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Bibliography on: covid-19

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ESP: PubMed Auto Bibliography 25 Oct 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.

NOTE: To obtain the entire bibliography (all 64600 citations) in bibtek format (a format that can be easily loaded into many different reference-manager software programs, click HERE.

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

Citations The Papers (from PubMed®)

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RevDate: 2020-10-24

Al-Ghafry M, Aygun B, Appiah-Kubi A, et al (2020)

Are children with SARS-CoV-2 infection at high risk for thrombosis? Viscoelastic testing and coagulation profiles in a case series of pediatric patients.

Pediatric blood & cancer, 67(12):e28737.

The coagulopathy of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is well documented in adults, with increases in D-dimer and prothrombin time found to be strong predictors of mortality, and anticoagulation shown to decrease this mortality. Viscoelastic parameters such as elevations in maximum clot firmness (MCF) on rotational thromboelastometry (ROTEM) have correlated with a hypercoagulable state in adults with SARS-CoV-2. We report our experience in children infected with SARS-CoV-2, with noted elevations in D-dimer and MCF on ROTEM (indicating hypercoagulability). Exploration of viscoelastic testing to provide additional laboratory-based evidence for pediatric-specific risk assessment for thromboprophylaxis in SARS-CoV-2 is warranted.

RevDate: 2020-10-24

Zabeen B, Ahmed B, J Nahar (2020)

Young people with type 1 diabetes on insulin pump therapy could fast safely during COVID 19 pandemic Ramadan - a telemonitoring experience in Bangladesh.

Journal of diabetes investigation [Epub ahead of print].

Our aim was to report our telemedicine experience with type 1 diabetes patients on insulin pumps who fasted during Ramadan 2020 at COVID 19 pandemic time. The routine diabetes outpatient care in our CDiC Paediatric Diabetes Center in BIRDEM hospital was closed as there was lock down since March 26 in Bangladesh. The diabetes team in our center started tele medicine care for routine follow up of patients. Nine patients contacted our diabetes team over phone who wished to fast this Ramadan. Mean age was 19.3 ± 5.0 years, 5 (55.6%) were female. Most of the patients fasted more than 20 days. Hyperglycaemia and mild hypoglycemia were common complications during fasting. There was no episode of severe hypoglycaemia or DKA and none of them required admission.During COVID-19 crisis in Bangladesh, patients with type 1 diabetes on insulin pump, could fast safely in Ramadan with support of telemedicine service by diabetes team.

RevDate: 2020-10-24

Markey K, Ventura CAA, O' Donnell C, et al (2020)

Cultivating ethical leadership in the recovery of COVID-19.

Journal of nursing management [Epub ahead of print].

AIM: The necessity of fostering ethical leadership in the recovery of COVID-19 is proposed.

BACKGROUND: Supporting physically and emotionally exhausted nurses, whilst ensuring quality standards of care delivery in the recovery phase of COVID-19, requires careful, considerate and proactive planning.

EVALUATION: Drawing on literature and utilising Lawton and Paez Gabriunas' (2015) integrated ethical leadership framework (purpose, practices, virtues), possible practical suggestions for the operationalisation of ethical leadership are proposed.

DISCUSSION: Nurse managers must maintain ethical vigilance in order to nurture values driven behaviour, demonstrating empathy and compassion for nurses experiencing physical and emotional exhaustion because of COVID-19. It is important that open dialogue, active listening and self-care interventions exist. Nurse managers have an essential role in inspiring and empowering nurses, building morale and a collective commitment to safe quality care.

CONCLUSION: Nurse managers need to consider ways of empowering, supporting and enabling nurses to apply ethical standards in every day practice.

Fostering ethical nurse leadership requires careful and sensitive planning, as well as charismatic, compassionate and inspirational leaders. Supporting staff through respect, empathy, role modelling and genuine conscientiousness is essential for increasing job performance and sustaining an ethical work environment.

RevDate: 2020-10-24

Anders RL (2020)

What can we learn from U.S. military nursing and COVID-19?.

Nursing inquiry, 27(4):e12384.

RevDate: 2020-10-24

Nørgård BM, Nielsen J, Knudsen T, et al (2020)

Hospitalization for COVID-19 in patients treated with selected immunosuppressant and immunomodulating agents, compared to the general population - a Danish cohort study.

British journal of clinical pharmacology [Epub ahead of print].

AIMS: In the Danish population, we examined whether patients treated with thiopurines, methotrexate, systemic corticosteroids, anti-TNF-α agents, anti-interleukin therapeutic agents, selective immunosuppressive agents, and cyclosporine/tacrolimus had an increased risk of hospitalization for COVID- 19, compared to the background population.

METHODS: ANationwide cohort study including all people alive in Denmark by March 1, 2020. Exposed patients constituted those exposed to thiopurines (N=5,484), methotrexate (N=17,977), systemic corticosteroids (N=55,868), anti-TNF-α agents (N=17,857), anti-interleukin therapeutic agents (N=3,744), selective immunosuppressive agents (N=3,026), and cyclosporine/tacrolimus (N=1,143) in a period of 12 months prior to March 1, 2020 (estimated time of outbreak in Denmark). We estimated the adjusted risk of hospitalization for COVID-19 for patients treated with the above-mentioned categories of medications, compared to the rest of the population.

RESULTS: The adjusted odds ratios of hospitalization in patients treated with corticosteroids and cyclosporine/tacrolimus were 1.64 (95% CI 1.35 to 2.00) and 4.75 (95% CI 1.96 to 11.49), respectively. The risks of hospitalization in patients treated with thiopurines, methotrexate, and anti-TNF-α agents, were 1.93 (95% CI 0.91 to 4.08), 0.74 (95% CI 0.43 to 1.28), 1.00 (95% CI 0.52 to 1.94), respectively. The number of outcomes in patients treated with anti-interleukin therapeutic agents and selective immunosuppressive agents was too small for analysis.

CONCLUSIONS: Patients treated with systemic corticosteroids and cyclosporine/tacrolimus had a significantly increased risk of being hospitalized for COVID-19. Our study does not uncover whether the increased risk is related to the drug itself, the underlying condition for which the patient is treated, or other factors.

RevDate: 2020-10-24

Khan SS, Marshall CL, Stylianou KA, et al (2020)

An evaluation of dermatology patients shielding during the COVID-19 outbreak.

Many governments around the world have enforced social distancing strategies in an effort to prevent the spread of the novel coronavirus, termed SARS-Co-V-2, which can lead to a fatal respiratory disease known as coronavirus disease 2019 (COVID-19). On 22nd March 2020 the UK government announced that over 1.5 million "extremely vulnerable" adults (those likely to suffer from more severe symptoms of COVID-19, such as age over 70, significant comorbidities or concurrent immunosuppression) would have to take additional measures and shield1 .

RevDate: 2020-10-24

Ramos PM, Ianhez M, HA Miot (2020)

Alopecia and Gray Hair Are Associated with COVID-19 Severity.

Individual vulnerability to severe acute respiratory syndrome due to COVID-19 has been associated with age and some comorbidities, such as hypertension, diabetes, and cardiovascular disease.1 Men have an increased risk for severe disease; conversely, prepubescent males appear to be protected.

RevDate: 2020-10-24

Agarwal A, Hassanandani T, Das A, et al (2020)

"Mask tinea": tinea faciei possibly potentiated by prolonged mask usage during the COVID-19 pandemic.

The COVID-19 pandemic emerged when India was already facing an epidemic-like situation of superficial dermatophytosis (tinea). The prevalence of tinea in India is currently 27.6%, with tinea faciei accounting for 1.8% cases.1 The use of face masks although necessary, has the potential to aggravate a worrisome situation in India.

RevDate: 2020-10-24

Banke-Thomas A, Chigozie Makwe C, Balogun M, et al (2020)

Utilization cost of maternity services for childbirth among pregnant women with COVID-19 in Nigeria's epicenter.

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

OBJECTIVE: To estimate utilization cost of spontaneous vaginal delivery (SVD) and caesarean delivery (CD) for pregnant women with Coronavirus Disease (COVID-19) at the largest teaching hospital in Lagos, the pandemic's epicenter in Nigeria.

METHODS: We collected facility-based and household costs of all nine pregnant women with COVID-19 managed at the hospital. We compared their mean facility-based costs with those paid by pregnant women pre-COVID-19, identifying cost-drivers. We also estimated what would have been paid without subsidies, testing assumptions with a sensitivity analysis.

RESULTS: Total utilization cost ranged from US$494 for SVD with mild COVID-19 to US$4,553 for emergency CD with severe COVID-19. Though 32-66% of facility-based cost were subsidized, cost of SVD and CD during the pandemic have doubled and tripled respectively compared to those paid pre-COVID. Of the facility-based costs, cost of personal protective equipment (PPE) was the major cost-driver (50%). Oxygen was the major driver for women with severe COVID-19 (48%). Excluding treatment costs for COVID-19, mean facility-based costs were US$228 (SVD) and US$948 (CD).

CONCLUSION: Despite cost exemptions and donations, utilization costs remain prohibitive. Regulation of PPE and medical oxygen supply chains and expansion of advocacy for health insurance enrolments are needed to minimize catastrophic health expenditure.

RevDate: 2020-10-24

Santoro F, Monitillo F, Raimondo P, et al (2020)

QTc interval prolongation and life-threatening arrhythmias during hospitalization in patients with COVID-19. Results from a multi-center prospective registry.

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America pii:5938528 [Epub ahead of print].

BACKGROUND: Prolonged QTc interval and life-threatening arrhythmias (LTA) are potential drug induced complications previously reported with antimalarial, antivirals and antibiotics.

