RevDate: 2020-07-13

Bozovich GE, Alves De Lima A, Fosco M, et al (2020)

[Collateral damage of COVID-19 pandemic in private healthcare centres of Argentina].

Medicina, 80 Suppl 3:37-41.

To contain the coronavirus pandemic (COVID-19), a strict nationwide lockdown has been enforced and the health systems have been reorganized to deal with this entity. During this period, changes in the care of non-infectious diseases have been observed. Our aim was to describe the impact of the COVID-19 pandemic in the care of non-communicable diseases. A structured retrospective survey was carried out in 31 healthcare centers affiliated with the Asociación de Clínicas, Sanatorios y Hospitales Privados de la República Argentina y Cámara de Entidades de Diagnóstico y Tratamiento. We compared data for April 2019 versus April 2020 regarding emergency room consultations, hospital admissions, invasive procedures and treatments, and bed occupancy. In April 2020, we observed a decrease in emergency room visits (75%) and hospitalizations (48%). A 62% decrease in admissions was noted for angina pectoris and acute coronary syndromes and a 46% decrease in admissions for stroke and transient ischemic attack. A meaningful decrease was found in coronary angioplasties (59%) and total percutaneous interventions (65%), and also a decrease in general surgeries (73%), and cardiac surgeries (58%). Although social distancing measures are a key public health strategy to flatten the infection curve, the observed decrease in medical visits and interventions may impact negatively on cardiovascular, cerebrovascular and cancer related morbidity and mortality. A collective effort is required to avoid the unintended consequences and collateral damage of the COVID-19 pandemic.

RevDate: 2020-07-13

Basbus L, Lapidus MI, Martingano I, et al (2020)

[Neutrophil to lymphocyte ratio as a prognostic marker in COVID-19].

Medicina, 80 Suppl 3:31-36.

In December 2019, a new coronavirus was identified as the cause of an outbreak of pneumonia and respiratory distress in Wuhan, China. It was declared pandemic in March 2020. It is important to know predictors of poor outcomes in order to optimize the strategies of care in newly diagnosed patients. The neutrophil to lymphocyte ratio (NLR) constitutes a novel prognostic marker for oncologic, cardiovascular and infectious diseases. We aimed to assess its prognostic value in COVID-19. We evaluated a retrospective cohort of 131 patients with COVID-19 from March to May 2020. We analyzed the association of an NLR = 3 with severe COVID-19, baseline characteristics of the population and the mortality rate. The median age was 52 years, and 54% were men. 21 patients presented criteria of severe disease, 9 of them required mechanical ventilation. NLR = 3 was found in 81% (18/21) of severe patients and in 33% (36/110) of mild patients (OR = 8.74. 95% CI 2.74-27.86; p < 0.001). Age and hypertension were associated with severe disease. A mortality rate of 7% (9) was obtained. Seven of the 9 patients who died presented NLR = 3, with a significant association between mortality and NLR = 3 (p = 0.03). NLR could be used in conjunction with other predictors, as an early prognostic marker in COVID-19 given its accessibility and low cost.

RevDate: 2020-07-13

Carboni Bisso I, Huespe I, Lockhart C, et al (2020)

[COVID-19 in the intensive care unit. Analysis of the experience during the first month of pandemic].

Medicina, 80 Suppl 3:25-30.

This is an analysis of clinical characteristics, images findings, laboratory variables and respiratory mechanics in patients with coronavirus disease 2019 (COVID-19) during the first month of the pandemic outbreak in Buenos Aires. In this descriptive case study of a single-centre, we included all confirmed cases of COVID-19 hospitalized in intensive care unit (ICU). All cases were confirmed by reverse transcription polymerase chain reaction. A total of 7 patients with confirmed COVID-19 were referred to out ICU. The median age was 71 years (interquartile range 52-75), including 4 men and 3 women. Patients most common clinical manifestations were fever (7), cough (5), asthenia (4) and shortness of breath (3). Among the radiological findings, five of them showed interstitial opacities and one patient had bilateral pulmonary consolidation. Five required invasive mechanical ventilation and multiple prone sessions. None died during hospitalization, although three still remain in the ICU. According to imaging examination, 71.4% showed interstitial opacities and one patient bilateral consolidation. Five patients required invasive mechanical ventilation and multiple prone sessions. None of them died during hospitalization, although three still remain in the ICU.

RevDate: 2020-07-13

Ortiz Z, Antonietti L, Capriati A, et al (2020)

[Concerns and demands regarding COVID-19. Survey of health personnel].

Medicina, 80 Suppl 3:16-24.

The COVID-19 pandemic affected the organization of health services and had consequences for health teams, according to the pre-existing safety and working conditions. During the first week of April 2020, a cross sectional study was carried out with a qualitative-quantitative approach. The aim was to explore the conditions determining the organizational climate: leadership, communication, institutional resources, cohesion/conflict management, and training; and how these were perceived by health personnel to deal with the pandemic. A total of 5670 healthcare workers participated in an online survey and 50 were interviewed, from all subsectors of the Argentinean health system (public, private and union-health insurance); 72.9% were women, 51.4% were physicians, and the predominant age group was under 40 years. In the qualitative sample (interviews), 52% were men, 62% were physicians, and the average age was 44.8 years. The dimensions of the organizational climate were stratified and five independent predictors of perception of conditions were identified: age, gender, tasks performed, health system subsector, and jurisdiction. The condition most frequently perceived as inadequate were the inaccessibility of institutional resources and the access to personal protective equipment was a major concern. Claims included the need of institutional strategies to support healthcare workers and of a clear and uniform communication. In conclusion, at the time of the study, the health personnel perceived serious deficits in their organizations regarding the conditions necessary to confront COVID-19, with differences among subsectors of the health system.

RevDate: 2020-07-13

Borracci RA, ND Giglio (2020)

Forecasting the effect of social distancing on COVID-19 autumn-winter outbreak in the metropolitan area of Buenos Aires.

Medicina, 80 Suppl 3:7-15.

Forecasting the extent of the domestic health risk of epidemics by mathematical modeling is a useful tool for evaluating the feasibility of policies for controlling outbreaks. The objective of this study was to develop a time-dependent dynamic simulation model to forecast the COVID-19 autumn-winter outbreak in the metropolitan area of Buenos Aires, and to assess the effect of social distancing on epidemic spread. The model used was the "Susceptible-Exposed-Infectious-Recovered" framework which incorporated appropriate compartments relevant to interventions such as quarantine, isolation and treatment. In a low-intervention scenario including only 2-week isolation for international travelers and their contacts, the model estimated a maximum peak of nearly 90 000 symptomatic cases for early May. For an intervention scenario with mandatory quarantine during a 5-month period, the curve of cases flattened and receded as the proportion of quarantined individuals increased. The maximum peak was expected to appear between May 8 and Jul 8 depending on the quarantine strategy, and the average number of infectious symptomatic cases were 46 840, 30 494, 23 164, 16 179, and 13 196 when 10%, 20%, 30%, 40%, and 50% of the population remained in a 5-month-term continuous quarantine, respectively. Only mandatory quarantine was able to delay the maximum peak of infection and significantly reduce the total number of infected individuals and deaths at a 150-day term. The interruption of the quarantine before 120 days of its beginning could generate an even more serious outbreak 30 days later, and surpass the scarce medical resources available for the intensive care of critically-ill patients.

RevDate: 2020-07-13

Zylberman V, Sanguineti S, Pontoriero AV, et al (2020)

Development of a hyperimmune equine serum therapy for COVID-19 in Argentina.

Medicina, 80 Suppl 3:1-6.

The disease named COVID-19, caused by the SARS-CoV-2 coronavirus, is currently generating a global pandemic. Vaccine development is no doubt the best long-term immunological approach, but in the current epidemiologic and health emergency there is a need for rapid and effective solutions. Convalescent plasma is the only antibody-based therapy available for COVID-19 patients to date. Equine polyclonal antibodies (EpAbs) put forward a sound alternative. The new generation of processed and purified EpAbs containing highly purified F(ab')2 fragments demonstrated to be safe and well tolerated. EpAbs are easy to manufacture allowing a fast development and scaling up for a treatment. Based on these ideas, we present a new therapeutic product obtained after immunization of horses with the receptor-binding domain of the viral Spike glycoprotein. Our product shows around 50 times more potency in in vitro seroneutralization assays than the average of convalescent plasma. This result may allow us to test the safety and efficacy of this product in a phase 2/3 clinical trial to be conducted in July 2020 in the metropolitan area of Buenos Aires, Argentina.

RevDate: 2020-07-13

Garcia-Pachon E, Zamora-Molina L, Soler-Sempere MJ, et al (2020)

Asthma prevalence in patients with SARS-CoV-2 infection detected by RT-PCR not requiring hospitalization.

Respiratory medicine, 171:106084 pii:S0954-6111(20)30224-9 [Epub ahead of print].

INTRODUCTION: The prevalence of asthma in patients hospitalized with SARS-CoV-2 has been studied and varies widely in the different series. However, the prevalence in SARS-infected patients not requiring hospitalization is not known. The objective of this study was to analyze the presence of asthma in a consecutive series of patients who tested positive in the RT-PCR assay for SARS-CoV-2 and did not require hospital admission.

METHODS AND RESULTS: A total of 218 patients (58% of those who tested positive) did not require hospitalization; they had a median age of 45 years (IQR 34-57) and 57% were female. Six patients (2.8%) had a previous diagnosis of asthma. Only one patient developed a mild aggravation of asthma symptoms associated with SARS-CoV-2 infection.

CONCLUSIONS: Few patients with asthma were infected by SARS-CoV-2, and this infection was not a significant cause of asthma exacerbation.

RevDate: 2020-07-13

Fullana MA, Hidalgo-Mazzei D, Vieta E, et al (2020)

Coping behaviors associated with decreased anxiety and depressive symptoms during the COVID-19 pandemic and lockdown.

