that among those who were not hospitalized (1,388 of 5,143, 27%). The most commonly reported conditions were diabetes mellitus, chronic lung disease, and cardiovascular disease. These preliminary findings suggest that in the United States, persons with underlying health conditions or other recognized risk factors for severe outcomes from respiratory infections appear to be at a higher risk for severe disease from COVID-19 than are persons without these conditions.

RevDate: 2020-04-02

Basch CH, Hillyer GC, Meleo-Erwin ZC, et al (2020)

Preventive Behaviors Conveyed on YouTube to Mitigate Transmission of COVID-19: Cross-Sectional Study.

JMIR public health and surveillance, 6(2):e18807 pii:v6i2e18807.

BACKGROUND: Accurate information and guidance about personal behaviors that can reduce exposure to severe acute respiratory syndrome coronavirus 2 are among the most important elements in mitigating the spread of coronavirus disease 2019 (COVID-19). With over 2 billion users, YouTube is a media channel that millions turn to when seeking information.

OBJECTIVE: At the time of this study, there were no published studies investigating the content of YouTube videos related to COVID-19. This study aims to address this gap in the current knowledge.

METHODS: The 100 most widely viewed YouTube videos uploaded throughout the month of January 2020 were reviewed and the content covered was described. Collectively, these videos were viewed over 125 million times.

RESULTS: Fewer than one-third of the videos covered any of the seven key prevention behaviors listed on the US Centers for Disease Control and Prevention website.

CONCLUSIONS: These results represent an important missed opportunity for disease prevention.

RevDate: 2020-04-02

de Lusignan S, Lopez Bernal J, Zambon M, et al (2020)

Emergence of a Novel Coronavirus (COVID-19): Protocol for Extending Surveillance Used by the Royal College of General Practitioners Research and Surveillance Centre and Public Health England.

JMIR public health and surveillance, 6(2):e18606 pii:v6i2e18606.

BACKGROUND: The Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) and Public Health England (PHE) have successfully worked together on the surveillance of influenza and other infectious diseases for over 50 years, including three previous pandemics. With the emergence of the international outbreak of the coronavirus infection (COVID-19), a UK national approach to containment has been established to test people suspected of exposure to COVID-19. At the same time and separately, the RCGP RSC's surveillance has been extended to monitor the temporal and geographical distribution of COVID-19 infection in the community as well as assess the effectiveness of the containment strategy.

OBJECTIVES: The aims of this study are to surveil COVID-19 in both asymptomatic populations and ambulatory cases with respiratory infections, ascertain both the rate and pattern of COVID-19 spread, and assess the effectiveness of the containment policy.

METHODS: The RCGP RSC, a network of over 500 general practices in England, extract pseudonymized data weekly. This extended surveillance comprises of five components: (1) Recording in medical records of anyone suspected to have or who has been exposed to COVID-19. Computerized medical records suppliers have within a week of request created new codes to support this. (2) Extension of current virological surveillance and testing people with influenza-like illness or lower respiratory tract infections (LRTI)-with the caveat that people suspected to have or who have been exposed to COVID-19 should be referred to the national containment pathway and not seen in primary care. (3) Serology sample collection across all age groups. This will be an extra blood sample taken from people who are attending their general practice for a scheduled blood test. The 100 general practices currently undertaking annual influenza virology surveillance will be involved in the extended virological and serological surveillance. (4) Collecting convalescent serum samples. (5) Data curation. We have the opportunity to escalate the data extraction to twice weekly if needed. Swabs and sera will be analyzed in PHE reference laboratories.

RESULTS: General practice clinical system providers have introduced an emergency new set of clinical codes to support COVID-19 surveillance. Additionally, practices participating in current virology surveillance are now taking samples for COVID-19 surveillance from low-risk patients presenting with LRTIs. Within the first 2 weeks of setup of this surveillance, we have identified 3 cases: 1 through the new coding system, the other 2 through the extended virology sampling.

CONCLUSIONS: We have rapidly converted the established national RCGP RSC influenza surveillance system into one that can test the effectiveness of the COVID-19 containment policy. The extended surveillance has already seen the use of new codes with 3 cases reported. Rapid sharing of this protocol should enable scientific critique and shared learning.

DERR1-10.2196/18606.

RevDate: 2020-04-02

Geldsetzer P (2020)

Use of Rapid Online Surveys to Assess People's Perceptions During Infectious Disease Outbreaks: A Cross-sectional Survey on COVID-19.

Journal of medical Internet research, 22(4):e18790 pii:v22i4e18790.

BACKGROUND: Given the extensive time needed to conduct a nationally representative household survey and the commonly low response rate of phone surveys, rapid online surveys may be a promising method to assess and track knowledge and perceptions among the general public during fast-moving infectious disease outbreaks.

OBJECTIVE: This study aimed to apply rapid online surveying to determine knowledge and perceptions of coronavirus disease 2019 (COVID-19) among the general public in the United States and the United Kingdom.

METHODS: An online questionnaire was administered to 3000 adults residing in the United States and 3000 adults residing in the United Kingdom who had registered with Prolific Academic to participate in online research. Prolific Academic established strata by age (18-27, 28-37, 38-47, 48-57, or ≥58 years), sex (male or female), and ethnicity (white, black or African American, Asian or Asian Indian, mixed, or "other"), as well as all permutations of these strata. The number of participants who could enroll in each of these strata was calculated to reflect the distribution in the US and UK general population. Enrollment into the survey within each stratum was on a first-come, first-served basis. Participants completed the questionnaire between February 23 and March 2, 2020.