OBJECTIVES: To evaluate prevalence and predictors of QTc interval prolongation and incidence of LTA during hospitalization for COVID-19 among patients with normal admission QTc.

METHODS: 110 consecutive patients were enrolled in a multicenter international registry. 12-lead ECG was performed at admission, after 7 and 14 days; QTc values were analyzed.

RESULTS: Fifteen (14%) patients developed a prolonged-QTc (pQT) after 7 days (mean QTc increase 66±20msec, +16%, p<0.001); these patients were older, had higher basal heart rates, higher rates of paroxysmal atrial fibrillation, lower platelet count. QTc increase was inversely proportional to baseline QTc levels and leukocyte count and directly to basal heart rates(p<0.01).At multivariate stepwise analysis including age, male gender, paroxysmal atrial fibrillation, basal QTc values, basal heart rate and dual antiviral therapy, age(OR 1.06, 95% C.I. 1.00-1.13, p<0.05), basal heart rate(OR 1.07, 95% C.I. 1.02-1.13, p<0.01) and dual antiviral therapy(OR 12.46, 95% C.I. 2.09-74.20, p<0.1) were independent predictors of QT-prolongation.Incidence of LTA during hospitalization was 3.6%. One patient experienced cardiac arrest and three non-sustained ventricular tachycardia. LTAs were recorded after a median of 9 days from hospitalization and were associated with 50% of mortality rate.

CONCLUSIONS: After 7 days of hospitalization, 14% of patients with Covid-19 developed pQTc; age, basal heart rate and dual antiviral therapy were found as independent predictor of pQTc. Life threatening arrhythmias have an incidence of 3.6% and were associated with poor outcome.

RevDate: 2020-10-24

Sun H, Jain A, Leone MJ, et al (2020)

CoVA: An Acuity Score for Outpatient Screening that Predicts COVID-19 Prognosis.

The Journal of infectious diseases pii:5938525 [Epub ahead of print].

BACKGROUND: We sought to develop an automatable score to predict hospitalization, critical illness, or death for patients at risk for COVID-19 presenting for urgent care.

METHODS: We developed the COVID-19 Acuity Score (CoVA) based on a single-center study of adult outpatients seen in respiratory illness clinics (RICs) or the emergency department (ED). Data was extracted from the Partners Enterprise Data Warehouse, and split into development (n = 9381, March 7-May 2) and prospective (n = 2205, May 3-14) cohorts. Outcomes were hospitalization, critical illness (ICU or ventilation), or death within 7 days. Calibration was assessed using the expected-to-observed event ratio (E/O). Discrimination was assessed by area under the receiver operating curve (AUC).

RESULTS: In the prospective cohort, 26.1%, 6.3%, and 0.5% of patients experienced hospitalization, critical illness, or death, respectively. CoVA showed excellent performance in prospective validation for hospitalization (expected-to-observed ratio (E/O): 1.01, AUC: 0.76); for critical illness (E/O 1.03, AUC: 0.79); and for death (E/O: 1.63, AUC=0.93). Among 30 predictors, the top five were age, diastolic blood pressure, blood oxygen saturation, COVID-19 testing status, and respiratory rate.

CONCLUSIONS: CoVA is a prospectively validated automatable score for the outpatient setting to predict adverse events related to COVID-19 infection.

RevDate: 2020-10-24

Ali E, Badawi M, Abdelmahmuod E, et al (2020)

Chronic Lymphocytic Leukemia Concomitant with COVID 19: A Case Report.

The American journal of case reports, 21:e926062 pii:926062.

BACKGROUND COVID-19 is a newly emerging disease that is not yet fully understood. It is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel virus that is easily transmitted from human to human through the respiratory route. Usually, it presents with fever, headache, fatigue accompanied by respiratory symptoms like cough and dyspnea, and other systemic involvements. Chronic lymphocytic leukemia (CLL) is a common lymphoproliferative neoplasm characterized by absolute lymphocytosis and demonstration of clonality unlike other causes of lymphocytosis. Patients with CLL are considered immunocompromised because of impaired humoral immunity (mainly) and cellular immunity. Therefore, they are vulnerable to various infections including COVID-19. Little is known about the COVID-19 infection when it unmasks CLL. CASE REPORT A 49-year-old man with no significant previous illnesses, and an unremarkable family history, presented with a moderate COVID-19 infection. He initially presented to the emergency department with fever and mild shortness of breath. A complete blood count showed a high white blood cell count with absolute lymphocytosis. Flow cytometry revealed the clonality of the lymphocytes confirming the diagnosis of CLL. Despite having CLL, he developed a moderate COVID-19 infection and recovered in a few days. To the best of our knowledge, this is the first report of CLL, which presented with a COVID-19 infection as the initial presentation. CONCLUSIONS Lymphocytosis is an unexpected finding in patients diagnosed with COVID-19 infection and the elevated lymphocytes may be indicative of other conditions. Secondary causes of lymphocytosis like malignancy or other infections should be considered in these cases.

RevDate: 2020-10-24

Ramakrishna JM, Libertin CR, Siegel J, et al (2020)

Three-tier stratification for CNS COVID-19 to help decide which patients should undergo lumbar puncture with CSF analysis: A case report and literature review.

Romanian journal of internal medicine = Revue roumaine de medecine interne pii:/j/rjim.ahead-of-print/rjim-2020-0031/rjim-2020-0031.xml [Epub ahead of print].

The COVID-19 pandemic continues to overwhelm global healthcare systems. While the disease primarily causes pulmonary complications, reports of central nervous system (CNS) involvement have recently emerged ranging from encephalopathy to stroke. This raises a practical dilemma for clinicians as to when to pursue neuroimaging and lumbar tap with cerebrospinal fluid (CSF) analysis in COVID-19 patients with neurological symptoms. We present a case of an encephalopathic patient infected with SARS-CoV-2 with no pulmonary symptoms. We propose a three-tier risk stratification for CNS COVID-19 aiming to help clinicians to decide which patients should undergo CSF analysis. The neurological examination remains an integral component of screening and evaluating patients for COVID-19 considering the range of emerging CNS complications.

RevDate: 2020-10-24

Pourani MR, Nekooghadam SM, Youssefian L, et al (2020)

CD147 inhibitors as a treatment for melanoma: promising agents against SARS-CoV-2 infection.

RevDate: 2020-10-24

Chang MJ, SR Lipner (2020)

Caring for Blind and Vision Impaired Dermatological Patients During the COVID-19 Pandemic.

RevDate: 2020-10-24

Kempuraj D, Thangavel R, Kempuraj DD, et al (2020)

Neuroprotective effects of flavone luteolin in neuroinflammation and neurotrauma.

BioFactors (Oxford, England) [Epub ahead of print].

Neuroinflammation leads to neurodegeneration, cognitive defects, and neurodegenerative disorders. Neurotrauma/traumatic brain injury (TBI) can cause activation of glial cells, neurons, and neuroimmune cells in the brain to release neuroinflammatory mediators. Neurotrauma leads to immediate primary brain damage (direct damage), neuroinflammatory responses, neuroinflammation, and late secondary brain damage (indirect) through neuroinflammatory mechanism. Secondary brain damage leads to chronic inflammation and the onset and progression of neurodegenerative diseases. Currently, there are no effective and specific therapeutic options to treat these brain damages or neurodegenerative diseases. Flavone luteolin is an important natural polyphenol present in several plants that show anti-inflammatory, antioxidant, anticancer, cytoprotective, and macrophage polarization effects. In this short review article, we have reviewed the neuroprotective effects of luteolin in neurotrauma and neurodegenerative disorders and pathways involved in this mechanism. We have collected data for this study from publications in the PubMed using the keywords luteolin and mast cells, neuroinflammation, neurodegenerative diseases, and TBI. Recent reports suggest that luteolin suppresses systemic and neuroinflammatory responses in Coronavirus disease 2019 (COVID-19). Studies have shown that luteolin exhibits neuroprotective effects through various mechanisms, including suppressing immune cell activation, such as mast cells, and inflammatory mediators released from these cells. In addition, luteolin can suppress neuroinflammatory response, activation of microglia and astrocytes, oxidative stress, neuroinflammation, and the severity of neuroinflammatory diseases such as Alzheimer's disease, Parkinson's disease, multiple sclerosis, and TBI pathogenesis. In conclusion, luteolin can improve cognitive decline and enhance neuroprotection in neurodegenerative diseases, TBI, and stroke.

RevDate: 2020-10-24

Scharmer C, Martinez K, Gorrell S, et al (2020)

Eating disorder pathology and compulsive exercise during the COVID-19 public health emergency: Examining risk associated with COVID-19 anxiety and intolerance of uncertainty.

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

OBJECTIVE: COVID-19 has led to disruptions in daily living and increased uncertainty about physical, financial, social, and psychological consequences, which may contribute to anxiety, eating disorder (ED) pathology, and compulsive exercise. Individual factors, such as intolerance of uncertainty, may impact risk for ED pathology and CE in response to COVID-19 anxiety. The current study examined associations between COVID-19 anxiety, trait intolerance of uncertainty, and COVID-19 intolerance of uncertainty and ED pathology and compulsive exercise.

METHOD: Undergraduate participants (N = 295) completed a series of online questionnaires between March and April of 2020.

RESULTS: COVID-19 anxiety and intolerance of uncertainty were associated with ED pathology, but not compulsive exercise. Additionally, both trait and COVID-19 intolerance of uncertainty moderated associations between COVID-19 anxiety and compulsive exercise and ED pathology. COVID-19 anxiety was more strongly related to compulsive exercise and ED pathology for individuals with lower intolerance of uncertainty.