BACKGROUND: The COVID-19 pandemic and lockdown might increase anxiety and depressive symptoms, but some behaviors may protect against them.

METHOD: To provide a preliminary evidence of the behaviors associated with decreased symptoms in the current COVID-19 pandemic and lockdown, we conducted a survey of 5545 adult individuals from the Spanish general population, two weeks after an official lockdown was established across the country.

RESULTS: Sixty-five percent of the sample reported anxiety or depressive symptoms. Following a healthy/balanced diet and not reading news/updates about COVID-19 very often were the best predictors of lower levels of anxiety symptoms. Following a healthy/balanced diet, following a routine, not reading news/updates about COVID-19 very often, taking the opportunity to pursue hobbies, and staying outdoors or looking outside were the best predictors of lower levels of depressive symptoms.

LIMITATIONS: Cross-sectional nature and use of sample of convenience.

CONCLUSIONS: This study suggests that "simple" coping behaviors may protect against anxiety and depressive symptoms during the COVID-19 pandemic and lockdown.

RevDate: 2020-07-13

Fusar-Poli P, Brambilla P, M Solmi (2020)

Learning from COVID-19 pandemic in northen italy: Impact on mental health and clinical care.

RevDate: 2020-07-13

Van Rheenen TE, Meyer D, Neill E, et al (2020)

Mental health status of individuals with a mood-disorder during the COVID-19 pandemic in Australia: Initial results from the COLLATE project.

Journal of affective disorders, 275:69-77 pii:S0165-0327(20)32395-8 [Epub ahead of print].

BACKGROUND: Physical-distancing strategies during the coronavirus (COVID-19) pandemic may be particularly detrimental to the mental health of individuals with a pre-existing mood disorder. Data on the mental health status of these individuals during the current pandemic is sparse, and their current mental health needs unclear.

METHOD: We characterised COVID-19 related lifestyle changes, primary concerns and psychological distress in n=1292 respondents self-reporting a mood disorder (either bipolar disorder or depressive disorder) and n=3167 respondents without any reported mental disorder from the COLLATE (COvid-19 and you: mentaL heaLth in AusTralia now survEy) project; an Australian national survey launched on April 1st 2020.

RESULTS: Psychological distress was heightened in the mood disorder group compared to the group with no mental disorder, with stress and depression further elevated in respondents with bipolar disorder compared to those with depressive disorder; and men with bipolar disorder having even higher levels of depression than women with bipolar disorder. Respondents with bipolar disorder were particularly concerned about financial issues associated with COVID-19 compared to those with depressive disorder and those with no mental disorder. Adverse changes to lifestyle behaviours were more prevalent in respondents with a mood disorder and linked to higher levels of distress.

LIMITATIONS: Mood disorder was self-reported and was not clinically verified.

CONCLUSIONS: Current psychological distress levels are elevated in individuals with mood disorder and are associated with maladaptive situational and lifestyle changes occurring in response to COVID-19.

RevDate: 2020-07-13

Ben-Ezra M, Sun S, Hou WK, et al (2020)

The association of being in quarantine and related COVID-19 recommended and non-recommended behaviors with psychological distress in Chinese population.

RevDate: 2020-07-13

Salazar de Pablo G, Vaquerizo-Serrano J, Catalan A, et al (2020)

Impact of coronavirus syndromes on physical and mental health of health care workers: Systematic review and meta-analysis.

Journal of affective disorders, 275:48-57 pii:S0165-0327(20)32380-6 [Epub ahead of print].

BACKGROUND: Health care workers (HCW) are at high risk of developing physical/mental health outcomes related to coronavirus syndromes. Nature and frequency of these outcomes are undetermined.

METHODS: PRISMA/MOOSE-compliant (PROSPERO-CRD42020180205) systematic review of Web of Science/grey literature until 15th April 2020, to identify studies reporting physical/mental health outcomes in HCW infected/exposed to Severe Acute Respiratory Syndrome -SARS-, Middle East Respiratory Syndrome -MERS-, Novel coronavirus -COVID-19-. Proportion random effect meta-analyses, I2 statistic, quality assessment and sensitivity analysis.

RESULTS: 115 articles were included (n=60,458 HCW, age 36.1±7.1, 77.1% female). Physical health outcomes: 75.9% HCW infected by SARS/MERS/COVID-19 reported fever (95%CI=65.9-83.7%, k=12, n=949), 47.9% cough (95%CI=39.2-56.8%, k=14, n=970), 43.6% myalgias (95%CI=31.9-56.0%, k=13, n=898), 42.3% chills (95%CI=20.2-67.9%, k=7, n=716), 41.2% fatigue (95%CI=18.2-68.8%, k=6, n=386), 34.6% headaches (95%CI=23.1-48.2%, k=11, n=893), 31.2% dyspnoea (95%CI=23.2-40.5%, k=12, n=1003), 25.3% sore throat (95%CI=18.8-33.2%, k=8, n=747), 22.2% nausea/vomiting (95%CI=14.9-31.8%, k=6, n=662), 18.8% diarrhoea (95%CI=11.9-28.4%, k=9, n=824). Mental health outcomes: 62.5% HCW exposed to SARS/MERS/COVID-19 reported general health concerns (95%CI=57.0-67,8%, k=2, n=2254), 43.7% fear (95%CI=33.9-54.0%, k=4, n=584), 37.9% insomnia (95%CI=30.9-45.5%, k=6, n=5067), 37.8% psychological distress (95%CI=28.4-48.2%, k=15, n=24,346), 34.4% burnout (95%CI=19.3-53.5%, k=3, n=1337), 29.0% anxiety features (95%CI=14.2-50.3%, k=6, n=9191), 26.3% depressive symptoms (95%CI=12.5-47.1%, k=8, n=9893), 20.7% post-traumatic stress disorder features (95%CI=13.2-31%, k=11, n=3826), 16.1% somatisation (95%CI=0.2-96.0%, k=2, n=2184), 14.0% stigmatisation feelings (95%CI=6.4-28.1%, k=2, n=411).

LIMITATIONS: Limited amount of evidence for some outcomes and suboptimal design in several studies included.

CONCLUSIONS: SARS/MERS/COVID-19 have a substantial impact on the physical and mental health of HCW, which should become a priority for public health strategies.

RevDate: 2020-07-13

Ma YF, Li W, Deng HB, et al (2020)

Prevalence of depression and its association with quality of life in clinically stable patients with COVID-19.

Journal of affective disorders, 275:145-148 pii:S0165-0327(20)32391-0 [Epub ahead of print].

INTRODUCTION: High risk of mental health problems is associated with Coronavirus Disease 2019 (COVID-19). This study explored the prevalence of depressive symptoms (depression hereafter) and its relationship with quality of life (QOL) in clinically stable patients with COVID-19.

METHODS: This was an online survey conducted in COVID-19 patients across five designated isolation hospitals for COVID-19 in Hubei province, China. Depression and QOL were assessed with standardized instruments.

RESULTS: A total of 770 participants were included. The prevalence of depression was 43.1% (95%CI: 39.6%-46.6%). Binary logistic regression analysis found that having a family member infected with COVID-19 (OR=1.51, P = 0.01), suffering from severe COVID-19 infection (OR=1.67, P = 0.03), male gender (OR=0.53, P<0.01), and frequent social media use to obtain COVID-19 related information (OR=0.65, P<0.01) were independently associated with depression. Patients with depression had lower QOL than those without.

CONCLUSION: Depression is highly prevalent in clinically stable patients with COVID-19. Regular screening and appropriate treatment of depression are urgently warranted for this population.

RevDate: 2020-07-13

Wang J, Wei H, L Zhou (2020)

Hotline services in China during COVID-19 pandemic.

RevDate: 2020-07-13

Peng M, Mo B, Liu Y, et al (2020)

Prevalence, risk factors and clinical correlates of depression in quarantined population during the COVID-19 outbreak.

Journal of affective disorders, 275:119-124 pii:S0165-0327(20)32393-4 [Epub ahead of print].

BACKGROUND: The COVID-19 outbreak has brought tremendous psychological pressure to the general population, which may lead to depression. Therefore, this study aim to evaluate the prevalence and clinical correlates of depressive symptoms in the general population quarantined during the COVID-19 outbreak in Shenzhen.

METHODS: 2237 quarantined general individuals participated in this cross-sectional study from February 14 to March 4, 2020, during their 14 days quarantine. They completed the Zung's Self-Rating Depression Scale (SDS) for depression, Zung's self-rating anxiety scale (SAS) for anxiety, the Pittsburgh Sleep Quality Index (PSQI) for sleep quality, and the Impact of Events Scale-Revised (IES-R) for post-traumatic stress symptoms (PTSS).

RESULTS: The prevalence of depressive symptom was 6.21% in quarantined individuals. The depressed group were younger, less married and educated, and had higher SAS, PSQI, IES-R total scores (all p<0.05), as well as more avoidance, intrusion and hyperarousal symptoms than the non-depressed group. Correlation analysis showed significant correlations between SDS score and the following parameters: age, marriage, education, SAS, PSQI, IES-R total and its three subscale scores (Bonferroni corrected all p<0.05). Further multiple regression indicated that age, marriage, education, SAS, PSQI, IES-R total score, Avoidance and Hyperarousal factor were independent predictors of depressive symptom.

LIMITATIONS: This study adopted a cross-sectional design and used self-report questionnaires.

CONCLUSIONS: Our results suggest an elevated prevalence of depressive symptom in quarantined general individuals in Shenzhen. Some demographic and clinical variables were associated with depressive symptoms.

RevDate: 2020-07-13

Duan L, Shao X, Wang Y, et al (2020)

An investigation of mental health status of children and adolescents in china during the outbreak of COVID-19.

Journal of affective disorders, 275:112-118 pii:S0165-0327(20)32387-9 [Epub ahead of print].