RESULTS: A total of 2986 and 2988 adults residing in the United States and the United Kingdom, respectively, completed the questionnaire. Of those, 64.4% (1924/2986) of US participants and 51.5% (1540/2988) of UK participants had a tertiary education degree, 67.5% (2015/2986) of US participants had a total household income between US $20,000 and US $99,999, and 74.4% (2223/2988) of UK participants had a total household income between £15,000 and £74,999. US and UK participants' median estimate for the probability of a fatal disease course among those infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was 5.0% (IQR 2.0%-15.0%) and 3.0% (IQR 2.0%-10.0%), respectively. Participants generally had good knowledge of the main mode of disease transmission and common symptoms of COVID-19. However, a substantial proportion of participants had misconceptions about how to prevent an infection and the recommended care-seeking behavior. For instance, 37.8% (95% CI 36.1%-39.6%) of US participants and 29.7% (95% CI 28.1%-31.4%) of UK participants thought that wearing a common surgical mask was "highly effective" in protecting them from acquiring COVID-19, and 25.6% (95% CI 24.1%-27.2%) of US participants and 29.6% (95% CI 28.0%-31.3%) of UK participants thought it was prudent to refrain from eating at Chinese restaurants. Around half (53.8%, 95% CI 52.1%-55.6%) of US participants and 39.1% (95% CI 37.4%-40.9%) of UK participants thought that children were at an especially high risk of death when infected with SARS-CoV-2.

CONCLUSIONS: The distribution of participants by total household income and education followed approximately that of the US and UK general population. The findings from this online survey could guide information campaigns by public health authorities, clinicians, and the media. More broadly, rapid online surveys could be an important tool in tracking the public's knowledge and misperceptions during rapidly moving infectious disease outbreaks.

RevDate: 2020-04-02

Le TQM, Takemura T, Moi ML, et al (2020)

Severe Acute Respiratory Syndrome Coronavirus 2 Shedding by Travelers, Vietnam, 2020.

Emerging infectious diseases, 26(7): [Epub ahead of print].

We analyzed 2 clusters of 12 patients in Vietnam with severe acute respiratory syndrome coronavirus 2 infection during January-February 2020. Analysis indicated virus transmission from a traveler from China. One asymptomatic patient demonstrated virus shedding, indicating potential virus transmission in the absence of clinical signs and symptoms.

RevDate: 2020-04-02

Lu J, Gu J, Li K, et al (2020)

COVID-19 Outbreak Associated with Air Conditioning in Restaurant, Guangzhou, China, 2020.

Emerging infectious diseases, 26(7): [Epub ahead of print].

During January 26-February 10, 2020, an outbreak of 2019 novel coronavirus disease in an air-conditioned restaurant in Guangzhou, China, involved 3 family clusters. The airflow direction was consistent with droplet transmission. To prevent the spread of the virus in restaurants, we recommend increasing the distance between tables and improving ventilation.

RevDate: 2020-04-02

Lei P, Fan B, P Wang (2020)

Differential Diagnosis for Coronavirus Disease (COVID-19): Beyond Radiologic Features.

RevDate: 2020-04-02

Ortiz PA (2020)

Teaching in the time of COVID-19.

RevDate: 2020-04-02

Thachil J (2020)

The versatile heparin in COVID-19.

Journal of thrombosis and haemostasis : JTH [Epub ahead of print].

Coagulopathy in corona virus infection has been shown to be associated with high mortality with high D-dimers being a particularly important marker for the coagulopathy.1 In the latest paper from the same group, the use of anticoagulant therapy with heparin was shown to decrease mortality as well. 2 This is especially so in patients i) who have met the sepsis induced coagulopathy (SIC) criteria ≥4 (40.0% vs 64.2%, P=0.029) compared to those with SIC score <4 (29.0% vs 22.6%, P=0.419).or ii) with markedly elevated D-dimer (greater than six-fold at the upper limit of normal).

RevDate: 2020-04-02

Zhang Y, Zheng L, Liu L, et al (2020)

Liver impairment in COVID-19 patients: a retrospective analysis of 115 cases from a single center in Wuhan city, China.

Liver international : official journal of the International Association for the Study of the Liver [Epub ahead of print].

BACKGROUND: The SARS-CoV-2 pandemic is an ongoing global health emergency. The aim of our study was to investigate the changes of liver function and its clinical significance in COVID-19 patients.

METHOD: This retrospective, single-center study was conducted on 115 confirmed cases of COVID-19 in Zhongnan hospital of Wuhan University from Jan 18 to Feb 22, 2020. Liver function and related indexes were analyzed to evaluate its relationship with disease progression in COVID-19 patients.

RESULTS: Part of the COVID-19 patients presented with varying degrees of abnormality in liver function indexes. However, the levels of ALT, AST, TBIL, GGT and LDH in COVID-19 patients were not significantly different in compared with hospitalized community-acquired pneumonia patients, and the levels of albumin is even significantly higher. Levels of ALT, AST, TBIL, LDH and INR showed statistically significant elevation in severe COVID-19 cases compared with that in mild cases. However, the clinical significance of the elevation is unremarkable. Majority of severe COVID-19 patients showed significantly decreasing in albumin level and continuously decreasing in the progress of illness. Most of the liver function indexes in COVID-19 patients were correlated with CRP and NLR, the markers of inflammation. Logistic regression analysis further identified NLR as the independent risk factor for severe COVID-19, as well as age.

CONCLUSIONS: Although abnormalities of liver function indexes are common in COVID-19 patients, the impairment of liver function is not a prominent feature of COVID-19, and also may not have serious clinical consequences.

RevDate: 2020-04-02

Brooke J, D Jackson (2020)

Older people and COVID-19: Isolation, risk and ageism.