DISCUSSION: COVID-19 anxiety may increase risk for ED pathology and may be specifically important in determining risk for ED pathology and compulsive exercise among individuals with lower intolerance of uncertainty. These results contribute to a growing body of research aimed at understanding the mental health consequences of the COVID-19 and suggest that individual factors (e.g., anxiety and intolerance of uncertainty) are important in determining risk for ED pathology and compulsive exercise in the context of the pandemic.

RevDate: 2020-10-24

Di Martino D, Chiaffarino F, Patanè L, et al (2020)

Assessing risk factors for severe forms of COVID-19 in a pregnant population: A clinical series from Lombardy, Italy.

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

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a global health emergency [1, 2], with Lombardy being the epicenter of this outbreak in Italy [3].

RevDate: 2020-10-24

Wu T (2020)

Persistence of humoral and cellular immune response after SARS-CoV-2 infection: opportunities and challenges.

Frontiers of medicine pii:10.1007/s11684-020-0823-4 [Epub ahead of print].

RevDate: 2020-10-24

Fan BE, Ng J, Chan SSW, et al (2020)

COVID-19 associated coagulopathy in critically ill patients: A hypercoagulable state demonstrated by parameters of haemostasis and clot waveform analysis.

Journal of thrombosis and thrombolysis pii:10.1007/s11239-020-02318-x [Epub ahead of print].

Patients with COVID-19 are known to be at risk of developing both venous, arterial and microvascular thrombosis, due to an excessive immuno-thrombogenic response to the SARS-CoV-2 infection. Overlapping syndromes of COVID-19 associated coagulopathy with consumptive coagulopathy and microangiopathy can be seen in critically ill patients as well. Blood was collected from 12 Intensive Care Unit (ICU) patients with severe COVID-19 who were on either mechanical ventilation or on high flow oxygen with a PaO2/FiO2 ratio of <300 mmHg. Laboratory tests were performed for parameters of haemostasis, clot waveform analysis and anti-phospholipid antibodies. CWA parameters were raised with elevated aPTT median Min1 (clot velocity) 9.3%/s (IQR 7.1-9.9%/s), elevated PT median Min1 10.3%/s (IQR 7.1-11.1%/s), elevated aPTT median Min2 (clot acceleration) 1.5%/s2 (IQR 1.0-1.6%/s2), elevated PT median Min2 5.2%/s2 (3.6-5.7%/s2), elevated aPTT median Max2 (clot deceleration) 1.3%/s2 (IQR 0.8-1.4%/s2) elevated PT median Max2 3.8%/s2 (IQR 2.6-4.2%/s2), increased aPTT median Delta change (decreased light transmission due to increased clot formation) 87.8% (IQR 70.2-91.8%) and PT median Delta change 33.0%. This together with raised median Factor VIII levels of 262.5%, hyperfibrinogenemia (median fibrinogen levels 7.5 g/L), increased median von Willebrand factor antigen levels 320% and elevated median D-dimer levels 1.7 μg/dl support the diagnosis of COVID-19 associated coagulopathy. A lupus anticoagulant was present in 50% of patients. Our laboratory findings further support the view that severe SARS-CoV-2 infection is associated with a state of hypercoagulability.

RevDate: 2020-10-24

Hoffmann C, E Wolf (2020)

Older age groups and country-specific case fatality rates of COVID-19 in Europe, USA and Canada.

Infection pii:10.1007/s15010-020-01538-w [Epub ahead of print].

PURPOSE: To evaluate the association between the percentages of older age groups among confirmed SARS-CoV-2 infections and the country-specific case fatality rate (CFR).

METHODS: This ecological study analyzed data from the 20 most severely affected European countries, USA and Canada, in which national health authorities provided data on age distribution and gender among confirmed SARS-CoV-2 cases and deaths.

RESULTS: The proportion of individuals older than 70 years among confirmed SARS-CoV-2 cases differed markedly between the countries, ranging from 4.9 to 40.4%. There was a strong linear association between the proportion of individuals older than 75 years and the country-specific CFRs (R2 = 0.803 for all countries, R2 = 0.961 after exclusion of three countries with incongruent data). Each 5% point increase of this older age group among confirmed SARS-CoV-2 cases was associated with an increase in CFR of 2.5% points (95% CI 1.9-3.1).

CONCLUSION: Data from 20 European countries and the USA and Canada showed that the variance of crude CFR of COVID-19 is predominantly (80-96%) determined by the proportion of older individuals who are diagnosed with SARS-CoV-2. The age distribution of SARS-CoV-2 infections is still far from being homogeneous. Detailed demographic data have to be taken into account in all the analyses on COVID-19-associated mortality. We urgently call for standardized data collection by national health authorities.

RevDate: 2020-10-24

Hectors SJ, Riyahi S, Dev H, et al (2020)

Multivariate analysis of CT imaging, laboratory, and demographical features for prediction of acute kidney injury in COVID-19 patients: a Bi-centric analysis.

Abdominal radiology (New York) pii:10.1007/s00261-020-02823-w [Epub ahead of print].

PURPOSE: To develop and externally validate a multivariate prediction model for the prediction of acute kidney injury (AKI) in COVID-19, based on baseline renal perfusion from contrast-enhanced CT together with clinical and laboratory parameters.

METHODS: In this retrospective IRB-approved study, we identified COVID-19 patients who had a standard-of-care contrast-enhanced abdominal CT scan within 5 days of their COVID-19 diagnosis at our institution (training set; n = 45, mean age 65 years, M/F 23/22) and at a second institution (validation set; n = 41, mean age 61 years, M/F 22/19). The CT renal perfusion parameter, cortex-to-aorta enhancement index (CAEI), was measured in both sets. A multivariate logistic regression model for predicting AKI was constructed from the training set with stepwise feature selection with CAEI together with demographical and baseline laboratory/clinical data used as input variables. Model performance in the training and validation set was evaluated with ROC analysis.

RESULTS: AKI developed in 16 patients (35.6%) of the training set and in 6 patients (14.6%) of the validation set. Baseline CAEI was significantly lower in the patients that ultimately developed AKI (P = 0.003). Logistic regression identified a model combining baseline CAEI, blood urea nitrogen, and gender as most significant predictor of AKI. This model showed excellent diagnostic performance for prediction of AKI in the training set (AUC = 0.89, P < 0.001) and good performance in the validation set (AUC 0.78, P = 0.030).

CONCLUSION: Our results show diminished renal perfusion preceding AKI and a promising role of CAEI, combined with laboratory and demographic markers, for prediction of AKI in COVID-19.

RevDate: 2020-10-24

Ionescu MI (2020)

An Overview of the Crystallized Structures of the SARS-CoV-2.

The protein journal pii:10.1007/s10930-020-09933-w [Epub ahead of print].

Many research teams all over the world focus their research on the SARS-CoV-2, the new coronavirus that causes the so-called COVID-19 disease. Most of the studies identify the main protease or 3C-like protease (Mpro/3CLpro) as a valid target for large-spectrum inhibitors. Also, the interaction of the human receptor angiotensin-converting enzyme 2 (ACE2) with the viral surface glycoprotein (S) is studied in depth. Structural studies tried to identify the residues responsible for enhancement/weaken virus-ACE2 interactions or the cross-reactivity of the neutralizing antibodies. Although the understanding of the immune system and the hyper-inflammatory process in COVID-19 are crucial for managing the immediate and the long-term consequences of the disease, not many X-ray/NMR/cryo-EM crystals are available. In addition to 3CLpro, the crystal structures of other nonstructural proteins offer valuable information for elucidating some aspects of the SARS-CoV-2 infection. Thus, the structural analysis of the SARS-CoV-2 is currently mainly focused on three directions-finding Mpro/3CLpro inhibitors, the virus-host cell invasion, and the virus-neutralizing antibody interaction.

RevDate: 2020-10-24

Sainz-Amo R, Baena-Álvarez B, Pareés I, et al (2020)

COVID-19 in Parkinson's disease: what holds the key?.

Journal of neurology pii:10.1007/s00415-020-10272-0 [Epub ahead of print].

INTRODUCTION: Parkinson's disease (PD) is more frequent in the elderly and increases the risk of respiratory infections. Previous data on PD and SARS-CoV-2 are scarce, suggesting a poor prognosis in advanced disease and second-line therapies.

METHODS: A retrospective case-control study comparing patients with PD and COVID-19 and patients with PD without COVID-19 was conducted during the pandemic period in Spain (March 1st-July 31st 2020) in a tertiary university hospital.

RESULTS: Thirty-nine (COVID-19 +) and 172 (COVID-19-) PD patients were included. Fifty-nine percent were males in both groups, with similar age (75.9 ± 9.0 COVID-19 + , 73.9 ± 10.0 COVID-19-), disease duration (8.9 ± 6.2 COVID-19 + , 8.5 ± 5.6 COVID-19-) and PD treatments. COVID-19 was mild in 10 (26%), required admission in 21 (54%) and caused death in 8 (21%) patients. Dementia was the only comorbidity more frequent in COVID-19 + patients (36% vs. 14%, p = 0.0013). However, in a multivariate analysis, institutionalization was the only variable associated with COVID-19 + (OR 17.0, 95% CI 5.0-60.0, p < 0.001). When considering severe COVID-19 (admission or death) vs. mild or absent COVID-19, institutionalization, neoplasm, dementia and a lower frequency of dopamine agonists were associated with severe COVID-19. In multivariate analysis, only institutionalization [OR 5.17, 95% CI 1.57-17, p = 0.004] and neoplasm [OR 8.0, 95%CI 1.27-49.8, p = 0.027] remained significantly associated.