OBJECTIVE: The sudden outbreak of Coronavirus Disease 2019 (COVID-19) has had a dramatic effect on the mental health of the public. In the present study, we demonstrated the psychological effects on children and adolescents associated with the epidemic .

METHODS: By using convenience sampling method, questionnaires, such as Spence Child Anxiety Scale, Child Depression Inventory and Coping style Scale, were distributed to participating 359 children and 3254 adolescents online.

RESULTS: The anxiety levels of children and adolescents were (23.87 ± 15.79) and (29.27 ± 19.79), respectively. 22.28% respondents were suffering from depressive symptoms. Seven significant factors associated with increased levels of anxiety, including female, resident in urban regions, emotion-focused coping style. Nine factors associated with increased levels of depression, such as smartphone addiction (OR 1.411, 95% CI 1.099-1.180), Internet addiction (OR 1.844, 95% CI 1.209-2.811), and resident in Hubei province (OR 3.107, 95% CI 1.252-7.708). Two additional factors associated with decreased levels of depressive symptoms: hours spend on Internet per day before the epidemic (OR 0.652, 95% CI 0.609-0.697) and tendency to apply problem-focused coping style (OR 0.937, 95% CI 0.923-0.951).

CONCLUSION: Our findings indicate that the COVID-19 outbreak has had a significant psychosocial impact on children and adolescents. Findings of current levels of anxiety and depression not only highlight the need to address emotional distress for children and adolescents during the epidemic but also provide researchers with scientific fundamentals to formulate targeted interventions based on the significant influencing factors.

RevDate: 2020-07-13

Palgi Y, Shrira A, Ring L, et al (2020)

The loneliness pandemic: Loneliness and other concomitants of depression, anxiety and their comorbidity during the COVID-19 outbreak.

RevDate: 2020-07-13

Solarino B, Ferorelli D, A Dell'Erba (2020)

Post-mortem routine practice in the era of the COVID-19 pandemic.

Journal of forensic and legal medicine, 74:102010 pii:S1752-928X(20)30117-7 [Epub ahead of print].

RevDate: 2020-07-13

Keten D, Okdemir E, A Keten (2020)

Precautions in postmortem examinations in Covid-19 - Related deaths: Recommendations from Germany.

Journal of forensic and legal medicine, 73:102000.

The Covid-19 pandemic is also a considerable risk for forensic workers, among other healthcare providers. The risk of contamination is serious in post-mortem procedures. SARS-CoV2 is a microorganism classified as Hazard Group 3. However, the lack of adequate scientific work on Covid-19 should prompt us to be even more cautious when handling potentially infected persons or materials. Before starting the post-mortem investigation a risk assessment should be carried out and the suitability of facilities, personnel and equipment should be evaluated. An autopsy room conforming to BSL 3 standards would be ideal but is not mandatory. For suspicious or approved cases however a number of procedural changes must be made concerning the body's removal, storage and inspection procedures. Facilities, equipment and training issues need to be revised against existing and potential risks of infection. In addition to proper ventilation and insulation, personal protective equipment, aerosol reduction measures and disinfection applications are required. As of yet it is still unclear how long this public health issue, which has grown to become a pandemic, will last. This article highlights preventive measures to be taken into consideration in post-mortem processes when a Covid-19 infection is suspected or confirmed. It should be noted that there is no standard guide yet in this regard. A guide should be created according to international standards and revised according to changing conditions.

RevDate: 2020-07-13

Dijkhuizen LGM, Gelderman HT, WLJM Duijst (2020)

Review: The safe handling of a corpse (suspected) with COVID-19.

Journal of forensic and legal medicine, 73:101999.

INTRODUCTION: Countries around the world are confronted with a rising count of patients that die from COVID-19. Up to this date, there is no scientific evidence that proves that a COVID-19 corpse is still infectious. Different guidelines are being followed worldwide on how to deal with a COVID-19 positive corpse. The aim of this review is to compare different guidelines and literature on best practice for handling a COVID-19 positive corpse.

RESULTS: The guidelines vary greatly in the use of PPE's and other safety measures especially during autopsy. There is great variation in the use of disinfectant and its concentration. Also recommended funeral services and contact with relatives vary greatly.

CONCLUSION: In conclusion, there is very limited scientific evidence on which the researched guidelines are based. It is unclear why some guidelines propose a "business as usual" attitude and others a "code-red" attitude. More scientific evidence is needed to substantiate the handling of COVID-19 positive corpses to make an educated decision on how to safely handle a COVID-19 positive corpse.

RevDate: 2020-07-13

Mahmud T, Rahman MA, SA Fattah (2020)

CovXNet: A multi-dilation convolutional neural network for automatic COVID-19 and other pneumonia detection from chest X-ray images with transferable multi-receptive feature optimization.

Computers in biology and medicine, 122:103869.

With the recent outbreak of COVID-19, fast diagnostic testing has become one of the major challenges due to the critical shortage of test kit. Pneumonia, a major effect of COVID-19, needs to be urgently diagnosed along with its underlying reasons. In this paper, deep learning aided automated COVID-19 and other pneumonia detection schemes are proposed utilizing a small amount of COVID-19 chest X-rays. A deep convolutional neural network (CNN) based architecture, named as CovXNet, is proposed that utilizes depthwise convolution with varying dilation rates for efficiently extracting diversified features from chest X-rays. Since the chest X-ray images corresponding to COVID-19 caused pneumonia and other traditional pneumonias have significant similarities, at first, a large number of chest X-rays corresponding to normal and (viral/bacterial) pneumonia patients are used to train the proposed CovXNet. Learning of this initial training phase is transferred with some additional fine-tuning layers that are further trained with a smaller number of chest X-rays corresponding to COVID-19 and other pneumonia patients. In the proposed method, different forms of CovXNets are designed and trained with X-ray images of various resolutions and for further optimization of their predictions, a stacking algorithm is employed. Finally, a gradient-based discriminative localization is integrated to distinguish the abnormal regions of X-ray images referring to different types of pneumonia. Extensive experimentations using two different datasets provide very satisfactory detection performance with accuracy of 97.4% for COVID/Normal, 96.9% for COVID/Viral pneumonia, 94.7% for COVID/Bacterial pneumonia, and 90.2% for multiclass COVID/normal/Viral/Bacterial pneumonias. Hence, the proposed schemes can serve as an efficient tool in the current state of COVID-19 pandemic. All the architectures are made publicly available at: https://github.com/Perceptron21/CovXNet.

RevDate: 2020-07-13

Robson B (2020)

Bioinformatics studies on a function of the SARS-CoV-2 spike glycoprotein as the binding of host sialic acid glycans.

Computers in biology and medicine, 122:103849.

SARS-CoV and SARS-CoV-2 do not appear to have functions of a hemagglutinin and neuraminidase. This is a mystery, because sugar binding activities appear essential to many other viruses including influenza and even most other coronaviruses in order to bind to and escape from the glycans (sugars, oligosaccharides or polysaccharides) characteristic of cell surfaces and saliva and mucin. The S1 N terminal Domains (S1-NTD) of the spike protein, largely responsible for the bulk of the characteristic knobs at the end of the spikes of SARS-CoV and SARS-CoV-2, are here predicted to be "hiding" sites for recognizing and binding glycans containing sialic acid. This may be important for infection and the ability of the virus to locate ACE2 as its known main host cell surface receptor, and if so it becomes a pharmaceutical target. It might even open up the possibility of an alternative receptor to ACE2. The prediction method developed, which uses amino acid residue sequence alone to predict domains or proteins that bind to sialic acids, is naïve, and will be advanced in future work. Nonetheless, it was surprising that such a very simple approach was so useful, and it can easily be reproduced in a very few lines of computer program to help make quick comparisons between SARS-CoV-2 sequences and to consider the effects of viral mutations.

RevDate: 2020-07-13

Iftikhar H, Ali HN, Farooq S, et al (2020)

Identification of potential inhibitors of three key enzymes of SARS-CoV2 using computational approach.

Computers in biology and medicine, 122:103848.

The recent outbreak of coronavirus disease-19 (COVID-19) continues to drastically affect healthcare throughout the world. To date, no approved treatment regimen or vaccine is available to effectively attenuate or prevent the infection. Therefore, collective and multidisciplinary efforts are needed to identify new therapeutics or to explore effectiveness of existing drugs and drug-like small molecules against SARS-CoV-2 for lead identification and repurposing prospects. This study addresses the identification of small molecules that specifically bind to any of the three essential proteins (RdRp, 3CL-protease and helicase) of SARS-CoV-2. By applying computational approaches we screened a library of 4574 compounds also containing FDA-approved drugs against these viral proteins. Shortlisted hits from initial screening were subjected to iterative docking with the respective proteins. Ranking score on the basis of binding energy, clustering score, shape complementarity and functional significance of the binding pocket was applied to identify the binding compounds. Finally, to minimize chances of false positives, we performed docking of the identified molecules with 100 irrelevant proteins of diverse classes thereby ruling out the non-specific binding. Three FDA-approved drugs showed binding to 3CL-protease either at the catalytic pocket or at an allosteric site related to functionally important dimer formation. A drug-like molecule showed binding to RdRp in its catalytic pocket blocking the key catalytic residues. Two other drug-like molecules showed specific interactions with helicase at a key domain involved in catalysis. This study provides lead drugs or drug-like molecules for further in vitro and clinical investigation for drug repurposing and new drug development prospects.

RevDate: 2020-07-13

Essid N, Allouche M, Lazzem M, et al (2020)

Ecotoxic response of nematodes to ivermectin, a potential anti-COVID-19 drug treatment.

Marine pollution bulletin, 157:111375.