Internationally, health authorities and governments are warning older people that they are at a higher risk of more serious and possible fatal illness associated with COVID-19. Mortality data from Oxford COVID-19 Evidence Service (25/3/20) indicates a risk of mortality of 3.6% for people in their 60s, which increases to 8.0% and 14.8% for people in their 70s and over 80s. Therefore, the global recommendation for older populations includes social isolation, which involves staying at home and avoiding contact with other people, possibly for an extended period of time, currently estimated to be between three and four months. Older populations in this current context, refers to people over 70 years, and 50 years in some particularly vulnerable Indigenous populations.

RevDate: 2020-04-02

Cai Q, Huang D, Ou P, et al (2020)

COVID-19 in a Designated Infectious Diseases Hospital Outside Hubei Province, China.

Allergy [Epub ahead of print].

BACKGROUND: The clinical characteristics of novel coronavirus disease (COVID-2019) patients outside the epicenter of Hubei province are less understood.

METHODS: We analyzed the epidemiological and clinical features of all COVID-2019 cases in the only referral hospital in Shenzhen city, China from January 11, 2020 to February 6, 2020 and followed until March 6, 2020.

RESULTS: Among the 298 confirmed cases, 233 (81.5%) had been to Hubei while 42 (14%) did not have a clear travel history. Only 192(64.4%) cases had a fever as the initial symptom. Compared to the non-severe cases, severe cases were associated with older age, those with underlying diseases, as well as higher levels of C-reactive protein, interleukin-6, and erythrocyte sedimentation rate. Slower clearance of the virus was associated with a higher risk of progression to critical condition. As of March 6, 2020, 268 (89.9%) patients were discharged and the overall case fatality ratio was 1.0%.

CONCLUSIONS: In a designated hospital outside Hubei Province, COVID-2019 patients could be effectively managed by properly using the existing hospital system. Mortality may be lowered when cases are relatively mild and there are sufficient medical resources to care and treat the disease.

RevDate: 2020-04-02

Ford P, M Foale (2020)

Converting gas-driven ventilators from oxygen to air.

During our preparedness for the COVID-19 pandemic we identified that our GE Healthcare anaesthetic machines (GE Healthcare, Amersham Place, Little Chalfont, UK) had a ventilator which was gas-driven, using oxygen. This resulted in a large amount of wasted oxygen. Our anaesthetic department has 52 anaesthetic machines which form part of our plan to increase our ITU capacity.

RevDate: 2020-04-02

Bouffet E, Challinor J, Sullivan M, et al (2020)

Early advice on managing children with cancer during the COVID-19 pandemic and a call for sharing experiences.

Pediatric blood & cancer [Epub ahead of print].

RevDate: 2020-04-02

Sun P, Ren J, Li K, et al (2020)

Response to: Sore throat in COVID-19: comment on "Clinical characteristics of hospitalized patients with SARS-CoV-2 infection: A single arm meta-analysis".

We thank Andrea Lovato et al for their letter, which was written in response to our recent meta-analysis published in the journal[1] . From the news, we learned that the heroic Italian people are fighting the Corona Virus Disease 2019 (COVID-19) tenaciously. We wish you a great victory in this battle. This article is protected by copyright. All rights reserved.

RevDate: 2020-04-02

Conforti C, Cannavò SP, Jafferany M, et al (2020)

Coronavirus disease 2019 (COVID-19): facts and controversies.

RevDate: 2020-04-02

Xie H, Zhao J, Lian N, et al (2020)

Clinical characteristics of Non-ICU hospitalized patients with coronavirus disease 2019 and liver injury:A Retrospective study.

Liver international : official journal of the International Association for the Study of the Liver [Epub ahead of print].

BACKGROUND & AIMS: Coronavirus disease 2019 (COVID-19) has raised world concern for global epidemic since December, 2019. Limited data are available for liver function in COVID-19 patients. We aimed to investigate the risk factors related to liver injury in the COVID-19 patients.

METHODS: A retrospective study was performed in Non-ICU Ward at Jinyintan Hospital from February 2, 2020 to February 23, 2020. Consecutively confirmed COVID-19 discharged cases were enrolled. The clinical characteristics of patients with liver injury and without liver injury were compared.

RESULTS: A total of 79 COVID-19 patients were included. 31.6%, 35.4% and 5.1% COVID-19 patients had elevated levels of ALT, AST and bilirubin, respectively. Median value of ALT, AST and bilirubin for entire cohort were 36.5 (17.5~71.5) U/L, 34.5 (25.3~ 55.3) U/L and 12.7 (8.1~15.4) mmol/L, respectively. There were no significant differences in age, previous medical history, and symptoms between the two groups. Males were more likely to have liver injury when infected with COVID-19 (p<0.05); Compared to patients without liver injury, patients with liver injury had increased levels of white blood cell counts, neutrophils, CRP and CT score (p< 0.05), and had a longer length of stay (p< 0.05). Logistic regression analyses suggested that the extent of pulmonary lesions on CT was a predictor of liver function damage (p< 0.05).

CONCLUSIONS: Liver injury is common in Non-ICU hospitalized COVID-19 patients. It may be related to systemic inflammation. Intense monitoring and evaluation of liver function in patients with severe pulmonary imaging lesions should be considered.

RevDate: 2020-04-02

Cui D, Zhang A, Liu A, et al (2020)

Clinical findings in a patient with hemophilia A affected by COVID-19.