CONCLUSION: In our experience, institutionalization and oncologic comorbidity, rather than PD-related variables, increased the risk of developing COVID-19, and impacted on its severity. These findings suggest that epidemiologic factors and frailty are key factors for COVID-19 morbidity/mortality in PD. Appropriate preventive strategies should be implemented in institutionalized patients to prevent infection and improve prognosis.

RevDate: 2020-10-24

West EA, Anker D, Amati R, et al (2020)

Corona Immunitas: study protocol of a nationwide program of SARS-CoV-2 seroprevalence and seroepidemiologic studies in Switzerland.

International journal of public health pii:10.1007/s00038-020-01494-0 [Epub ahead of print].

OBJECTIVES: Seroprevalence studies to assess the spread of SARS-CoV-2 infection in the general population and subgroups are key for evaluating mitigation and vaccination policies and for understanding the spread of the disease both on the national level and for comparison with the international community.

METHODS: Corona Immunitas is a research program of coordinated, population-based, seroprevalence studies implemented by Swiss School of Public Health (SSPH+). Over 28,340 participants, randomly selected and age-stratified, with some regional specificities will be included. Additional studies in vulnerable and highly exposed subpopulations are also planned. The studies will assess population immunological status during the pandemic.

RESULTS: Phase one (first wave of pandemic) estimates from Geneva showed a steady increase in seroprevalence up to 10.8% (95% CI 8.2-13.9, n = 775) by May 9, 2020. Since June, Zurich, Lausanne, Basel City/Land, Ticino, and Fribourg recruited a total of 5973 participants for phase two thus far.

CONCLUSIONS: Corona Immunitas will generate reliable, comparable, and high-quality serological and epidemiological data with extensive coverage of Switzerland and of several subpopulations, informing health policies and decision making in both economic and societal sectors. ISRCTN Registry: https://www.isrctn.com/ISRCTN18181860 .

RevDate: 2020-10-24

Lalli MA, Langmade SJ, Chen X, et al (2020)

Rapid and extraction-free detection of SARS-CoV-2 from saliva by colorimetric reverse-transcription loop-mediated isothermal amplification.

Clinical chemistry pii:5937967 [Epub ahead of print].

BACKGROUND: Rapid, reliable, and widespread testing is required to curtail the ongoing COVID-19 pandemic. Current gold standard nucleic acid tests are hampered by supply shortages in critical reagents including nasal swabs, RNA extraction kits, personal protective equipment, instrumentation, and labor.

METHODS: To overcome these challenges, we developed a rapid colorimetric assay using reverse-transcription loop-mediated isothermal amplification (RT-LAMP) optimized on human saliva samples without an RNA purification step. We describe the optimization of saliva pretreatment protocols to enable analytically sensitive viral detection by RT-LAMP. We optimized the RT-LAMP reaction conditions and implemented high-throughput unbiased methods for assay interpretation. We tested whether saliva pretreatment could also enable viral detection by conventional reverse-transcription quantitative polymerase chain reaction (RT-qPCR). Finally, we validated these assays on clinical samples.

RESULTS: The optimized saliva pretreatment protocol enabled analytically sensitive extraction-free detection of SARS-CoV-2 from saliva by colorimetric RT-LAMP or RT-qPCR. In simulated samples, the optimized RT-LAMP assay had a limit of detection of 59 (95% confidence interval: 44-104) particle copies per reaction. We highlighted the flexibility of LAMP assay implementation using three readouts: naked-eye colorimetry, spectrophotometry, and real-time fluorescence. In a set of 30 clinical saliva samples, colorimetric RT-LAMP and RT-qPCR assays performed directly on pretreated saliva samples without RNA extraction had accuracies greater than 90%.

CONCLUSIONS: Rapid and extraction-free detection of SARS-CoV-2 from saliva by colorimetric RT-LAMP is a simple, sensitive, and cost-effective approach with broad potential to expand diagnostic testing for the virus causing COVID-19.

RevDate: 2020-10-24

Kronenfeld JP, FJ Penedo (2020)

Novel Coronavirus (COVID-19): telemedicine and remote care delivery in a time of medical crisis, implementation, and challenges.

Translational behavioral medicine pii:5938027 [Epub ahead of print].

The novel Coronavirus (COVID-19) caused by the SARS-CoV-2 virus has led to many challenges throughout the world, one of which is the delivery of health care to patients while they remain home. Telemedicine, or the use of electronic information and telecommunication technologies to support and promote long-distance clinical health care, has been utilized by health care providers for many years, but its widespread implementation did not occur until the onset of the COVID-19 pandemic. Currently, it has become the primary mechanism of care delivery for patients during the COVID-19 pandemic. While obstacles are present for hospitals and providers to establish these services, most barriers exist with patient access. Patients require advanced technical support, translator services, and other measures to become comfortable engaging in a telemedicine encounter. In addition, appropriate follow-up must be provided for chronic medical illnesses and malignancies, helping to prevent the evolution of these conditions during the COVID-19 crisis. Finally, we must ensure equity for all patients seeking to access health services, including those of lower socioeconomic status. Many of these patients rely on public hotspots or library computers for their internet connectivity, but this is likely not conducive to a clinical encounter. These barriers must be addressed to ensure health equity for all patients seeking care. Telemedicine can connect patients and providers during this time of crisis and hopefully will serve as a model for continued use after the pandemic has abated.

RevDate: 2020-10-24

Brooks AT, Allen HK, Thornton L, et al (2020)

Behavioral medicine challenges in the shadow of a global pandemic.

Translational behavioral medicine pii:5938028 [Epub ahead of print].

Health behavior researchers should refocus and retool as it becomes increasingly clear that the challenges of the COVID-19 pandemic surpass the direct effects of COVID-19 and include unique, drastic, and ubiquitous consequences for health behavior. The circumstances of the pandemic have created a natural experiment, allowing researchers focusing on a wide range of health behaviors and populations with the opportunity to use previously collected and future data to study: (a) changes in health behavior prepandemic and postpandemic, (b) health behavior prevalence and needs amidst the pandemic, and (c) the effects of the pandemic on short- and long-term health behavior. Our field is particularly challenged as we attempt to consider biopsychosocial, political, and environmental factors that affect health and health behavior. These realities, while daunting, should call us to action to refocus and retool our research, prevention, and intervention efforts.

RevDate: 2020-10-24

Grenache DG, Ye C, SB Bradfute (2020)

Correlation of SARS-CoV-2 neutralizing antibodies to an automated chemiluminescent serological immunoassay.

The journal of applied laboratory medicine pii:5937978 [Epub ahead of print].

INTRODUCTION: Neutralizing antibodies (NAbs) are capable of binding to a virus to render incapable of infection. The ability of commercially available SARS-CoV-2 serological tests to detect NAbs has not been widely reported. We sought to correlate the antibodies detected by an automated chemiluminescent immunoassay with NAbs.

METHODS: Residual serum samples from 35 patients that had a positive antibody test using the LIAISON® SARS-CoV-2 S1/S2 IgG chemiluminescent immunoassay and two antibody-negative control sera were tested for NAbs using a plaque reduction neutralization test (PRNT).

RESULTS: NAbs were detected in 66% (23/35) of the antibody-positive samples. The immunoassay signal value ranged from 21.7 to 131.3 AU/mL (median, 90.5) with significant correlation between it and the PRNT (r = 0.61, p = 0.002). In the samples without NAbs, the immunoassay signal ranged from 16.3 to 66.2 AU/mL (median, 27.2). An immunoassay signal cutoff of > 41 AU/mL was 91% sensitive and 92% specific for the detection of NAbs.

DISCUSSION: It is important that correlates of immunity to SARS-CoV-2 be identified and NAbs are considered to be central indicators of such. PRNT is the gold-standard test for identifying NAbs but it cannot be used for large-scale testing of populations. It is necessary to establish relationships between it and widely used commercial serological assays for SARS-CoV-2.

RevDate: 2020-10-24

Basile K, McPhie K, Carter I, et al (2020)

Cell-based culture of SARS-CoV-2 informs infectivity and safe de-isolation assessments during COVID-19.

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America pii:5937368 [Epub ahead of print].

BACKGROUND: The detection of SARS-CoV-2 RNA by real-time polymerase chain reaction (PCR) in respiratory samples collected from persons recovered from COVID-19 does not necessarily indicate shedding of infective virions. By contrast, the isolation of SARS-CoV-2 using cell-based culture likely indicates infectivity, but there are limited data on the correlation between SARS-CoV-2 culture and PCR.

METHODS: One hundred and ninety-five patients with varying severity of COVID-19 were tested (outpatients [n=178]), inpatients [n=12] and critically unwell patients admitted to the intensive care unit [ICU; n=5]). SARS-CoV-2 PCR positive samples were cultured in Vero C1008 cells and inspected daily for cytopathic effect (CPE). SARS-CoV-2-induced CPE was confirmed by PCR of culture supernatant. Where no CPE was observed, PCR was performed on day four to confirm absence of virus replication. Cycle threshold (Ct) of the day four PCR (Ctculture) and the PCR of the original clinical sample (Ctsample) were compared, and positive cultures were defined where Ctsample - Ctculture was ≥3.

FINDINGS: Of 234 samples collected, 228 (97%) were from the upper respiratory tract. SARS-CoV-2 was only successfully isolated from samples with Ctsample ≤32, including in 28/181 (15%), 19/42 (45%) and 9/11 samples (82%) collected from outpatients, inpatients, and ICU patients, respectively. The mean duration from symptom onset to culture positivity was 4.5 days (range 0-18). SARS-CoV-2 was significantly more likely to be isolated from samples collected from inpatients (p<0∙001) and ICU patients (p<0∙0001) compared with outpatients respectively, and in samples with lower Ctsample.