At the end of March 2020, ivermectin was confirmed as a drug for COVID-19 treatment. A significant amount of ivermectin could deposit into sediments of the semi-closed Mediterranean Sea, where three European COVID-19 epicenters are located: Italy, Spain, and France. Meiobenthic nematodes were exposed to three ivermectin doses (1.8 ng.g-1, 9 ng.g-1, and 18 ng.g-1) for 10 days. Ivermectin caused a great reduction in abundance. However, the diversity indices decreased only at high doses. Ivermectin disadvantaged the 1B-Cr-Id functional type (non-selective deposit feeders and nematodes with circular or indistinct amphids) and benefited the 2A-REL-Sp type (epistrate feeders and nematodes with rounded or elongated loop amphids). Thus, Trophic Diversity and Amphideal Diversity index values increased with sedimentary ivermectin enrichment. Large amphideal foveas were more efficient for 2A-REL-Sp nematodes to avoid ivermectin. The responses of the functional type 2A-REL-Sp and corresponding taxa predict post-COVID-19 environmental concerns and the bioaccumulation of ivermectin in seafoods.

RevDate: 2020-07-13

Anonymous (2020)

Correction to: Deep Vein Thrombosis in Hospitalized Patients With COVID-19 in Wuhan, China: Prevalence, Risk Factors, and Outcome.

Circulation, 142(2):e33.

RevDate: 2020-07-13

Anonymous (2020)

Correction to: Population Trends in Rates of Percutaneous Coronary Revascularization for Acute Coronary Syndromes Associated With the COVID-19 Outbreak.

Circulation, 142(2):e32.

RevDate: 2020-07-13

Kuehn BM (2020)

COVID-19 Leads to Major Changes for Cardiologists in Training.

Circulation, 142(2):175-177.

RevDate: 2020-07-13

Spyropoulos AC, JI Weitz (2020)

Hospitalized COVID-19 Patients and Venous Thromboembolism: A Perfect Storm.

Circulation, 142(2):129-132.

RevDate: 2020-07-13

Mollica V, Rizzo A, F Massari (2020)

The pivotal role of TMPRSS2 in coronavirus disease 2019 and prostate cancer.

RevDate: 2020-07-13

Luthar SS, Ebbert AM, NL Kumar (2020)

The Well-Being Index (WBI) for schools: A brief measure of adolescents' mental health.

Psychological assessment pii:2020-49918-001 [Epub ahead of print].

Schools are increasingly concerned with the well-being of the whole child - likely, more so since the COVID-19 pandemic - and goals here were to document the psychometric properties of a brief new measure of adolescent mental health, the Well-Being Index (WBI). The measure assesses 4 symptom areas, 2 each of internalizing and externalizing symptoms-Depression, Anxiety, Rule-Breaking, and Substance Use-and an optional scale on Isolation at School. A total of 2,444 students from 2 high schools completed the WBI, the Youth Self-Report (YSR), and other related measures. Alpha coefficients showed acceptable internal consistency, with values for the 5 WBI subscales at .83, .84, .78, .79, and .74, respectively. Both exploratory and confirmatory factor analyses demonstrated consistent factorial validity. Correlations with corresponding YSR subscales indicated good convergent and discriminant validity. The WBI Substance Use and Isolation at School subscales, similarly, had high correlations with subscales from preexisting measures. Criterion-related validity was indicated in significant correlations between WBI subscales and conceptually related dimensions of close relationships. Also examined was the percentage of youth falling above clinical cutoffs on both the WBI and YSR, and findings demonstrated high concurrent validity. Collectively, results suggest the promise of the WBI as a brief, psychometrically sound measure to assess the adjustment of adolescents, along with perceptions of school climate that can be modified toward fostering their overall well-being. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

RevDate: 2020-07-13

Poater A (2020)

Michael Acceptors Tuned by the Pivotal Aromaticity of Histidine to Block COVID19 Activity.

The journal of physical chemistry letters [Epub ahead of print].

COVID protease (SARS-CoV-2 Mpro) has been checked to be blocked by inhibitors, and with particular successful performance by α-ketoamide derivative substrates like 13b of Hilgenfeld and coworkers. After the biological characterization, here DFT calculations do not only explain how the inhibitor 13b produces a thermodynamically favorable interaction, but how to reach it kinetically. The controversial and unprovable concept of aromaticity here enjoys being the agent that rationalizes the seemingly innocent role of histidine (His41 of Mpro). Not only does it have a H-bond with the hydroxyl group, but it is the proton carrier of the thiol of Cys145 at almost zero energy cost that favours the interaction with the inhibitor that acts as a Michael acceptor.

RevDate: 2020-07-13

Braga CL, Silva-Aguiar RP, Battaglini D, et al (2020)

The renin-angiotensin-aldosterone system: Role in pathogenesis and potential therapeutic target in COVID-19.

Pharmacology research & perspectives, 8(4):e00623.

Coronavirus disease 2019 (COVID-19), caused by the SARS-CoV-2 novel coronavirus, has spread worldwide causing high fatality rates. Neither a vaccine nor specific therapeutic approaches are available, hindering the fight against this disease and making better understanding of its pathogenesis essential. Despite similarities between SARS-CoV-2 and SARS-CoV, the former has unique characteristics which represent a great challenge to physicians. The mechanism of COVID-19 infection and pathogenesis is still poorly understood. In the present review, we highlight possible pathways involved in the pathogenesis of COVID-19 and potential therapeutic targets, focusing on the role of the renin-angiotensin-aldosterone system.

RevDate: 2020-07-13

Sannes TS, Yeh IM, TF Gray (2020)

Caring for Loved Ones with Cancer during the COVID-19 Pandemic: A Double Hit Risk for Social Isolation and Need for Action.

Psycho-oncology [Epub ahead of print].

RevDate: 2020-07-13

Novak N, Peng WM, Naegeli MC, et al (2020)

SARS-CoV-2, COVID-19, skin and immunology - what do we know so far?.

Allergy [Epub ahead of print].

The pandemic condition Coronavirus-disease (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can take asymptomatic, mild, moderate, and severe courses. COVID-19 affects primarily the respiratory airways leading to dry cough, fever, myalgia, headache, fatigue, and diarrhea and can end up in interstitial pneumonia and severe respiratory failure. Reports about the manifestation of various skin lesions and lesions of the vascular system in some subgroups of SARS-CoV-2 positive patients as such features outside the respiratory sphere, are rapidly emerging. Vesicular, urticarial and maculopapular eruptions as well as livedo, necrosis and other vasculitis forms have been reported most frequently in association with SARS-CoV-2 infection. In order to update information gained, we provide a systematic overview of the skin lesions described in COVID-19 patients, discuss potential causative factors and describe differential diagnostic evaluations. Moreover, we summarize current knowledge about immunologic, clinical and histologic features of virus- as well as drug-induced lesions of the skin and changes to the vascular system in order to transfer this knowledge to potential mechanisms induced by SARS-CoV-2.

RevDate: 2020-07-13

Giacalone S, Minuti A, Spigariolo CB, et al (2020)

Facial dermatoses in general population due to personal protective masks: first observations after lockdown.

Since SARS-COV-2 pandemic began, frontline healthcare workers demonstrated to develop facial dermatoses, such as acne, rosacea and seborrheic dermatitis, secondary to prolonged use of personal protective equipment (PPE).

RevDate: 2020-07-13

Patell R, Khan A, Bogue T, et al (2020)

Heparin induced thrombocytopenia antibodies in COVID-19.

RevDate: 2020-07-13

Ovsyannikova IG, Haralambieva IH, Crooke SN, et al (2020)

The role of host genetics in the immune response to SARS-CoV-2 and COVID-19 susceptibility and severity.

Immunological reviews [Epub ahead of print].

This article provides a review of studies evaluating the role of host (and viral) genetics (including variation in HLA genes) in the immune response to coronaviruses, as well as the clinical outcome of coronavirus-mediated disease. The initial sections focus on seasonal coronaviruses, SARS-CoV, and MERS-CoV. We then examine the state of the knowledge regarding genetic polymorphisms and SARS-CoV-2 and COVID-19. The article concludes by discussing research areas with current knowledge gaps and proposes several avenues for future scientific exploration in order to develop new insights into the immunology of SARS-CoV-2.

RevDate: 2020-07-13

Kushlaf H (2020)

COVID-19 in MuSK Myasthenia Gravis: A Case Report.

RevDate: 2020-07-13

Valmasoni M, Pierobon ES, Capovilla G, et al (2020)

Providing surgery for cancer during the COVID-19 pandemic: experience of a northern Italian referral centre.

RevDate: 2020-07-13

Huxtable R, J Ives (2020)

Author response to: Ethics for surgeons during the COVID-19 pandemic.

RevDate: 2020-07-13

Quarto G, Grimaldi G, Castaldo L, et al (2020)

Avoiding disruption of timely surgical management of genitourinary cancers during the early phase of COVID-19 pandemic.

BJU international [Epub ahead of print].

As of early July 2020, over 10,000,000 confirmed SARS-CoV-2 (COVID-19) cases and 500,000 deaths have been recorded worldwide. This dramatic surge of the pandemic resulted in hospital overcrowding and shortage of intensive care unit (ICU) beds, creating a global crisis in health care systems. As many other specialties, Urology was impacted at different levels. A decline in number of elective surgeries was observed, with peaks of over 94% reduction in most affected regions. Outpatient clinics were largely shifted to virtual consults. Interestingly, there was a significant decrease in hospital attendance for urological emergencies. Urologic surgical training was negatively impacted.

RevDate: 2020-07-13

Harkin DW (2020)

Ethics for surgeons during the COVID-19 pandemic.

RevDate: 2020-07-13

Lu X, Wang L, Tian S, et al (2020)

Demobilization strategy for general surgery departments during the recovery period of the COVID-19 pandemic: experience and recommendations from frontline surgeons in Wuhan.

RevDate: 2020-07-13

van der Lee ML, MPJ Schellekens (2020)

Bridging the distance: continuing psycho-oncological care via video-consults during the COVID-19 pandemic.