At the end of 2019, a cluster of pneumonia patients were confirmed to be infected with a novel coronavirus, known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), in Wuhan, Hubei Province, China. This infectious disease was designated as coronavirus disease 2019 (COVID-19). It rapidly spreads throughout the world. More than 80,000 cases have been reported in China and epidemics have grown in other countries.

RevDate: 2020-04-02

Abdelmaksoud A, Goldust M, M Vestita (2020)

Comment on "COVID-19 and psoriasis: Is it time to limit treatment with immunosuppressants? A call for action".

RevDate: 2020-04-02

Rudnicka L, Gupta M, Kassir M, et al (2020)

Priorities for Global Health Community in COVID-19 Pandemic.

RevDate: 2020-04-02

Vetrugno L, Bove T, Orso D, et al (2020)

Our Italian Experience Using Lung Ultrasound for Identification, Grading and Serial Follow-up of Severity of Lung Involvement for Management of Patients with COVID-19.

Echocardiography (Mount Kisco, N.Y.) [Epub ahead of print].

Lung ultrasound (LU) has rapidly become a tool for assessment of patients stricken by the novel coronavirus 2019 (COVID-19). Over the past two and a half months (January, February and first half of March 2020) we have used this modality for identification of lung involvement along with pulmonary severity in patients with suspected or documented COVID-19 infection. Use of LU has helped us in clinical decision making and reduced the use of both chest x-rays and computed tomography (CT).

RevDate: 2020-04-02

Danrad R, Smith DL, EK Kerut (2020)

Radiologic Chest CT Findings From COVID-19 in Orleans Parish, Lousiana.

Echocardiography (Mount Kisco, N.Y.) [Epub ahead of print].

Orleans Parish in Louisiana is in the midst of an exponentially increasing number of patient admissions with COVID-19 and respiratory symptoms. Patients have been described having CT findings most consistent with an Early stage (< 7 days from symptoms onset) or an Advanced stage (8-14 days from symptoms onset). We describe and illustrate those Early and Advanced stage CT findings from patients with documented COVID-19 who have been admitted to University Medical Center in New Orleans, Louisiana.

RevDate: 2020-04-02

Luan J, Jin X, Lu Y, et al (2020)

SARS-CoV-2 spike protein favors ACE2 from Bovidae and Cricetidae.

Journal of medical virology [Epub ahead of print].

SARS-CoV-2 causes the recent COVID-19 public health crisis. Bat is the widely believed original host of SARS-CoV-2. However, its intermediate host before transmitting to human is not clear. Some studies proposed pangolin, snake or turtle as the intermediate hosts. ACE2 is the receptor for SARS-CoV-2, which determines the potential host range for SARS-CoV-2. Based on the structural information of the complex of human ACE2 and SARS-CoV-2 RBD, we analyzed the affinity to S protein of the 20 key residues in ACE2 from mammal, bird, turtle and snake. Several ACE2 proteins from Primates, Bovidae, Cricetidae and Cetacea maintained the majority of key residues in ACE2 for associating with SARS-CoV-2 RBD. The simulated structures indicated that ACE2 proteins from Bovidae and Cricetidae were able to associate with SARS-CoV-2 RBD. We found that nearly half of the key residues in turtle, snake and bird are changed. The simulated structures showed several key contacts with SARS-CoV-2 RBD in turtle and snake ACE2 were abolished. Our study demonstrated that neither snake nor turtle was the intermediate hosts for SARS-CoV-2, which further reinforced the concept that the reptiles are resistant against infection of coronavirus. Our study suggested that Bovidae and Cricetidae should be included in the screening of intermediate hosts for SARS-CoV-2. This article is protected by copyright. All rights reserved.

RevDate: 2020-04-02

Nouri-Vaskeh M, L Alizadeh (2020)

Fecal Transmission in COVID-19: A Potential Shedding Rout.

We read with interest recent article by Zhang et al 1 on the diagnosis of Coronavirus disease 2019 (COVID-19) by fecal specimen test. Following the recent outbreak of pneumonia with unknown pathogen in Hubei province in China, a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) isolated from human airway epithelial cells and the disease was named COVID-19.2 It is a public health emergency of international concern and rapidly spearing all over the world.3 This article is protected by copyright. All rights reserved.

RevDate: 2020-04-02

Lovato A, Rossettini G, C de Filippis (2020)

Sore throat in COVID-19: comment on "Clinical characteristics of hospitalized patients with SARS-CoV-2 infection: A single arm meta-analysis".

We read with interest the recent meta-analysis by Sun et al.1 that included 50466 patients with Coronavirus Disease 2019 (COVID-19). The author found that fever and cough were the most common symptoms, and several subjects had muscle soreness or fatigue. In addition, they reported that "by reading the included literature, we found that diarrhea, hemoptysis, headache, sore throat, shock, and other symptoms are rare".1 This article is protected by copyright. All rights reserved.

RevDate: 2020-04-02

Agostini A, Floridi C, Borgheresi A, et al (2020)

Proposal of a low-dose, long-pitch, dual-source chest CT protocol on third-generation dual-source CT using a tin filter for spectral shaping at 100 kVp for CoronaVirus Disease 2019 (COVID-19) patients: a feasibility study.

La Radiologia medica pii:10.1007/s11547-020-01179-x [Epub ahead of print].

AIM: To subjectively and objectively evaluate the feasibility and diagnostic reliability of a low-dose, long-pitch dual-source chest CT protocol on third-generation dual-source CT (DSCT) with spectral shaping at 100Sn kVp for COVID-19 patients.