CONCLUSION: SARS-CoV-2 culture may be used as a surrogate marker for infectivity and inform de-isolation protocols.

RevDate: 2020-10-24

Maveddat A, Mallah H, Rao S, et al (2020)

Severe Acute Respiratory Distress Syndrome Secondary to Coronavirus 2 (SARS-CoV-2).

The international journal of occupational and environmental medicine, 11(4):157-178.

The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19) and has created a worldwide pandemic. Many patients with this infection have an asymptomatic or mild illness, but a small percentage of patients require hospitalization and intensive care. Patients with respiratory tract involvement have a spectrum of presentations that range from scattered ground-glass infiltrates to diffuse infiltrates with consolidation. Patients with the latter radiographic presentation have severe hypoxemia and usually require mechanical ventilation. In addition, some patients develop multiorgan failure, deep venous thrombi with pulmonary emboli, and cytokine storm syndrome. The respiratory management of these patients should focus on using low tidal volume ventilation with low intrathoracic pressures. Some patients have significant recruitable lung and may benefit from higher positive end-expiratory pressure (PEEP) levels and/or prone positioning. There is no well-established anti-viral treatment for this infection; the United States Food and Drug Administration (FDA) has provided emergency use authorization for convalescent plasma and remdesivir for the treatment of patients with COVID-19. In addition, randomized trials have demonstrated that dexamethasone improves outcomes in patients on mechanical ventilators or on oxygen. There are ongoing trials of other drugs which have the potential to moderate the acute inflammatory state seen in some of these patients. These patients often need prolonged high-level intensive care. Hospitals are confronted with significant challenges in patient management, supply management, health care worker safety, and health care worker burnout.

RevDate: 2020-10-24

Pirjani R, Rabiei M, Abiri A, et al (2020)

An Overview on Guidelines on COVID-19 Virus and Natural and Assisted Reproductive Techniques Pregnancies.

International journal of fertility & sterility, 14(3):264-271.

In this article, we reviewed and compared some of COVID-19 and pregnancy guidelines; this can be useful for pregnant women including those with a history of infertility specially those undergone assisted reproductive techniques (ART). The general advice given for prenatal care is to reduce face-to-face visits. All women who refer for prenatal visits should be evaluated for signs of the infection at the time of entry. The triage of suspected women should be done separately from other patients. Outpatient monitoring with a 14-day selfquarantine can be considered for asymptomatic infected women and for those with mild symptoms. Inpatient management criteria include moderate to severe symptoms and the target level of oxygen saturation is 92 to 95% in different guidelines. In the presence of fever, it is important to conduct a thorough examination of other causes of the fever. It is important to monitor fluid intake and output, maintain fluid and electrolyte balance and prevent fluid overload. Thromboembolic prophylaxis is recommended. Corticosteroid administration is based on obstetrics indications, while in critical ill cases, it should be based on multi-disciplinary teams (MDT) decision. A positive COVID-19 result in the absence of other obstetrics causes, cannot be considered an indication for delivery in mild and asymptomatic cases. In critically ill pregnant women, an individualized decision should be made about delivery time by the MDT. General anesthetic should be avoided unless inevitable for standard procedures such as intubation is an aerosol-generating procedure (AGP). There is agreement on the point that babies born to infected mothers, even if isolated from the mother at birth, should be considered a close contact of the mother and tested for COVID-19 and separated from other neonates. Breastfeeding is encouraged and hand hygiene and face mask during feeding are highly recommended by all guidelines.

RevDate: 2020-10-24

Mahdian S, Shahhoseini M, A Moini (2020)

COVID-19 Mediated by Basigin Can Affect Male and Female Fertility.

International journal of fertility & sterility, 14(3):262-263.

Coronavirus disease 2019 (COVID-19) prevalence has caused many problems in society and disrupted many regular aspects of life. COVID-19 contains major structural proteins that among them, S protein can promote fusion of the viral and cellular membranes and facilitate the entry of coronavirus into the host cells. Basigin (BSG) is one of the most important receptors for COVID-19 that mediates its entry to host cells. Also, Basigin has an important role in male and female reproduction. Basigin is expressed in the uterus and plays an important role during embryo implantation and needed for successful implantation. Therefore, disruption or inhibition of Basigin causes to a weakness in embryo implantation. Therefore, if a woman or a man is infected with COVID-19, it is recommended that they do not attempt to conception until their treatment is complete. It is also recommended tests for COVID-19 be performed on infertile couples before using assisted reproductive technology (ART).

RevDate: 2020-10-24

Zeng HL, Di C, Yan J, et al (2020)

Proteomic characteristics of bronchoalveolar lavage fluid in critical COVID-19 patients.

The FEBS journal [Epub ahead of print].

Up to 10-20% of patients with Coronavirus Disease 2019 (COVID-19) develop a severe pulmonary disease due to immune dysfunction and cytokine dysregulation. However, the extracellular proteomic characteristics in respiratory tract of these critical COVID-19 still remains to be investigated. In the present study, we performed a quantitative proteomic analysis of the bronchoalveolar lavage fluid (BALF) from patients with critical COVID-19 and from non-COVID-19 controls. Our study identified 358 differentially expressed BALF proteins (p < 0.05), among which 41 were significantly changed after using the Benjamini-Hochberg correction (q < 0.05). The up-regulated signaling was found to be mainly involved in inflammatory signaling and response to oxidative stress. A series of increased extracellular factors including Tenascin-C (TNC), Mucin-1 (KL-6 or MUC1), Lipocalin-2 (LCN2), periostin (POSTN), Chitinase 3-like 1 (CHI3L1 or YKL40), S100A12, as well as the antigens including lymphocyte antigen 6D /E48 antigen (LY6D), CD9 antigen, CD177 antigen, prostate stem cell antigen (PSCA) were identified. Among which, the pro-inflammatory factor TNC and KL-6, that were further validated in serum of another thirty-nine COVID-19 patients and healthy controls, showing high potentials of being biomarkers or therapeutic candidates for COVID-19. This BALF proteome associated with COVID-19 would also be a valuable resource for researches on anti-inflammatory medication and understanding the molecular mechanisms of host response.

RevDate: 2020-10-24

Li Z, Niu S, Guo B, et al (2020)

Stem cell therapy for COVID-19, ARDS and pulmonary fibrosis.

Cell proliferation [Epub ahead of print].

Coronavirus disease 2019 (COVID-19) is an acute respiratory infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 mainly causes damage to the lung, as well as other organs and systems such as the hearts, the immune system and so on. Although the pathogenesis of COVID-19 has been fully elucidated, there is no specific therapy for the disease at present, and most treatments are limited to supportive care. Stem cell therapy may be a potential treatment for refractory and unmanageable pulmonary illnesses, which has shown some promising results in preclinical studies. In this review, we systematically summarize the pathogenic progression and potential mechanisms underlying stem cell therapy in COVID-19, and registered COVID-19 clinical trials. Of all the stem cell therapies touted for COVID-19 treatment, mesenchymal stem cells (MSCs) or MSC-like derivatives have been the most promising in preclinical studies and clinical trials so far. MSCs have been suggested to ameliorate the cytokine release syndrome (CRS) and protect alveolar epithelial cells by secreting many kinds of factors, demonstrating safety and possible efficacy in COVID-19 patients with acute respiratory distress syndrome (ARDS). However, considering the consistency and uniformity of stem cell quality cannot be quantified nor guaranteed at this point, more work remains to be done in the future.

RevDate: 2020-10-24

Rodic N, M Tahir (2020)

Positive Postmortem Test for SARS-CoV-2 Following Embalming in Confirmed COVID-19 Autopsy.

American journal of clinical pathology pii:5937348 [Epub ahead of print].

RevDate: 2020-10-24

Cao Z, Tang F, Chen C, et al (2020)

Impact of systematic factors on the outbreak outcome of novel coronavirus disease (COVID-19) in China.

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

BACKGROUND: The novel coronavirus disease (COVID-19) spread world widely and caused a new pandemic. The Chinese government took strong intervention measures in the early stage of the epidemic, including strict travel-ban and social distancing policies. Prioritizing contribution of different factors is important for precise prevention and control of infectious diseases. Here, we proposed a novel framework for resolving this question and applied it to data from China.

OBJECTIVE: To systematically reveal factors and their contribution to the control of COVID-19 in China, both at the national and city level.

METHODS: Daily COVID-19 cases and related multidimensional data, including travel-related, medical, socioeconomic, environmental, and Influenza-like illness factors, from 343 cities in China were collected. Correlation analysis and interpretable machine learning algorithm were used to explore the quantitative contribution of different factors on either new cases or growth rate of COVID-19 for the epidemic period from January 17 to February 29, 2020.

RESULTS: Many factors considered in this study are correlated to the spread of COVID-19 in China. Overall, travel-related population movements are the main contributing factors for both new cases and growth rate of COVID-19 in China, and the contributions are as high as 77% and 41%, respectively. There is a clear lag effect for travel related factors (previous vs current week: 45% vs 32% for new cases, and 21% vs 20% for growth rate). The contribution for travel from non-Wuhan regions is non-ignorable (12% and 26% for new cases and growth rate), especially for the growth rate (rank first as a single factor). City flow, a measure of control strength, contributes 16% and 7% to new cases and growth rate. Socioeconomic factors also play important roles in the growth rate of COVID-19 in China with 28% contribution. Other factors, including medical, environmental and influenza-like illness ones, also contribute to new cases and growth rate of COVID-19 in China. Based on the analysis for individual city, compared to Beijing, population flow from Wuhan and internal flow within the city are driving factors for more new cases in Wenzhou, while for Chongqing the contribution is mainly from population flow from Hubei beyond Wuhan. The higher growth rate for Wenzhou is driven by its population-related factors.