Psycho-oncology [Epub ahead of print].

RevDate: 2020-07-13

English W, Habib Bedwani N, Smith C, et al (2020)

Investigation and management of suspected appendicitis during the COVID-19 pandemic.

RevDate: 2020-07-13

Bellini MI, Tortorici F, M Capogni (2020)

Resuming elective surgical activity after the COVID-19 wave: what the patients need to know.

As COVID-19 outbreak enters its second phase of lockdown ease, healthcare plans involve elective surgery re-establishment to provide essential life-saving care. Patients are increasingly requesting information about their facility's readiness for safely performing surgery. This information should be open and transparent including patient's education with objective data regarding the state of the pandemic in the country and the control measures undertaken by the facility.

RevDate: 2020-07-13

Copertino DC, Duarte RRR, Powell TR, et al (2020)

Montelukast drug activity and potential against SARS-CoV-2.

COVID-19 presents a major worldwide public health emergency. Many research efforts are ongoing to find effective antiviral treatments via novel drug design or drug repurposing (Duarte et al., 2020). One drug, remdesivir, has been shown to have activity against the SARS-CoV-2 RNA dependent RNA polymerase (RdRp), and has been used clinically in severe COVID-19 disease, but more accessible and readily available treatments are needed for all stages of infection. This article is protected by copyright. All rights reserved.

RevDate: 2020-07-13

Smolander J, A Bruchfeld (2020)

[COVID-19 and kidney disease].

Lakartidningen, 117: pii:20110.

Acute kidney injury (AKI), albuminuria and hematuria are common in Covid-19 and have been shown to increase mortality. Assessment with a urinary dipstick and creatinine at admission should be completed with a urinary sediment and quantification of albuminuria if positive. SARS-Cov-2 seems to enter and infect the endothelium and kidney cells, and contributes to damage in addition to hypercoagulability, multi organ failure and hyperinflammation. Underhydration and rhabdomyolysis can contribute to acute tubular necrosis. Anti-inflammatory treatment may be considered and discussed with a nephrologist. Treatment with ACEi/ARBs should be continued if possible.

RevDate: 2020-07-13

Sy SL, MN Munshi (2020)

Caring for Older Adults With Diabetes During the COVID-19 Pandemic.

JAMA internal medicine pii:2768362 [Epub ahead of print].

RevDate: 2020-07-13

Fihn SD (2020)

COVID-19-Back to the Future.

JAMA internal medicine pii:2768360 [Epub ahead of print].

RevDate: 2020-07-13

Martinez E, D Redding (2020)

Osteopathic Response to the COVID-19 Pandemic.

The Journal of the American Osteopathic Association pii:2765189 [Epub ahead of print].

RevDate: 2020-07-13

Klompas M, Baker MA, C Rhee (2020)

Airborne Transmission of SARS-CoV-2: Theoretical Considerations and Available Evidence.

JAMA pii:2768396 [Epub ahead of print].

RevDate: 2020-07-13

Hamid HKS (2020)

Laparoscopy may improve postoperative outcomes of COVID-19 patients.

The journal of trauma and acute care surgery [Epub ahead of print].

RevDate: 2020-07-13

Pata F, Khan M, Iovino D, et al (2020)

Laparoscopy or laparotomy during COVID-19: the pendulum continues swinging as uncertainty remains on virus transmission & epidemiology.

The journal of trauma and acute care surgery [Epub ahead of print].

RevDate: 2020-07-13

Nguyen AX, Gervasio KA, AY Wu (2020)

COVID-19 Recommendations From Ophthalmic and Plastic Reconstructive Surgery Societies Worldwide.

Ophthalmic plastic and reconstructive surgery, 36(4):334-345.

PURPOSE: The COVID-19 pandemic has brought unprecedented challenges for oculoplastic surgeons worldwide, in terms of care delivery, medical equipment and at-risk patient management. To date, there are no centralized or compiled international COVID-19 guidelines for oculoplastic surgeons.

METHODS: We examined COVID-19 guidelines published by oculoplastic societies worldwide. All countries around the world were initially considered in this study, but only 9 oculoplastic societies met the inclusion criteria: (1) publicly available guidelines displayed on the oculoplastic society's website, or (2) guidelines received from the oculoplastic society after contacting them twice using the contact information on their website.

RESULTS: The 9 oculoplastic societies examined include: the American Society of Ophthalmic Plastic and Reconstructive Surgery, the British Oculoplastic Surgery Society, the Canadian Society of Oculoplastic Surgery, the European Society of Ophthalmic Plastic and Reconstructive Surgery, la Sociedad Española de Cirugía Plástica Ocular y Orbitaria, la Asociación Colombiana de Cirugía Plastica Ocular, the Asia Pacific Society of Ophthalmic Plastic & Reconstructive Surgery, the Oculoplastics Association of India, and the Philippine Society of Ophthalmic Plastic and Reconstructive Surgery. They all agree that urgent procedures should not be delayed, while non-necessary procedures (including all elective clinic services) should be postponed. When adequate protective equipment is available, oculoplastic surgeons must treat urgent cases. Eight out of 9 societies have provided recommendations on personal protective equipment use in order to prevent the spread of COVID-19 and to adequately protect mucous membranes. Other recommendations provided by certain societies are related to shelter in place measures, hand hygiene and surface disinfection protocols, patient triage, and thyroid eye disease management.

CONCLUSIONS: All 9 societies with published recommendations have provided valuable recommendations to their members, regarding urgency of care and infection control solutions (personal protective equipment, hand hygiene, telemedicine, and social isolation).

RevDate: 2020-07-13

Sisman J, Jaleel MA, Moreno W, et al (2020)

INTRAUTERINE TRANSMISSION OF SARS-COV-2 INFECTION IN A PRETERM INFANT.

The Pediatric infectious disease journal [Epub ahead of print].

We present a preterm infant who developed a fever and mild respiratory disease on the second day of life. Infant severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nasopharyngeal testing was positive at 24 and 48 hours of life. Placenta histopathology revealed SARS-CoV-2 infection by electron microscopy and immunohistochemistry. Further understanding of the risk factors that lead to in utero transmission of SARS-CoV-2 infection is needed.

RevDate: 2020-07-13

Demirjian A, Singh C, Tebruegge M, et al (2020)

Probable Vertical Transmission of SARS-CoV-2 Infection.

The Pediatric infectious disease journal [Epub ahead of print].

BACKGROUND: To date, although neonatal infections with severe acute respiratory syndrome coronovirus 2 (SARS-CoV-2) have been described, none of these have been proven to be the result of vertical transmission of SARS-CoV-2.

METHODS: We describe the probable vertical transmission of SARS-CoV-2 in a neonate born to a mother with coronavirus disease 2019 (COVID-19).

RESULTS: Following cesarean section, the neonate was kept in strict isolation. Molecular tests for SARS-CoV-2 on respiratory samples, blood, and meconium were initially negative, but positive on a nasopharyngeal aspirate on the third day of life. On day 5, the neonate developed fever and coryza, which spontaneously resolved. Viral genomic analysis from the mother and neonate showed identical sequences except for 1 nucleotide.

CONCLUSION: This report has important implications for infection control and clinical management of pregnant women with COVID-19 and their newborns.

RevDate: 2020-07-13

Siberry GK, Reddy UM, LM Mofenson (2020)

SARS-COV-2 Maternal-Child Transmission: Can It Occur Before Delivery and How Do We Prove It?.

The Pediatric infectious disease journal [Epub ahead of print].

RevDate: 2020-07-13

Somekh I, Yakub Hanna H, Heller E, et al (2020)

AGE-DEPENDENT SENSORY IMPAIRMENT IN COVID-19 INFECTION AND ITS CORRELATION WITH ACE2 EXPRESSION.

The Pediatric infectious disease journal [Epub ahead of print].

Among individuals who tested positive for coronavirus disease 2019, smell and taste sensations were significantly less impaired among children than among adults, in a stepwise manner. Sensory impairment was correlated with recent data of angiotensin-converting enzyme 2 expression in the corresponding age groups. This is the first report to compare sensory impairment in children and adults testing positive for coronavirus disease 2019.

RevDate: 2020-07-13

White KA, LA Ruth-Sahd (2020)

Compassionate Teaching Strategies Amid the COVID-19 Pandemic.

Nurse educator [Epub ahead of print].

RevDate: 2020-07-13

Wilson JM, Lee J, Fitzgerald HN, et al (2020)

Job Insecurity and Financial Concern during the COVID-19 Pandemic are Associated with Worse Mental Health.

Journal of occupational and environmental medicine [Epub ahead of print].

OBJECTIVE: To determine whether job insecurity due to COVID-19 and financial concern were associated with worse mental health during the COVID-19 pandemic.

METHOD: Participants (N = 474 employed U.S. individuals) completed an online survey from April 6-12, 2020. Linear regressions were used to examine factors associated with mental health.

RESULTS: After accounting for demographic characteristics, health status, other COVID-19 experiences, and anxiety symptoms, greater job insecurity due to COVID-19 was related to greater depressive symptoms. Conversely, after accounting for covariates and depressive symptoms, greater financial concern was related to greater anxiety symptoms. Further, greater job insecurity was indirectly related to greater anxiety symptoms due to greater financial concern.

CONCLUSIONS: Findings suggest that employers should aim to reduce job insecurity and financial concern among employees during the COVID-19 pandemic to address the associated mental health consequences.

RevDate: 2020-07-13

Gliksman R (2020)

COVID-19 Trials and Tribulations by Rebecca Gliksman MD MPH.

Journal of occupational and environmental medicine [Epub ahead of print].

RevDate: 2020-07-13

Belingheri M, Paladino ME, Labra M, et al (2020)

Healthcare Workers with Diabetes. Need for more attention in COVID-19 outbreak.