MATERIALS AND METHODS: Patients with COVID-19 and positive swab-test undergoing to a chest CT on third-generation DSCT were included. The imaging protocol included a dual-energy acquisition (HD-DECT, 90/150Sn kVp) and fast, low-dose, long-pitch CT, dual-source scan at 100Sn kVp (LDCT). Subjective (Likert Scales) and objective (signal-to-noise and contrast-to-noise ratios, SNR and CNR) analyses were performed; radiation dose and acquisition times were recorded. Nonparametric tests were used.

RESULTS: The median radiation dose was lower for LDCT than HD-DECT (Effective dose, ED: 0.28 mSv vs. 3.28 mSv, p = 0.016). LDCT had median acquisition time of 0.62 s (vs 2.02 s, p = 0.016). SNR and CNR were significantly different in several thoracic structures between HD-DECT and LDCT, with exception of lung parenchyma. Qualitative analysis demonstrated significant reduction in motion artifacts (p = 0.031) with comparable diagnostic reliability between HD-DECT and LDCT.

CONCLUSIONS: Ultra-low-dose, dual-source, fast CT protocol provides highly diagnostic images for COVID-19 with potential for reduction in dose and motion artifacts.

RevDate: 2020-04-02

Varrassi G (2020)

Warning Against the Use of Anti-Inflammatory Medicines to Cure COVID-19: Building Castles in the Air.

RevDate: 2020-04-02

Bai Z, Gong Y, Tian X, et al (2020)

The Rapid Assessment and Early Warning Models for COVID-19.

Virologica Sinica pii:10.1007/s12250-020-00219-0 [Epub ahead of print].

Human beings have experienced a serious public health event as the new pneumonia (COVID-19), caused by the severe acute respiratory syndrome coronavirus has killed more than 3000 people in China, most of them elderly or people with underlying chronic diseases or immunosuppressed states. Rapid assessment and early warning are essential for outbreak analysis in response to serious public health events. This paper reviews the current model analysis methods and conclusions from both micro and macro perspectives. The establishment of a comprehensive assessment model, and the use of model analysis prediction, is very efficient for the early warning of infectious diseases. This would significantly improve global surveillance capacity, particularly in developing regions, and improve basic training in infectious diseases and molecular epidemiology.

RevDate: 2020-04-02

Lu R, Wu X, Wan Z, et al (2020)

Development of a Novel Reverse Transcription Loop-Mediated Isothermal Amplification Method for Rapid Detection of SARS-CoV-2.

RevDate: 2020-04-02

Lai THT, Tang EWH, Chau SKY, et al (2020)

Reply to ocular manifestation, eye protection, and COVID-19.

RevDate: 2020-04-02

Abel T, D McQueen (2020)

The COVID-19 pandemic calls for spatial distancing and social closeness: not for social distancing!.

RevDate: 2020-04-02

Abel T, D McQueen (2020)

Critical health literacy and the COVID-19 crisis.

Health promotion international pii:5815087 [Epub ahead of print].

RevDate: 2020-04-02

Gostin LO, LF Wiley (2020)

Governmental Public Health Powers During the COVID-19 Pandemic: Stay-at-home Orders, Business Closures, and Travel Restrictions.

JAMA pii:2764283 [Epub ahead of print].

RevDate: 2020-04-02

Williamson V, Murphy D, N Greenberg (2020)

COVID-19 and experiences of moral injury in front-line key workers.

Occupational medicine (Oxford, England) pii:5814939 [Epub ahead of print].

RevDate: 2020-04-02

Liu S, Zheng Q, Z Wang (2020)

Potential covalent drugs targeting the main protease of the SARS-CoV-2 coronavirus.

Bioinformatics (Oxford, England) pii:5814924 [Epub ahead of print].

MOTIVATION: Since December 2019, the newly identified coronavirus SARS-CoV-2 has caused a massive health crisis worldwide and resulted in over 70,000 COVID-19 infections so far. Clinical drugs targeting SARS-CoV-2 are urgently needed to decrease the high fatality rate of confirmed COVID-19 patients. Traditional de novo drug discovery needs more than 10 years, so drug repurposing seems the best option currently to find potential drugs for treating COVID-19.

RESULTS: Compared with traditional non-covalent drugs, covalent drugs have attracted escalating attention recent years due to their advantages in potential specificity upon careful design, efficiency, and patient burden. We recently developed a computational protocol named as SCAR for discovering covalent drugs. In this work, we used the SCAR protocol to identify possible covalent drugs (approved or clinically tested) targeting the main protease (3CLpro) of SARS-CoV-2. We identified 11 potential hits, among which at least 6 hits were exclusively enriched by the SCAR protocol. Since the preclinical or clinical information of these identified drugs is already available, they might be ready for being clinically tested in the treatment of COVID-19.

RevDate: 2020-04-02

Momplaisir F (2020)

The COVID-19 pandemic: we are all in this together.

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America pii:5814957 [Epub ahead of print].

RevDate: 2020-04-02

Cao J, Tu WJ, Cheng W, et al (2020)

Clinical Features and Short-term Outcomes of 102 Patients with Corona Virus Disease 2019 in Wuhan, China.

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America pii:5814897 [Epub ahead of print].

OBJECTIVE: In December, 2019, a series of pneumonia cases of unknown cause emerged in Wuhan, Hubei, China. In this study, we investigate clinical and laboratory features and short-term outcomes of patients with Corona Virus Disease 2019(COVID-19).

METHODS: All patients with COVID-19 admitted to Wuhan University Zhongnan Hospital in Wuhan, China, between January 3 and February 1, 2020 were included. All those patients were with laboratory-confirmed infection. Epidemiological, clinical, radiological characteristics, underlying diseases, laboratory tests treatment, complications and outcomes data were collected. Outcomes were followed up at discharge until Feb 15, 2020.