CONCLUSIONS: Many factors contributed to the outbreak outcome of COVID-19 in China. Travel-related population movement was the main driving factor with strong lag effect, and population movement from non-Wuhan regions is a non-ignorable hidden variable. For the growth rate, more factors were involved, including the socioeconomic ones that contributed more than a quarter. Those differential effects for various factors, along with city-level specificity, emphasize the importance of targeted and precise strategies for outbreak control of current COVID-19 crisis and other future infectious diseases.

RevDate: 2020-10-24

Lau YL, Ismail IB, Izati Binti Mustapa N, et al (2020)

A Sensitive Reverse Transcription Loop-Mediated Isothermal Amplification Assay for Direct Visual Detection of SARS-CoV-2.

The American journal of tropical medicine and hygiene [Epub ahead of print].

A simple and rapid reverse transcription loop-mediated isothermal amplification (RT-LAMP) assay was developed for the detection of SARS-CoV-2. The RT-LAMP assay was highly specific for SARS-CoV-2 and was able to detect one copy of transcribed SARS-CoV-2 RNA within 24 minutes. Assay validation performed using 50 positive and 32 negative clinical samples showed 100% sensitivity and specificity. The RT-LAMP would be valuable for clinical diagnosis and epidemiological surveillance of SARS-CoV-2 infection in resource-limited areas as it does not require the use of sophisticated and costly equipment.

RevDate: 2020-10-24

Bianco C, Baselli G, Malvestiti F, et al (2020)

Genetic insight into Covid-19 related liver injury.

Metabolic dysfunction and fatty liver disease (FLD) are epidemiologically associated with increased risk of severe COVID-19 requiring hospitalization (1, 2). The mechanism may encompass promotion of inflammation by facilitation of liver injury, which is a frequent feature of severe COVID-19 (3). However, metabolic dysfunction rather than FLD itself may induce disease progression (2). Indeed, we previously showed that a genetic FLD-risk score does not predispose to severe COVID-19 in UK Biobank population-based cohort (UKBB) (4).

RevDate: 2020-10-24

Digby R, Winton-Brown T, Finlayson F, et al (2020)

Hospital staff well-being during the first wave of COVID-19: Staff perspectives.

International journal of mental health nursing [Epub ahead of print].

The purpose of this research is to determine the impact of working during the early stage of the COVID-19 pandemic on the well-being of staff at one 600-bed acute hospital in metropolitan Melbourne, Australia. This exploratory study is part of a larger mixed methods survey project, reporting the qualitative data from an on-line survey of clinical staff working at one acute hospital between April 16th and May 13th, 2020 during the COVID-19 pandemic. Responses to five free-text questions were analysed using inductive content analysis. 321 medical, nursing, allied health and non-clinical staff responded to the survey. Respondents reported anxiety, fear and uncertainty related to the pandemic, from the perspectives of work, home, family and community. They reported feeling confused by inconsistent messages received from government, hospital executive, managers and media. Seven themes were identified: (i) worrying about patient care, (ii) changed working conditions, (iii) working in the changed hospital environment, (iv) impact of the pandemic, (v) personal isolation and uncertainty, (vi) leadership and management and (vii) additional support needed for staff. Despite the pandemic being comparatively well-controlled in Australia, all disciplines reported a high degree of anticipatory anxiety. Staff working in healthcare require both managerial and psychological support to minimise anxiety and promote well-being and resilience in order to deal with the health crisis. Regular unambiguous communication directing the way forward is crucial.

RevDate: 2020-10-24

Coll E, Fernández-Ruiz M, Sánchez-Álvarez JE, et al (2020)

Covid-19 in transplant recipients: the spanish experience.

American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons [Epub ahead of print].

We report the nationwide experience with solid organ transplant (SOT) and hematopoietic stem cell transplant (HSCT) recipients diagnosed with coronavirus disease 2019 (COVID-19) in Spain until 13 July 2020. We compiled information for 778 (423 kidney, 113 HSCT, 110 liver, 69 heart, 54 lung, 8 pancreas, 1 multivisceral) recipients. Median age at diagnosis was 61 years (interquartile range [IQR]: 52-70), and 66% were male. The incidence of COVID-19 in SOT recipients was two-fold higher compared to the Spanish general population. The median interval from transplantation was 59 months (IQR: 18-131). Infection was hospital-acquired in 13% of cases. No donor-derived COVID-19 was suspected. Most patients (89%) were admitted to the hospital. Therapies included hydroxychloroquine (84%), azithromycin (53%), protease inhibitors (37%), and interferon-β (5%), whereas immunomodulation was based on corticosteroids (41%) and tocilizumab (21%). Adjustment of immunosuppression was performed in 85% of patients. At the time of analysis, complete follow-up was available from 652 patients. Acute respiratory distress syndrome occurred in 35% of patients. Ultimately, 174 (27%) patients died. In univariate analysis, risk factors for death were lung transplantation (odds ratio [OR]: 2.5; 95% CI: 1.4-4.6), age >60 years (OR: 3.7; 95% CI: 2.5-5.5), and hospital-acquired COVID-19 (OR: 3.0; 95% CI: 1.9-4.9).

RevDate: 2020-10-24

Wai KC, Xu MJ, Lee RH, et al (2020)

Head and neck surgery during the coronavirus-19 pandemic: The University of California San Francisco experience.

Head & neck [Epub ahead of print].

BACKGROUND: Guidelines regarding head and neck surgical care have evolved during the coronavirus-19 (COVID-19) pandemic. Data on operative management have been limited.

METHODS: We compared two cohorts of patients undergoing head and neck or reconstructive surgery between March 16, 2019 and April 16, 2019 (pre-COVID-19) and March 16, 2020 and April 16, 2020 (COVID-19) at an academic center. Perioperative, intraoperative, and postoperative outcomes were recorded.

RESULTS: There were 63 operations during COVID-19 and 84 operations during pre-COVID-19. During COVID-19, a smaller proportion of patients had benign pathology (12% vs 20%, respectively) and underwent thyroid procedures (2% vs 23%) while a greater proportion of patients underwent microvascular reconstruction±ablation (24% vs 12%,). Operative times increased, especially among patients undergoing microvascular reconstruction±ablation (687 ± 112 vs 596 ± 91 minutes, P = .04). Complication rates and length of stay were similar.

CONCLUSIONS: During COVID-19, perioperative outcomes were similar, operative time increased, and there were no recorded transmissions to staff or patients. Continued surgical management of head and neck cancer patients can be provided safely.

RevDate: 2020-10-24

Franca RA, Ugga L, Guadagno E, et al (2020)

Neuroinvasive potential of SARS-CoV2 with neuroradiological and neuropathological findings: is the brain a target or a victim?.

APMIS : acta pathologica, microbiologica, et immunologica Scandinavica [Epub ahead of print].

Coronaviridae family includes pathogen viruses for humans, that lead to clinical conditions with main respiratory involvement; many of these viruses have notoriously a neuroinvasive potential, as demonstrated by published data on SARS-CoV and MERS-CoV epidemics, as well by results obtained in experimental models. During pandemic of Coronavirus Disease 2019 (COVID-19) it is noticed that the central nervous system involvement represented a truly significant moment in the history of some COVID-19 patients; indeed, clinical and radiological features published in literature regarding COVID-19 disease are consistent with a neurological involvement. It is also known that histopathological data related to SARS-CoV2 infection have been published with considerable delay, which was even greater for neuropathological information. Moreover, many published data are incomplete, and often the lesions described are not directly related to the action of the virus. In this review we collected the available radiological and neuropathological information, in order to delineate a more complete picture of the relationship between SARS-Cov2 and brain, focusing our attention on the two most important neuroinvasion routes for the virus. We also highlighted what we consider methodological mistakes both in the autopsy procedures and brain study in COVID-19 deaths. We emphasize the need for a complete study of all the organs in case of autopsy. It is important that through this experience we no longer do the mistake of neglecting the brain.

RevDate: 2020-10-24

Younger DS (2020)

Postmortem Neuropathology in Covid-19.

This study concerns the clinicopathologic correlation of 50 decedents of 2019 coronavirus disease (Covid-19) due to severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) from among 250 reported patients succumbing to Covid-19 illness (1-7) who underwent detailed postmortem neuropathological studies. This disease, which starts in the lungs, is a multisystem disorder affecting all major organs including the brain. These cases provide a more complete picture of Covid-19 illness, and are important in the development of effective treatment strategies.

RevDate: 2020-10-24

Chilimuri S, Sun H, Alemam A, et al (2020)

Tocilizumab use in patients with moderate to severe COVID-19: A retrospective cohort study.

Journal of clinical pharmacy and therapeutics [Epub ahead of print].

WHAT IS KNOWN AND OBJECTIVE: The coronavirus disease 2019 (COVID-19) associated cytokine activation can lead to a rapid progression into respiratory failure, shock and multiorgan failure. Interleukin-6 (IL-6) is a pro-inflammatory cytokine that likely contributes to the pathogenesis of cytokine release syndrome. It is hypothesized that modulating IL-6 levels or its effects with tocilizumab, a recombinant humanized anti-IL-6 receptor monoclonal antibody, may alter the course of disease.

METHODS: We examined the association between tocilizumab use and intubation or death at a community hospital in New York City. Data were obtained regarding consecutive patients hospitalized with COVID-19. The primary end point was a composite of intubation or death in a time-to-event analysis. We compared outcomes in patients who received tocilizumab with those in patients who did not, using a multivariable Cox model with inverse probability weighting according to the propensity score.