Journal of occupational and environmental medicine [Epub ahead of print].

RevDate: 2020-07-13

Segarra B, Heras NB, Ortiz MV, et al (2020)

Are Hospitals Safe? A Prospective Study on SARS-CoV-2 Prevalence and Outcome on Surgical Fracture Patients. A Closer Look at Hip Fracture Patients.

Journal of orthopaedic trauma [Epub ahead of print].

OBJECTIVES: To describe clinical characteristics of fracture patients, including a closer look to hip fracture patients, and determine how epidemiological variables may have influenced on a higher vulnerability to SARS-CoV-2 infection, as the basis for the considerations needed to reintroduce elective surgery during the pandemic.

DESIGN: Longitudinal prospective cohort study.

SETTING: Level I Trauma Center in the East of Spain.

PATIENTS/PARTICIPANTS: 144 consecutive fracture patients 18 years or older admitted for surgery.

INTERVENTION: Patients were tested for SARS-CoV-2 with either molecular and/or serological techniques and screened for presentation of COVID-19.

MAIN OUTCOME MEASUREMENTS: Patients were interviewed and charts reviewed for demographic, epidemiological, clinical and surgical characteristics.

RESULTS: We interviewed all patients and tested 137 (95.7%) of them. Three positive patients for SARS-CoV-2 were identified (2.1%). One was asymptomatic and the other two required admission due to COVID-19 related symptoms. Mortality for the whole cohort was 13 patients (9%). Significant association was found between infection by SARS-CoV-2 and epidemiological variables including: intimate exposure to respiratory symptomatic patients (p=0.025) and intimate exposure to SARS-CoV-2 positive patients (p=0.013). No association was found when crowding above 50 people was tested individually (p=0.187). When comparing the 2020 and 2019 hip fracture cohorts we found them to be similar, including 30-day mortality. A significant increase in surgical delay from 1.5 to 1.8 days was observed on the 2020 patients (p=0.034).

CONCLUSIONS: Patients may be treated safely at hospitals if strict recommendations are followed. Both cohorts of hip fracture patients had similar 30-day mortality.

LEVEL OF EVIDENCE: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

RevDate: 2020-07-13

Thakrar A, Chui K, Kapoor A, et al (2020)

30-day Mortality Rate of Patients with Hip Fractures during the COVID-19 Pandemic: A Single Centre Prospective Study in the United Kingdom.

Journal of orthopaedic trauma [Epub ahead of print].

OBJECTIVES: During the COVID-19 pandemic, the care of hip fracture patients remains a clinical priority. Our study aims to investigate the 30-day mortality rate of hip fracture patients during the first thirty days of the pandemic in the UK.

METHODS: A single-center, observational, prospective study of patients presenting with hip fractures. Data collection started from 'day zero' of the COVID-19 pandemic in the UK and continued for thirty days. We collected data on time-to-surgery, Clinical Frailty Scale (CFS) score, Nottingham Hip Fracture Score (NHFS), COVID-19 infection status, 30-day mortality and cause of death. For comparison, we collected retrospective data during the same thirty-day period in 2018, 2019 and the previous six months (Control groups A, B and C, respectively).

RESULTS: 43 patients were included in the study. There was no difference in age or gender between the Study and Control groups. The 30-day mortality rate of the Study group was 16.3%, which was higher than Control groups A (P=0.022), B (P=0.003) and C (P=0.001). The prevalence of COVID-19 infection in our Study group was 26%. Of the seven mortalities recorded, four patients tested positive for COVID-19 infection. In our Study group, COVID-19 infection correlated significantly with 30-day mortality (P=0.002, odds ratio 2.4).

CONCLUSIONS: Our study demonstrated a significant increase in 30-day mortality amongst hip fracture patients during the first thirty days of the COVID-19 pandemic in the UK. A positive COVID-19 test result in patients with hip fractures is associated with a 2.4-fold increase in risk of 30-day mortality.

LEVEL OF EVIDENCE: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

RevDate: 2020-07-13

Konda SR, Ranson RA, Solasz SJ, et al (2020)

Modification of a Validated Risk Stratification Tool to Characterize Geriatric Hip Fracture Outcomes and Optimize Care in a Post COVID-19 World.

Journal of orthopaedic trauma [Epub ahead of print].

OBJECTIVES: 1. To demonstrate how a risk assessment tool modified to account for the COVID-19 virus during the current global pandemic is able to provide risk assessment for low-energy geriatric hip fracture patients. 2. To provide a treatment algorithm for care of COVID-19 positive/suspected hip fractures patients that accounts for their increased risk of morbidity and mortality.

SETTING: One academic medical center including 4 level 1 trauma centers, 1 university-based tertiary-care referral hospital, and 1 orthopedic specialty hospital.

PATIENTS/PARTICIPANTS: 1278 patients treated for hip fractures between October 2014 and April 2020, including 136 patients treated during the COVID-19 pandemic between February 1, 2020 and April 15, 2020.

INTERVENTION: The STTGMAORIGINAL score was modified by adding COVID-19 virus as a risk factor for mortality to create the STTGMACOVID score. Patients were stratified into quartiles to demonstrate differences in risk distribution between the scores.

MAIN OUTCOME MEASUREMENTS: Inpatient and 30-day mortality, major, and minor complications.

RESULTS: Both STTGMA score and COVID-19 positive/suspected status are independent predictors of inpatient mortality, confirming their use in risk assessment models for geriatric hip fracture patients. Compared to STTGMAORIGINAL where COVID-19 patients are haphazardly distributed among the risk groups and COVID-19 inpatient and 30 days mortalities comprise 50% of deaths in the minimal and low risk cohorts, the STTGMACOVID tool is able to triage 100% of COVID-19 patients and 100% of COVID-19 inpatient and 30 day mortalities into the highest risk quartile, where it was demonstrated that these patients have a 55% rate of pneumonia, a 35% rate of acute respiratory distress syndrome, a 22% rate of inpatient mortality, and a 35% rate of 30 day mortality. COVID-19 patients who are symptomatic on presentation to the ED and undergo surgical fixation have a 30% inpatient mortality rate compared to 12.5% for patients who are initially asymptomatic but later develop symptoms.

CONCLUSION: The STTGMA tool can be modified for specific disease processes, in this case to account for the COVID-19 virus and provide a robust risk stratification tool that accounts for a heretofore unknown risk factor. COVID-19 positive/suspected status portends a poor outcome in this susceptible trauma population and should be included in risk-assessment models. These patients should be considered high risk for perioperative morbidity and mortality. Patients with COVID-19 symptoms on presentation should have surgery deferred until symptoms improve or resolve and should be reassessed for surgical treatment versus definitive nonoperative treatment with palliative care and/or hospice care.

LEVEL OF EVIDENCE: Prognostic Level III. See Instructions for Authors for a complete description of Levels of Evidence.

RevDate: 2020-07-13

Sockalingam S, Clarkin C, Serhal E, et al (2020)

Responding to Health Care Professionals' Mental Health Needs During COVID-19 Through the Rapid Implementation of Project ECHO.

The Journal of continuing education in the health professions [Epub ahead of print].

OBJECTIVE: The COVID-19 pandemic can cause significant mental health distress amongst health care professionals (HCPs). We describe the psychological needs of HCPs during COVID-19 and the implementation of Project ECHO Coping with COVID (ECHO-CWC) to help HCPs' manage COVID-19 distress.

METHODS: We used an established rapid implementation approach to accelerate the development and delivery of ECHO-CWC to address the emerging needs of HCPs. Participants' needs were identified using a 10-question survey of participants' perceived risk of COVID-19 and a 5-item self-efficacy measure. Implementation outcomes consisted of participant engagement and session satisfaction scores using a 5-point Likert scale.

RESULTS: 426 participants registered for ECHO-CWC. Needs assessment data (n=129) showed that most participants' reported feeling increased stress at work (84.5%), fear of infecting others (75.2%), and fear of falling ill (70.5%) from COVID-19, yet most participants accepted the risk associated with work during this time (59.7%). Participants were highly satisfied with the initial five sessions (mean=4.26).

CONCLUSION: HCPs reported the greatest concern with fears of infection and infecting others during the acute phase of the pandemic. Using an iterative curriculum design approach and existing implementation frameworks, the ECHO tele-education model can be rapidly mobilized to address HCPs mental health needs during the COVID-19 pandemic.

RevDate: 2020-07-13

Gottlieb M, Egan DJ, Krzyzaniak SM, et al (2020)

Rethinking the Approach to Continuing Professional Development Conferences in the Era of COVID-19.

The Journal of continuing education in the health professions [Epub ahead of print].

The COVID-19 pandemic has required a substantial change to the approach used for traditional, in-person continuing professional development (CPD) conferences. Running a virtual CPD conference will necessitate consideration of digital platforms and conversion of large group and small group sessions, abstract presentations, and networking events to a digital medium. This paper will discuss these challenges and present strategies to address them for CPD conference planning in the era of COVID-19.

RevDate: 2020-07-13

Di Liberto IA, Pilato G, Geraci S, et al (2020)

Impact on hospital admission of ST-elevation myocardial infarction patients during coronavirus disease 2019 pandemic in an Italian Hospital.

Journal of cardiovascular medicine (Hagerstown, Md.) [Epub ahead of print].

: The worldwide pandemic caused by the novel acute respiratory syndrome coronavirus 2 (SARS-CoV2) has resulted in a new and lethal disease named coronavirus disease 2019 (COVID-19). The prevalence of COVID-19 has posed a great threat to people's health worldwide and many people who need cardiovascular care were afraid of hospital admission, also in geographic areas with a few number of cases. This document shows how the pandemic is impacting hospital admission and the care of ST-elevation myocardial infarction patients. We analyzed the number of interventional cardiology procedures to treat ST-elevation myocardial infarction (STEMI) in our catheterization laboratory, before and during the COVID-19 pandemic in a specific period.