RESULTS: The study cohort included 102 adult patients. The median (IQR) age was 54 years (37-67years) and 48.0% were female. A total of 34 patients (33.3%) were exposed to source of transmission in the hospital setting (as health care workers, patients, or visitors) and 10 patients (9.8%) had a familial cluster. Eighteen patients (17.6%) were admitted to the ICU, and 17 patients died (mortality, 16.7%; 95% confidence interval [CI], 9.4%-23.9%). Among patients who survived, they were younger, more likely were health care workers and less likely suffered from comorbidities. They were also less likely suffered from complications. There was no difference in drug treatment rates between the survival and non-survival groups. Patients who survived less likely required admission to the intensive care unit (14.1% vs. 35.3%). Chest imaging examination showed that death patients more likely had ground-glass opacity (41.2% vs. 12.9%).

CONCLUSIONS: The mortality rate was high among the COVID-19 patients described in our cohort who met our criteria for inclusion in this analysis. Patient characteristics seen more frequently in those who died were development of systemic complications following onset of the illness and the severity of disease requiring admission to the ICU. Our data support those described by others that COVID-19 infection results from human-to-human transmission, including familial clustering of cases, and nosocomial transmission. There were no differences in mortality among those who did or did not receive antimicrobial or glucocorticoid drug treatment.

RevDate: 2020-04-02

Reina J (2020)

[Remdesivir, the antiviral hope against SARS-CoV-2].

Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia [Epub ahead of print].

On December 31, 2019 a pneumonia outbreak caused by a new coronavirus (SARS-CoV-2) was detected in the city of Wuhan (China). Due to the high capacity of diffusion and human infection it has become a new zoonotic pandemic. The absence of a vaccine has determined the search for antiviral drugs with the capacity to inhibit the replication of the new virus. Among them, remdesivir, an analogue of adenosine, is what seems to have a more promising future. This drug has shown in vitro and in animals a high capacity to block infection and viral replication with attainable concentrations in human plasma. Although all studies have been carried out with SARS-CoV and MERS-CoV, it seems that by virological and functional analogy, remdesivir is one of the few antiviral drugs with proven efficacy. However, studies and clinical trials in humans are required to know the result of their application in them.

RevDate: 2020-04-02

Berlin-Broner Y, L Levin (2020)

'Dental Hierarchy of Needs' in the COVID-19 Era - or Why Treat When It Doesn't Hurt?.

Oral health & preventive dentistry, 18(2):95.

RevDate: 2020-04-02

Bergquist R, L Rinaldi (2020)

Covid-19: Pandemonium in our time.

Geospatial health, 15(1):.

While pandemonium has come to mean wild and noisy disorder, the reference here is to John Milton's epic poem Paradise Lost and the upheaval following Lucifer's banishment from Heaven and his construction of Pandæmonium as his hub. Today's avalanche of conflicting news on how to deal with the coronavirus disease 2019 (Covid-19) brings to mind the Trinity nuclear bomb test with Enrico Fermi estimating its strength by releasing small pieces of paper into the air and measuring their displacement by the shock wave. Fermi's result, in fact not far from the true value, emphasised his ability to make good approximations with few or no actual data. The current wave of Covid-19 presents just this kind of situation as it engulfs the world from ground zero in Wuhan, China. Much information is indeed missing, but datasets that might lead to useful ideas on how to handle this pandemic are steadily accumulating.

RevDate: 2020-04-02

Tveito K (2020)

Cytokine storms in COVID-19 cases?.

Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke, 140: pii:20-0239.

RevDate: 2020-04-02

Jørgensen HJ, CD Neves (2020)

COVID-19: One world, one health.

Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke, 140(5): pii:20-0212.

RevDate: 2020-04-02

Mallapaty S (2020)

Coronavirus can infect cats - dogs, not so much.

RevDate: 2020-04-02

Ahn DG, Shin HJ, Kim MH, et al (2020)

Current Status of Epidemiology, Diagnosis, Therapeutics, and Vaccines for Novel Coronavirus Disease 2019 (COVID-19).

Journal of microbiology and biotechnology, 30(3):313-324.

Coronavirus disease 2019 (COVID-19), which causes serious respiratory illness such as pneumonia and lung failure, was first reported in Wuhan, the capital of Hubei, China. The etiological agent of COVID-19 has been confirmed as a novel coronavirus, now known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is most likely originated from zoonotic coronaviruses, like SARS-CoV, which emerged in 2002. Within a few months of the first report, SARS-CoV-2 had spread across China and worldwide, reaching a pandemic level. As COVID-19 has triggered enormous human casualties and serious economic loss posing global threat, an understanding of the ongoing situation and the development of strategies to contain the virus's spread are urgently needed. Currently, various diagnostic kits to test for COVID-19 are available and several repurposing therapeutics for COVID-19 have shown to be clinically effective. In addition, global institutions and companies have begun to develop vaccines for the prevention of COVID-19. Here, we review the current status of epidemiology, diagnosis, treatment, and vaccine development for COVID-19.

RevDate: 2020-04-02

Chen Z, He S, Li F, et al (2020)

Mobile field hospitals, an effective way of dealing with COVID-19 in China: sharing our experience.

Bioscience trends [Epub ahead of print].

During the COVID-19 outbreak, China made great progress in controlling the epidemic, and the number of confirmed and suspected cases continues to decrease thanks to the various efforts employed. Mobile field hospitals have played a huge role in the centralized management of patients and they have effectively reduced transmission. This article describes some of our experiences operating mobile field hospitals in order to provide a reference and to better inform countries that are dealing with this crisis.