RESULTS AND DISCUSSION: In this single-centre retrospective cohort study involving 1225 hospitalized patients with SARS-CoV-2 infection, the probability to respiratory failure, which was measured as intubation or death, was less frequent in patients who received tocilizumab.

WHAT IS NEW AND CONCLUSION: Tocilizumab and other IL-6 receptor monoclonal antibodies may evolve as a viable option in treating patients with moderate and severe COVID-19.

RevDate: 2020-10-24

Provenzi L, Grumi S, Gardani A, et al (2020)

Italian parents welcomed a telehealth family-centred rehabilitation programme for children with disability during COVID-19 lockdown.

Acta paediatrica (Oslo, Norway : 1992) [Epub ahead of print].

Northern Italy was dramatically affected by COVID-19 during early 2020. Suspending educational and rehabilitation services during the lockdown that followed increased the burden on the parents of children with special healthcare needs, including those diagnosed with autism spectrum disorder, psychomotor delays and other neurodevelopmental disabilities. In this context, the parents had to provide round-the-clock care, without direct access to local services and healthcare specialists. Assuring continuity of family-centred care was a key priority during lockdown.

RevDate: 2020-10-24

Lam K, McClelland S, MJ Dallo (2020)

ECG: essential in care of patients with COVID-19.

RevDate: 2020-10-24

Wickremsinhe ER, Ji QC, Gleason CR, et al (2020)

Land O'Lakes Workshop on Microsampling: Enabling Broader Adoption.

The AAPS journal, 22(6):135 pii:10.1208/s12248-020-00524-2.

The microsampling workshop generated recommendations pertaining to blood sampling site (venous blood versus capillary blood), when to conduct a bridging study, statistical approaches to establish correlation/concordance and deciding on sample size, opportunities and challenges with patient-centric sampling, and how microsampling technology can enrich clinical drug development. Overall, the goal was to provide clarity and recommendations and enable the broader adoption of microsampling supporting patients' needs, convenience, and the transformation from clinic-centric to patient-centric drug development. The need and adoption of away-from-clinic sampling techniques has become critical to maintain patient safety during the current COVID-19 pandemic.

RevDate: 2020-10-24

Yeh YYA (2020)

Reflections on a Patient Suicide in the Time of COVID-19.

RevDate: 2020-10-24

Shapiro MA (2020)

Competence vs. Identity, Trainees vs. Physicians: How COVID-19 Has Highlighted Role Confusion in Residency Training.

RevDate: 2020-10-24

Pimentel JVC, E Silva TDOS, Filgueiras ABT, et al (2020)

The Impact of Science-Unbased Measures Against COVID-19 in Clinical Decision-Making Process.

AAPS PharmSciTech, 21(8):293 pii:10.1208/s12249-020-01848-0.

RevDate: 2020-10-24

Markandeya , Verma PK, Mishra V, et al (2020)

Spatio-temporal assessment of ambient air quality, their health effects and improvement during COVID-19 lockdown in one of the most polluted cities of India.

Environmental science and pollution research international pii:10.1007/s11356-020-11248-3 [Epub ahead of print].

The present work aims to investigate seasonal variations in air pollution levels in Lucknow and assess the ambient air quality of the city together with highlighting the health impacts of major pollutants like PM10, PM2.5, SO2, NO2, Pb, Ni and aerosols from 2010 to 2019. The maximum and minimum values of PM10, PM2.5, SO2, NO2, Pb and Ni were found to be 270.75 and 122.45 μg/m3, 124.95 and 95.52 μg/m3, 25.60 and 8.05 μg/m3, 75.65 and 23.85 μg/m3, 0.66 and 0.03 μg/m3 and 0.07 and 0.01 ng/m3, respectively. Health impact of particulate matter has also been assessed with AirQ+, and it was estimated that long-term exposure of PM10 was attributed to between 37 and 48% for post-neonatal (age 1-12 months) mortality rate due to all causes, whereas long-term attributable proportions in mortality due to exposure of PM2.5 were to about 19 to 28% from all causes. Further, an attempt has also been made to evaluate the impact of lockdown amid COVID-19 on the ambient air quality of Lucknow. During the lockdown, PM2.5 levels reduced by 65% (at Gomti Nagar), 23% (at central school), 79% (at Lalbagh) and 35% (at Talkatora), due to which, air quality index of Gomti Nagar came down to 43, well below 50 which falls in the healthy range. NO2 levels also came down. However, levels of SO2 did not show significant reduction. Correlating the data between aerosol optical depth and Angstrom exponent by Pearson correlation analysis revealed a significant positive correlation (r = 0.65, P < 0.001).

RevDate: 2020-10-24

Selioutski O, Sinha SR, Tatum W, et al (2020)

Letter to the Editor: Electroencephalography at the time of COVID-19 pandemic in Italy.

RevDate: 2020-10-24

Faggiano A, S Carugo (2020)

Can the implementation of electronic surveys with quick response (QR) codes be useful in the COVID-19 era?.

International journal of epidemiology pii:5937252 [Epub ahead of print].

RevDate: 2020-10-24

Lanza GA, De Vita A, Ravenna SE, et al (2020)

Electrocardiographic findings at presentation and clinical outcome in patients with SARS-CoV-2 infection.

Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology pii:5937244 [Epub ahead of print].

AIMS: The main severe complications of SARS-CoV-2 infection are pneumonia and respiratory distress syndrome. Recent studies, however, reported that cardiac injury, as assessed by troponin levels, is associated with a worse outcome in these patients. No study hitherto assessed whether the simple standard electrocardiogram (ECG) may be helpful for risk stratification in these patients.

METHODS AND RESULTS: We studied 324 consecutive patients admitted to our Emergency Department with a confirmed diagnosis of SARS-CoV-2 infection. Standard 12-lead ECG recorded on admission was assessed for cardiac rhythm and rate, atrioventricular and intraventricular conduction, abnormal Q/QS wave, ST segment and T wave changes, corrected QT interval, and tachyarrhythmias. At a mean follow-up of 31 ± 11 days, 44 deaths occurred (13.6%). Most ECG variables were significantly associated with mortality, including atrial fibrillation (P = 0.002), increasing heart rate (P = 0.002), presence of left bundle branch block (LBBB; P < 0.001), QRS duration (P <0 .001), a QRS duration of ≥110 ms (P < 0.001), ST segment depression (P < 0.001), abnormal Q/QS wave (P = 0.034), premature ventricular complexes (PVCs; P = 0.051), and presence of any ECG abnormality [hazard ratio (HR) 4.58; 95% confidence interval (CI) 2.40-8.76; P < 0.001]. At multivariable analysis, QRS duration (P = 0.002), QRS duration ≥110 ms (P = 0.03), LBBB (P = 0.014) and presence of any ECG abnormality (P = 0.04) maintained a significant independent association with mortality.

CONCLUSION: Our data show that standard ECG can be helpful for an initial risk stratification of patients admitted for SARS-CoV-2 infectious disease.

RevDate: 2020-10-24

Silva L, D Figueiredo Filho (2020)

Using Benford's law to assess the quality of COVID-19 register data in Brazil.

Journal of public health (Oxford, England) pii:5937152 [Epub ahead of print].

We employ Newcomb-Benford law (NBL) to evaluate the reliability of COVID-19 figures in Brazil. Using official data from February 25 to September 15, we apply a first digit test for a national aggregate dataset of total cases and cumulative deaths. We find strong evidence that Brazilian reports do not conform to the NBL theoretical expectations. These results are robust to different goodness of fit (chi-square, mean absolute deviation and distortion factor) and data sources (John Hopkins University and Our World in Data). Despite the growing appreciation for evidence-based-policymaking, which requires valid and reliable data, we show that the Brazilian epidemiological surveillance system fails to provide trustful data under the NBL assumption on the COVID-19 epidemic.

RevDate: 2020-10-24

Greenwood E, C Swanton (2020)

Consequences of COVID-19 for cancer care - a CRUK perspective.

Nature reviews. Clinical oncology pii:10.1038/s41571-020-00446-0 [Epub ahead of print].

RevDate: 2020-10-24

Anonymous (2020)

Correction to: Acute endodontic and dental trauma provision during the COVID-19 crisis.

British dental journal, 229(8):555.

Author's correction note: Clinical article Br Dent J 2020; 229: 169-175.When this article was initially published, panels B and C of were duplicates. The correct figure is presented here.The authors apologise for any convenience caused.

RevDate: 2020-10-24

Denning DW, Kilcoyne A, C Ucer (2020)

Non-infectious status indicated by detectable IgG antibody to SARS-CoV-2.

British dental journal, 229(8):521-524.

A key tenet of protection from infection for dentists is to know who is not infectious. The evidence base regarding protection from respiratory pathogens in dentistry is poor. Those with a positive SARS-CoV-2 IgG antibody are non-infectious (>99% certainty) and can be safely treated with good universal precautions, even for aerosol generating procedures. Viral infectivity with SARS-CoV-2 lasts eight days, unlike viral polymerase chain reaction (PCR) swab tests which can persist for as long as seven weeks. SARS-CoV-2 IgG antibody becomes detectable from 11 days after infection. SARS-CoV-2 IgG antibodies are usually neutralising against the virus and their direct antiviral activity was partially demonstrated in 33,000 patients with COVID-19 treated with convalescent plasma in the USA. So, a positive SARS-CoV-2 IgG antibody is a much more accurate determination of infectiousness than a repeat PCR which is only 70% sensitive. It remains to be seen whether SARS-Cov-2 vaccine responses include protective IgG titres and, once vaccines become widespread, can be used to assist decision-making on appropriate personal protective equipment (PPE) in dentistry.