RevDate: 2020-07-13

Imazio M, Brucato A, Lazaros G, et al (2020)

Anti-inflammatory therapies for pericardial diseases in the COVID-19 pandemic: safety and potentiality.

Journal of cardiovascular medicine (Hagerstown, Md.) [Epub ahead of print].

: The COVID-19 pandemic is challenging our cardiovascular care of patients with heart diseases. In the setting of pericardial diseases, there are two possible different scenarios to consider: the patient being treated for pericarditis who subsequently becomes infected with SARS-CoV-2, and the patient with COVID-19 who develops pericarditis or pericardial effusion. In both conditions, clinicians may be doubtful regarding the safety of nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, colchicine, and biological agents, such as anti-IL1 agents (e.g. anakinra), that are the mainstay of therapy for pericarditis.For NSAIDs, there is no clear scientific evidence linking ibuprofen and other NSAIDs to worsening of COVID-19; however, it seems prudent to continue them, if necessary to control pericarditis, and on the other hand, to prefer paracetamol for fever and systemic symptoms related to COVID-19. Treatments with corticosteroids, colchicine, and anakinra appear well tolerated in the context of COVID-19 infection and are currently actively evaluated as potential therapeutic options for COVID infection at different stages of the disease. On this basis, currently most treatments for pericarditis do not appear contraindicated also in the presence of possible COVID-19 infection and should not be discontinued, and some (corticosteroids, colchicine, and anakinra) can be considered to treat both conditions.

RevDate: 2020-07-13

Popejoy L, Vogelsmeier A, Boren W, et al (2020)

A Coordinated Response to the COVID-19 Pandemic in Missouri Nursing Homes.

Journal of nursing care quality [Epub ahead of print].

RevDate: 2020-07-13

Abdel-Aziz M (2020)

Smell Disorder Could Warn Head and Neck Surgeons for Diagnosis of COVID-19.

The Journal of craniofacial surgery [Epub ahead of print].

RevDate: 2020-07-13

Clark AE, Levy J, FM Lee (2020)

Laboratory-developed test regulation and the immunocompromised patient: uncertainty ahead.

Current opinion in infectious diseases, 33(4):304-311.

PURPOSE OF THE REVIEW: Laboratory-developed tests (LDTs) are essential for the clinical care of immunocompromised individuals. These patients often require specialized testing not available from commercial manufacturers and are therefore dependent on the laboratory to create, validate, and perform these assays. Recent paradigm-shifting legislation could alter the way that LDTs are operationalized and regulated.

RECENT FINDINGS: On March 5th, 2020 the Verifying Accurate and Leading-Edge In-Vitro Clinical Tests Development Act (VALID) was introduced in the US Congress. This statute would overhaul existing regulatory framework by unifying the oversight of LDTs and commercial in-vitro diagnostic tests (IVDs) through the FDA. If enacted, LDTs would be subject to regulatory requirements like those found in commercial submissions for market review. Stakeholders continue to discuss the details and scope of the proposed legislation in the setting of the Severe Acute Respiratory Syndrome Coronavirus 2 pandemic, where LDTs are integral to the national COVID-19 response.

SUMMARY: Congressional lawmakers have introduced legislation to alter the regulatory framework governing LDTs. Moving forward, a balance must be struck to ensure the availability of safe and accurate testing without delays or overregulation that could be harmful to patients. The downstream implications of how VALID and other legislation will impact laboratories, clinicians, and patients warrant close examination.

RevDate: 2020-07-13

Wiederhold NP, PE Verweij (2020)

Aspergillus fumigatus and pan-azole resistance: who should be concerned?.

Current opinion in infectious diseases, 33(4):290-297.

PURPOSE OF REVIEW: Although clinical outcomes in the treatment of aspergillosis have markedly improved with the availability of newer triazoles, the development of resistance to these antifungals, especially in Aspergillus fumigatus, is a growing concern. The purpose of this review is to provide an update on azole resistance mechanisms and their epidemiology in A. fumigatus, the clinical implications of azole resistance, and to discuss future treatment options against azole-resistant aspergillosis.

RECENT FINDINGS: Resistance may develop through either patient or environmental azole exposure. Environmental exposure is the most prevalent means of resistance development, and these isolates can cause disease in various at-risk groups, which now include those with influenza, and potentially COVID-19. Although current treatment options are limited, newer therapies are in clinical development. These include agents with novel mechanisms of action which have in vitro and in vivo activity against azole-resistant A. fumigatus.

SUMMARY: Azole-resistant A. fumigatus is an emerging threat that hampers our ability to successfully treat patients with aspergillosis. Certain geographic regions and patient populations appear to be at increased risk for this pathogen. As new patient groups are increasingly recognized to be at increased risk for invasive aspergillosis, studies to define the epidemiology and management of azole-resistant A. fumigatus are critically needed. While treatment options are currently limited, new agents under clinical development may offer hope.

RevDate: 2020-07-13

Patel V, Nolan IT, Morrison SD, et al (2020)

Visiting Subinternships in Wake of the COVID-19 Crisis: An Opportunity for Improvement.

Annals of plastic surgery, 85(2S Suppl 2):S153-S154.

RevDate: 2020-07-13

Le MQ, Rosales R, Shapiro LT, et al (2020)

The Down Side of Prone Positioning: The Case of a COVID-19 Survivor.

American journal of physical medicine & rehabilitation [Epub ahead of print].

The coronavirus 2019 (COVID-19) pandemic has resulted in a surge of patients with acute respiratory distress syndrome (ARDS). Prone positioning may be used in such patients to optimize oxygenation. Severe infections may leave survivors with significant functional impairment necessitating rehabilitation. Those who have experienced prolonged prone positioning are at increased risk for complications not typically associated with critical illness. This case report describes the course and clinical findings of a survivor of ARDS due to COVID-19 who was prone positioned while in intensive care and subsequently admitted to an inpatient rehabilitation facility. Her related complications, as well as those described in the literature, are reviewed. Critical elements of a comprehensive rehabilitation treatment plan for those who have been prone positioned, including implementation of preventive strategies, as well as early recognition and treatment of related injuries, will be described.

RevDate: 2020-07-13

Ekiz T, Kara M, Özcan F, et al (2020)

Sarcopenia and COVID-19: A Manifold Insight on Hypertension and the Renin Angiotensin System.

American journal of physical medicine & rehabilitation [Epub ahead of print].

RevDate: 2020-07-13

Murphy EP, Fenelon C, Murphy RP, et al (2020)

Are Virtual Fracture Clinics During the COVID-19 Pandemic a Potential Alternative for Delivering Fracture Care? A Systematic Review.

Clinical orthopaedics and related research [Epub ahead of print].

BACKGROUND: Virtual fracture clinics are an alternative to the traditional model of fracture care. Since their introduction in 2011, they have become increasingly used in the United Kingdom and Ireland. The coronavirus disease 2019 (COVID-19) health crisis has driven institutions to examine such innovative solutions to manage patient care. The current controversies include quantifying safety outcomes, such as potential delayed or missed injuries, inadequate treatment, and medicolegal claims. Questions also exist regarding the potential for cost reductions and efficiencies that may be achieved. Physical distancing has limited the number of face-to-face consultations, so this review was conducted to determine if virtual fracture clinics can provide an acceptable alternative in these challenging times.

QUESTIONS/PURPOSES: The aim of this systematic review was to describe (1) adverse outcomes, (2) cost reductions, and (3) efficiencies associated with the virtual fracture clinic model.

METHODS: A systematic review of the PubMed, MEDLINE, and Embase databases was conducted from database inception to March 2020. The keywords "virtual" or "telemedicine" or "telehealth" or "remote" or "electronic" AND "fracture" or "trauma" or "triage" AND "clinic" or "consultation" were entered, using the preferred reporting items for systematic reviews and meta-analyses. Inclusion criteria included adults and children treated for injuries by a virtual clinic model at the initial review. Eligible injuries included injuries deemed to not need surgical intervention, and those able to be treated remotely using defined protocols. Exclusion criteria consisted of patients reviewed by telemedicine using video links or in person at the initial review. Initially, 1065 articles were identified, with 665 excluded as they did not relate to virtual fracture clinics. In all, 400 articles were screened for eligibility, and 27 full-text reviews were conducted on 18 studies (30,512 virtual fracture clinic encounters). Three subdomains focusing on adverse outcomes, cost reductions, and efficiencies were recorded. The term adverse outcomes was used to describe any complications, further surgeries, re-referrals back to the clinic, or deviations from the protocols. Efficiency described the number of patients reviewed and discharged using the model, savings in clinic slots, reduced waiting times, or a reduction in consumption of resources such as radiographs. All studies were observational and the quality was assessed using Newcastle-Ottawa tool, which demonstrated a median score of 6 ± 1.8, indicating moderate quality.

RESULTS: Six studies reported adverse outcomes in detail, with events ranging from inappropriate splinting, deviations from protocols, and one patient underwent an osteotomy for a malunion. Efficiency varied from direct discharge proportions of 18% in early studies to 100% once the virtual fracture clinic model was more established. Cost reductions compared with estimates derived from conventional fracture clinics varied from USD 53 to USD 297 and USD 39,125 to USD 305876 compared with traditional fracture clinic visits.

CONCLUSIONS: Virtual fracture clinics may provide a means to treat patients remotely, using agreed-upon protocols. They have an important role in the current COVID-19 pandemic, due to the possibility to provide ongoing care in an otherwise challenging setting. More robust studies looking at this model of care will be needed to assess its long-term effects on patients, institutions, and health care systems.

LEVEL OF EVIDENCE: Level IV, therapeutic study.

RevDate: 2020-07-13

Khor WB, Yip L, Zhao P, et al (2020)

Evolving Practice Patterns in Singapore's Public Sector Ophthalmology Centers During the COVID-19 Pandemic.