RevDate: 2020-04-02

Chawla D, Chirla D, Dalwai S, et al (2020)

Perinatal-Neonatal Management of COVID-19 Infection - Guidelines of the Federation of Obstetric and Gynecological Societies of India (FOGSI), National Neonatology Forum of India (NNF), and Indian Academy of Pediatrics (IAP).

Indian pediatrics pii:S097475591600154 [Epub ahead of print].

JUSTIFICATION: During the current rapidly evolving pandemic of COVID-19 infection, pregnant women with suspected or confirmed COVID-19 and their newborn infants form a special vulnerable group that needs immediate attention. Unlike other elective medical and surgical problems for which care can be deferred during the pandemic, pregnancies and childbirths will continue. Perinatal period poses unique challenges and care of the mother-baby dyads requires special resources for prevention of transmission, diagnosis of infection and providing clinical care during labor, resuscitation and postnatal period.

PROCESS: The GRADE approach recommended by the World Health Organization was used to develop the guideline. A Guideline Development Group (GDG) comprising of obstetricians, neonatologists and pediatricians was constituted. The GDG drafted a list of questions which are likely to be faced by clinicians involved in obstetric and neonatal care. An e-survey was carried out amongst a wider group of clinicians to invite more questions and prioritize. Literature search was carried out in PubMed and websites of relevant international and national professional organizations. Existing guidelines, systematic reviews, clinical trials, narrative reviews and other descriptive reports were reviewed. For the practice questions, the evidence was extracted into evidence profiles. The context, resources required, values and preferences were considered for developing the recommendations.

OBJECTIVES: To provide recommendations for prevention of transmission, diagnosis of infection and providing clinical care during labor, resuscitation and postnatal period.

RECOMMENDATIONS: A set of twenty recommendations are provided under the following broad headings: 1) pregnant women with travel history, clinical suspicion or confirmed COVID-19 infection; 2) neonatal care; 3) prevention and infection control; 4) diagnosis; 5) general questions.

RevDate: 2020-04-02

Shanker V (2020)

Measles Immunization: Worth Considering Containment Strategy for SARS-CoV-2 Global Outbreak.

Indian pediatrics pii:S097475591600153 [Epub ahead of print].

RevDate: 2020-04-02

Sundaram M, Ravikumar N, Bansal A, et al (2020)

Novel Coronavirus 2019 (2019-nCoV) Infection: Part II - Respiratory Support in the Pediatric Intensive Care Unit in Resource-limited Settings.

Indian pediatrics pii:S097475591600152 [Epub ahead of print].

The 2019-novel coronavirus predominantly affects the respiratory system with manifestations ranging from upper respiratory symptoms to full blown acute respiratory distress syndrome (ARDS). It is important to recognize the risk factors, categorize severity and provide early treatment. Use of high flow devices and non-invasive ventilation has been discouraged due to high chances of aerosol generation. Early intubation and mechanical ventilation are essential to prevent complications and worsening, especially in resource-limited settings with very few centers having expertise to manage critical cases. Hydrophobic viral filter in the ventilator circuit minimizes chances of transmission of virus. Strategies to manage ARDS in COVID-19 include low tidal volume ventilation with liberal sedation-analgesia. At the same time, prevention of transmission of the virus to healthcare workers is extremely important in the intensive care setting dealing with severe cases and requiring procedures generating aerosol. We, herein, provide guidance on non-invasive respiratory support, intubation and management of ARDS in a child with COVID-19.

RevDate: 2020-04-02

Licastro D, Rajasekharan S, Dal Monego S, et al (2020)

Isolation and full-length genome characterization of SARS-CoV-2 from COVID-19 cases in Northern Italy.

In December 2019, the novel coronavirus Severe Acquired Respiratory Syndrome SARS-CoV-2 emerged in the city of Wuhan in the Hubei province, People's Republic of China, as the etiologic agent of coronavirus disease 2019 (COVID-19), which has hence spread worldwide causing a global pandemic (1-3).….

RevDate: 2020-04-02

Cagliani R, Forni D, Clerici M, et al (2020)

Computational inference of selection underlying the evolution of the novel coronavirus, SARS-CoV-2.

Journal of virology pii:JVI.00411-20 [Epub ahead of print].

The novel coronavirus (SARS-CoV-2) recently emerged in China is thought to have a bat origin, as its closest known relative (BatCoV RaTG13) was described in horseshoe bats. We analyzed the selective events that accompanied the divergence of SARS-CoV-2 from BatCoV RaTG13. To this aim, we applied a population genetics-phylogenetics approach, which leverages within-population variation and divergence from an outgroup. Results indicated that most sites in the viral ORFs evolved under strong to moderate purifying selection. The most constrained sequences corresponded to some non-structural proteins (nsps) and to the M protein. Conversely, nsp1 and accessory ORFs, particularly ORF8, had a non-negligible proportion of codons evolving under very weak purifying selection or close to selective neutrality. Overall, limited evidence of positive selection was detected. The 6 bona fide positively selected sites were located in the N protein, in ORF8, and in nsp1. A signal of positive selection was also detected in the receptor-binding motif (RBM) of the spike protein but most likely resulted from a recombination event that involved the BatCoV RaTG13 sequence. In line with previous data, we suggest that the common ancestor of SARS-CoV-2 and BatCoV RaTG13 encoded/encodes an RBM similar to that observed in SARS-CoV-2 itself and in some pangolin viruses. It is presently unknown whether the common ancestor still exists and which animals it infects. Our data however indicate that divergence of SARS-CoV-2 from BatCoV RaTG13 was accompanied by limited episodes of positive selection, suggesting that the common ancestor of the two viruses was poised for human infection.IMPORTANCE Coronaviruses are dangerous zoonotic pathogens: in the last two decades three coronaviruses have crossed the species barrier and caused human epidemics. One of these is the recently emerged SARS-CoV-2. We investigated how, since its divergence from a closely related bat virus, natural selection shaped the genome of SARS-CoV-2. We found that distinct coding regions in the SARS-CoV-2 genome evolve under different degrees of constraint and are consequently more or less prone to tolerate amino acid substitutions. In practical terms, the level of constraint provides indications about which proteins/protein regions are better suited as possible targets for the development of antivirals or vaccines. We also detected limited signals of positive selection in three viral ORFs. However, we warn that, in the absence of knowledge about the chain of events that determined the human spill-over, these signals should not be necessarily interpreted as evidence of an adaptation to our species.