Asia-Pacific journal of ophthalmology (Philadelphia, Pa.) [Epub ahead of print].

Coronavirus disease 19 (COVID-19) was first reported in Wuhan, China, in December 2019, and has since become a global pandemic. Singapore was one of the first countries outside of China to be affected and reported its first case in January 2020. Strategies that were deployed successfully during the 2003 outbreak of severe acute respiratory syndrome have had to evolve to contain this novel coronavirus. Like the rest of the health care services in Singapore, the practice of ophthalmology has also had to adapt to this rapidly changing crisis. This article discusses the measures put in place by the 3 largest ophthalmology centers in Singapore's public sector in response to COVID-19, and the challenges of providing eye care in the face of stringent infection control directives, staff redeployments and "social distancing." The recently imposed "circuit breaker," effectively a partial lockdown of the country, has further limited our work to only the most essential of services. Our staff are also increasingly part of frontline efforts in the screening and care of patients with COVID-19. However, this crisis has also been an opportunity to push ahead with innovative practices and given momentum to the use of teleophthalmology and other digital technologies. Amidst this uncertainty, our centers are already planning for how ophthalmology in Singapore will be practiced in this next stage of the COVID-19 pandemic, and beyond.

RevDate: 2020-07-13

Kadkhoda K (2020)

Severe acute respiratory syndrome coronavirus 2, original antigenic sin, and antibody-dependent enhancement: ménage à trois.

Current opinion in rheumatology [Epub ahead of print].

BACKGROUND: Shortly after its emergence in December 2019, the coronavirus disease 2019 (COVID-19) was declared as a pandemic by the World Health Organization. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is the seventh member of the Coronaviridae family of viruses that causes disease in humans.

THE PROBLEM: Despite the established role of molecular diagnostics, COVID-19 serodiagnosis remains a poorly discovered and enigmatic area. Although there are numerous commercial serological products available globally, there is a severe paucity of high-quality peer-reviewed literature on their true performance characteristics. That being said, publications including in-house developed serological tests started to shed light on the kinetics of the humoral response.

SUMMARY: In spite of intense focus of assessing the performance characteristics of the commercially-available kits, the main issue remains rather invisible, that is, lack of solid science behind COVID-19 serology its clinical usefulness thereof. This short review summarizes the key points as to why COVID-19 is not jest ready to fly.

PURPOSE OF REVIEW: Despite having been mentioned as a testing option, COVID-19 serology has significant shortcomings that needs discussing. This short review is meant to shed light on one of those aspects.

RevDate: 2020-07-13

Scarcella J (2020)

Courage in the Face of COVID-19.

Academic medicine : journal of the Association of American Medical Colleges [Epub ahead of print].

RevDate: 2020-07-13

Li HO, AMJ Bailey (2020)

Medical Education Amid the COVID-19 Pandemic: New Perspectives for the Future.

Academic medicine : journal of the Association of American Medical Colleges [Epub ahead of print].

RevDate: 2020-07-13

Roll R, Chiu M, C Huang (2020)

Answering the Call to Action: COVID-19 Curriculum Design by Students for Students.

Academic medicine : journal of the Association of American Medical Colleges [Epub ahead of print].

RevDate: 2020-07-13

Schlégl ÁT, Pintér Z, Kovács A, et al (2020)

Teaching Basic Surgical Skills Using Homemade Tools in Response to COVID-19.

Academic medicine : journal of the Association of American Medical Colleges [Epub ahead of print].

RevDate: 2020-07-13

Zaki MM, BV Nahed (2020)

Utilizing Virtual Interviews in Residency Selection Beyond COVID-19.

Academic medicine : journal of the Association of American Medical Colleges [Epub ahead of print].

RevDate: 2020-07-13

Schreckenbach T, Lahrsow M, N Fritsch (2020)

SARS-CoV-2 Pandemic--A Complicated Case of Appendicitis.

Deutsches Arzteblatt international, 117(20):364.

RevDate: 2020-07-13

George R, A George (2020)

Prevention of COVID-19 in the workplace.

South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 110(4):269-270.

RevDate: 2020-07-13

Reid M, Suleman F, M De Villiers (2020)

The SARS-CoV-2 pandemic: An urgent need to relook at the training of the African health workforce.

South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 110(4):12875.

RevDate: 2020-07-13

George R, A George (2020)

COVID-19 as an occupational disease?.

South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 110(4):12874.

RevDate: 2020-07-13

Preiser W, Mendelson M, J Taljaard (2020)

Optimising influenza vaccination during a SARS-CoV-2 epidemic in South Africa could help maintain the integrity of our healthcare system.

South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 110(4):12873.

RevDate: 2020-07-13

Preiser W, Van Zyl G, A Dramowski (2020)

COVID-19: Getting ahead of the epidemic curve by early implementation of social distancing.

South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 110(4):12876.

RevDate: 2020-07-13

Singh JA, K Moodley (2020)

Critical care triaging in the shadow of COVID-19: Ethics considerations.

South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 110(5):355-359.

Since the World Health Organization declared coronavirus disease 2019 (COVID-19) a Public Health Emergency of International Concern, COVID-19 infection and the associated mortality have increased exponentially, globally. South Africa (SA) is no exception. Concerns abound over whether SA's healthcare system can withstand a demand for care that is disproportionate to current resources, both in the state and private health sectors. While healthcare professionals in SA have become resilient and adept at making difficult decisions in the face of resource limitations, a surge in COVID-19 cases could place a severe strain on the country's critical care services and necessitate unprecedented rationing decisions. This could occur at two critical points: access to ventilation, and withdrawal of intensive care in non- responsive or deteriorating cases. The ethical dimensions of decision-making at both junctures merit urgent consideration.

RevDate: 2020-07-13

Le Grange JM, Dickinson SJ, JRJ Davis (2020)

Capacity building during COVID-19: Utilising South Africa's underutilised international medical graduates.

South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 110(5):343-344.

RevDate: 2020-07-13

Boffa J, Mhlaba T, Sulis G, et al (2020)

COVID-19 and tuberculosis in South Africa: A dangerous combination.

South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 110(5):341-342.

There has been much speculation during the past week about the catastrophe that awaits once coronavirus disease 2019 (COVID-19) establishes itself in the poorest communities of South Africa (SA) and, importantly, in informal settlements. Evidence to date suggests that COVID-19 is efficiently passed from infected individuals via large droplets and hard-surface fomites.

RevDate: 2020-07-13

Nkonki L, S Fonn (2020)

Decisive and strong leadership and intersectoral action from South Africa in response to the COVID-19 virus.

South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 110(5):339-340.

RevDate: 2020-07-13

George R, A George (2020)

Compensation for occupationally acquired COVID-19.

South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 110(5):12880.

RevDate: 2020-07-13

Decloedt EH, Reuter H, Allwood B, et al (2020)

Benefit v. risk when using chloroquine in patients with severe COVID-19 disease.

South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 110(5):12903.

RevDate: 2020-07-13

Fagan JJ, Cairncross L, Biccard B, et al (2020)

COVID-19 exposes health worker shortages in the USA and UK, but nationalism and self-interest must not exploit medical workforces from low- and middle-income countries.

South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 110(5):12905.

RevDate: 2020-07-13

Seiler NK, Swamy R, Xiao J, et al (2020)

Tobacco smoking cessation in mental health services during the COVID-19 pandemic.

Journal of addictive diseases [Epub ahead of print].

Tobacco smoking is more prevalent among people who experience mental illness. It is therefore a prominent issue for psychiatric inpatient units. The COVID-19 pandemic has meant that many psychiatric inpatient units are no longer granting leave and outdoor smoking breaks, prompting the question of whether to allow tobacco smoking or enforce smoking bans in mental health services. There is currently mixed evidence that tobacco smoking is associated with a higher risk of developing COVID-19 and poorer outcomes for COVID-19 cases, potentially due to current small sample sizes. Considering the benefits of smoking cessation in this vulnerable population, the current pandemic should be used as an opportunity to further enforce smoking cessation in mental health facilities and encourage nicotine replacement therapy alongside cessation counseling.

RevDate: 2020-07-13

Ataguba OA, JE Ataguba (2020)

Social determinants of health: the role of effective communication in the COVID-19 pandemic in developing countries.

Global health action, 13(1):1788263.

The coronavirus disease 2019 (COVID-19) pandemic has affected many countries with increasing morbidity and mortality. Interestingly, many of the actions and policies adopted in countries are linked to the social determinants of health (SDH). The SDH are critical determinants of health and health inequalities that are not directly within the health sector. Policies such as social distancing, good hygiene, avoiding large gatherings, cancelling of social and sports events, using personal protective equipment, schools and restaurants closure, country lockdown, etc. are not necessarily within the health sector but have been promoted to prevent and attenuate COVID-19 infection rates significantly. The SDH that serve to reduce morbidity will forestall or substantially reduce the pressure on many weak health systems in developing countries that cannot cope with increased hospitalisation and intensive health care. This paper argues that one of the most critical social determinants of health (i.e. effective crisis and risk communication), is crucial in many developing countries, including those with fewer confirmed coronavirus cases. We note that the effectiveness of many of the other SDH in reducing the burden of the COVID-19 pandemic hinges on effective communication, especially crisis and risk communication. Although many countries are adopting different communication strategies during the COVID-19 crisis, effective crisis and risk communication will lead to building trust, credibility, honesty, transparency, and accountability. The peculiarity of many developing countries in terms of regional, cultural, linguistic and ethnic diversity is an essential consideration in ensuring effective crisis and risk communication. Developing countries facing significant poverty and disease burden cannot afford to handle the burgeoning of COVID-19 infections and must take preventive measures seriously. Thus, we submit that there is a need to intensify SDH actions and ensure that no one is left behind when communicating crisis and risk to the population to address the COVID-19 pandemic.

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