RevDate: 2020-04-02

Klein BC, NA Busis (2020)

COVID-19 is catalyzing the adoption of teleneurology.

Neurology pii:WNL.0000000000009494 [Epub ahead of print].

The novel coronavirus, COVID-19, changed the world within a matter of weeks. The primary action to constrain the spread of the virus is social isolation. Given this public health principle, and the shortage of personal protective equipment during the global pandemic, all health care stakeholders need to reconsider the indications for face-to-face health care encounters in providing patient care. Which encounters are imperative and which ones can be switched to non-face-to-face care? What changes in laws, regulations, payment policies and workflow are needed to enable this transition? (1,2,3).

RevDate: 2020-04-02

Shellhaas RA (2020)

Neurologists and Covid-19: A note on courage in a time of uncertainty.

Neurology pii:WNL.0000000000009496 [Epub ahead of print].

Neurologists are used to uncertainty - diagnoses are frequently challenging, too often there are limited treatment options, and unpredictable prognoses are our bread and butter. When colleagues struggle to communicate bad news, they regularly turn to us. We practice staying steady and calm amidst our patients' fears, confusion, suffering, and anxiety. We listen, perform detailed exams, and do our best to provide helpful insights. This emphasis on listening and thoughtful problem solving is the core of our art and should be front and center as we partner with colleagues to face an unprecedented set of challenges related to the Covid-19 pandemic.

RevDate: 2020-04-02

Sim MR (2020)

The COVID-19 pandemic: major risks to healthcare and other workers on the front line.

RevDate: 2020-04-02

Czernin J, Fanti S, Meyer PT, et al (2020)

Imaging clinic operations in the times of COVID-19: Strategies, Precautions and Experiences.

Journal of nuclear medicine : official publication, Society of Nuclear Medicine pii:jnumed.120.245738 [Epub ahead of print].

RevDate: 2020-04-02

Albano D, Bertagna F, Bertolia M, et al (2020)

INCIDENTAL FINDINGS SUGGESTIVE OF COVID-19 IN ASYMPTOMATIC PATIENTS UNDERGOING NUCLEAR MEDICINE PROCEDURES IN A HIGH PREVALENCE REGION.

Journal of nuclear medicine : official publication, Society of Nuclear Medicine pii:jnumed.120.246256 [Epub ahead of print].

Infection with the novel coronavirus SARS-CoV-2 may remain asymptomatic, leading to under-recognition of the related disease, COVID-19, and to incidental findings in nuclear imaging procedures performed for standard clinical indications. Here, we report about our local experience in a region with high COVID-19 prevalence and dynamically increasing infection rates. Methods: Within the 8 day period of March 16-24, 2020, hybrid imaging studies of asymptomatic patients who underwent 18F-FDG-PET/CT or 131I-SPECT/CT for standard oncologic indications at our institution in Brescia, Italy, were analyzed for findings suggestive of COVID-19. Presence, radiological features and metabolic activity of interstitial pneumonia were identified, correlated with subsequent short-term clinical course and described in a case series. Results: Six of 65 patients (9%) that underwent PET/CT for various malignancies showed unexpected signs of interstitial pneumonia on CT and elevated regional FDG-avidity. Additionally, 1 of 12 patients who received radioiodine for differentiated thyroid carcinoma also showed interstitial pneumonia on SPECT/CT. 5/7 patients had subsequent proof of COVID-19 by RT-PCR. The remaining 2 patients were not tested immediately but underwent quarantine and careful monitoring. Conclusion: Incidental findings suggestive of COVID-19 may not be infrequent in hybrid imaging of asymptomatic patients, in regions with expansive spread of SARS-CoV-2. Nuclear medicine services should prepare accordingly.

RevDate: 2020-04-02

Czernin J (2020)

Dr. Li Wenliang and the Time of COVID-19.

Journal of nuclear medicine : official publication, Society of Nuclear Medicine pii:jnumed.120.245712 [Epub ahead of print].

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ESP Quick Facts

ESP Origins

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

ESP Support

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

ESP Rationale

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

ESP Goal

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

ESP Usage

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

ESP Content

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

ESP Help

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

ESP Plans

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

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This is a must read book for anyone with an interest in invasion biology. The full title of the book lays out the author's premise — The New Wild: Why Invasive Species Will Be Nature's Salvation. Not only is species movement not bad for ecosystems, it is the way that ecosystems respond to perturbation — it is the way ecosystems heal. Even if you are one of those who is absolutely convinced that invasive species are actually "a blight, pollution, an epidemic, or a cancer on nature", you should read this book to clarify your own thinking. True scientific understanding never comes from just interacting with those with whom you already agree. R. Robbins

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Papers in Classical Genetics

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

Digital Books

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

Timelines

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

Biographies

Biographical information about many key scientists.

Selected Bibliographies

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

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