RevDate: 2020-10-24

Ledford H (2020)

The race to make COVID antibody therapies cheaper and more potent.

RevDate: 2020-10-24

Tregoning J (2020)

Coronavirus diaries: a new year for science.

RevDate: 2020-10-24

IHME COVID-19 Forecasting Team (2020)

Modeling COVID-19 scenarios for the United States.

Nature medicine pii:10.1038/s41591-020-1132-9 [Epub ahead of print].

We use COVID-19 case and mortality data from 1 February 2020 to 21 September 2020 and a deterministic SEIR (susceptible, exposed, infectious and recovered) compartmental framework to model possible trajectories of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and the effects of non-pharmaceutical interventions in the United States at the state level from 22 September 2020 through 28 February 2021. Using this SEIR model, and projections of critical driving covariates (pneumonia seasonality, mobility, testing rates and mask use per capita), we assessed scenarios of social distancing mandates and levels of mask use. Projections of current non-pharmaceutical intervention strategies by state-with social distancing mandates reinstated when a threshold of 8 deaths per million population is exceeded (reference scenario)-suggest that, cumulatively, 511,373 (469,578-578,347) lives could be lost to COVID-19 across the United States by 28 February 2021. We find that achieving universal mask use (95% mask use in public) could be sufficient to ameliorate the worst effects of epidemic resurgences in many states. Universal mask use could save an additional 129,574 (85,284-170,867) lives from September 22, 2020 through the end of February 2021, or an additional 95,814 (60,731-133,077) lives assuming a lesser adoption of mask wearing (85%), when compared to the reference scenario.

RevDate: 2020-10-24

Zhang B, Chao CW, Tsybovsky Y, et al (2020)

A platform incorporating trimeric antigens into self-assembling nanoparticles reveals SARS-CoV-2-spike nanoparticles to elicit substantially higher neutralizing responses than spike alone.

Scientific reports, 10(1):18149 pii:10.1038/s41598-020-74949-2.

Antigens displayed on self-assembling nanoparticles can stimulate strong immune responses and have been playing an increasingly prominent role in structure-based vaccines. However, the development of such immunogens is often complicated by inefficiencies in their production. To alleviate this issue, we developed a plug-and-play platform using the spontaneous isopeptide-bond formation of the SpyTag:SpyCatcher system to display trimeric antigens on self-assembling nanoparticles, including the 60-subunit Aquifex aeolicus lumazine synthase (LuS) and the 24-subunit Helicobacter pylori ferritin. LuS and ferritin coupled to SpyTag expressed well in a mammalian expression system when an N-linked glycan was added to the nanoparticle surface. The respiratory syncytial virus fusion (F) glycoprotein trimer-stabilized in the prefusion conformation and fused with SpyCatcher-could be efficiently conjugated to LuS-SpyTag or ferritin-SpyTag, enabling multivalent display of F trimers with prefusion antigenicity. Similarly, F-glycoprotein trimers from human parainfluenza virus-type 3 and spike-glycoprotein trimers from SARS-CoV-2 could be displayed on LuS nanoparticles with decent yield and antigenicity. Notably, murine vaccination with 0.08 µg of SARS-CoV-2 spike-LuS nanoparticle elicited similar neutralizing responses as 2.0 µg of spike, which was ~ 25-fold higher on a weight-per-weight basis. The versatile platform described here thus allows for multivalent plug-and-play presentation on self-assembling nanoparticles of trimeric viral antigens, with SARS-CoV-2 spike-LuS nanoparticles inducing particularly potent neutralizing responses.

RevDate: 2020-10-24

Zhao Y, Shang Y, Ren Y, et al (2020)

Omics study reveals abnormal alterations of breastmilk proteins and metabolites in puerperant women with COVID-19.

Signal transduction and targeted therapy, 5(1):247 pii:10.1038/s41392-020-00362-w.

RevDate: 2020-10-24

Haraszti S, Sendil S, N Jensen (2020)

Delayed Presentation of Acute Generalized Exanthematous Pustulosis Following Treatment with Cefepime in a Patient with COVID-19 without the Use of Hydroxychloroquine.

The American journal of case reports, 21:e926901 pii:926901.

BACKGROUND Acute generalized exanthematous pustulosis (AGEP) is a rare exanthem characterized by the abrupt onset of numerous small, non-follicular, sterile pustules arising on an erythematous base. AGEP is often associated with medications; however, it has also been connected to various viral infections including cytomegalovirus, parvovirus B19, and Epstein-Barr virus. Coronavirus disease 2019 (COVID-19) has been associated with a variety of skin findings, including erythematous or patchy rash, urticaria, hives, blisters, petechiae, livedo reticularis, and even AGEP in a patient undergoing treatment with hydroxychloroquine. CASE REPORT A 78-year-old man with a past medical history of benign prostatic hyperplasia, coronary artery disease, and atrial fibrillation presented with septic shock secondary to a urinary tract infection. On day 7 of treatment with cefepime, he became febrile and developed a pustular rash and persistent hypotension without any respiratory symptoms. Subsequently, he was diagnosed with COVID-19. Skin biopsy of the rash revealed AGEP. CONCLUSIONS AGEP is an uncommon cutaneous eruption often triggered by medications and viruses. AGEP is thought to be mediated by pro-inflammatory cells and cytokines. This report describes an unusual presentation of AGEP following treatment with cefepime for a urinary tract infection in a 78-year-old man who was found to be positive for SARS-CoV-2 infection, but was not treated with hydroxychloroquine. Although AGEP has been described in association with some viral infections, it is more commonly a drug-associated dermatosis, commonly seen during treatment with antibiotics. As in this case, AGEP usually resolves after discontinuation of the offending antibiotic.

RevDate: 2020-10-24

Miorin L, Kehrer T, Sanchez-Aparicio MT, et al (2020)

SARS-CoV-2 Orf6 hijacks Nup98 to block STAT nuclear import and antagonize interferon signaling.

Proceedings of the National Academy of Sciences of the United States of America [Epub ahead of print].

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of the ongoing coronavirus disease 2019 (COVID-19) pandemic that is a serious global health problem. Evasion of IFN-mediated antiviral signaling is a common defense strategy that pathogenic viruses use to replicate and propagate in their host. In this study, we show that SARS-CoV-2 is able to efficiently block STAT1 and STAT2 nuclear translocation in order to impair transcriptional induction of IFN-stimulated genes (ISGs). Our results demonstrate that the viral accessory protein Orf6 exerts this anti-IFN activity. We found that SARS-CoV-2 Orf6 localizes at the nuclear pore complex (NPC) and directly interacts with Nup98-Rae1 via its C-terminal domain to impair docking of cargo-receptor (karyopherin/importin) complex and disrupt nuclear import. In addition, we show that a methionine-to-arginine substitution at residue 58 impairs Orf6 binding to the Nup98-Rae1 complex and abolishes its IFN antagonistic function. All together our data unravel a mechanism of viral antagonism in which a virus hijacks the Nup98-Rae1 complex to overcome the antiviral action of IFN.

RevDate: 2020-10-24

Lee MA, Sprecher E, L Vernacchio (2020)

The Role of COVID-19 in Transitioning to a Better Pediatric Payment Model.

Pediatrics pii:peds.2020-008672 [Epub ahead of print].

RevDate: 2020-10-24

Good MF, MT Hawkes (2020)

The Interaction of Natural and Vaccine-Induced Immunity with Social Distancing Predicts the Evolution of the COVID-19 Pandemic.

mBio, 11(5):.

The existence and nature of immunity to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are currently unknown; however, neutralizing antibodies are thought to play the major role and data from studying other coronaviruses suggest that partial clinical immunity lasting up to 1 year will occur postinfection. We show how immunity, depending on its durability, may work with current social practices to limit the spread of the virus. We further show that a vaccine that is 50% effective and taken by 50% of the population will prevent further loss of life, providing that social distancing is still practiced and that immunity does not wane quickly.IMPORTANCE The ability of our society to function effectively moving forward will depend on how the spread of the SARS-CoV-2 virus is contained. Immunity to the virus will be critical to this equation.

RevDate: 2020-10-24

Sigorski D, Sobczuk P, Osmola M, et al (2020)

Impact of COVID-19 on anxiety levels among patients with cancer actively treated with systemic therapy.

ESMO open, 5(5):.

BACKGROUND: Life-threatening diseases have a negative impact on emotional well-being and psychosocial functioning. This study aimed to assess the relationship between the level of anxiety caused by a neoplasm and the threat of coronavirus infection among patients with cancer actively treated with systemic therapy during the COVID-19 pandemic. Additionally, we searched for clinical factors associated with a higher level of anxiety.

METHODS: In this multicentre, prospective, non-interventional study conducted in Poland, we enrolled 306 actively treated patients with cancer and collected their clinical data, including age, gender, cancer type and treatment intention. The fear/anxiety of SARS-CoV-2 were rated in Fear of COVID-19 Scale (SRA-FCV-19S) and Numerical Anxiety Scale (SRA-NAS). The fear and anxiety associated with cancer (CRA) were rated with the NAS (CRA-NAS).

RESULTS: The mean level of SRA-FCV-19S was 18.5±7.44, which was correlated with the SRA-NAS (r=0.741, p<0.001). SRA-FCV-19S was significantly higher in women versus men (20.18±7.56 vs 16.54±6.83; p<0.001) and was tumour type-dependent (p=0.037), with the highest anxiety observed in patients with breast cancer (17.63±8.75). In the multivariate analysis, only the female gender was significantly associated with higher SRA. CRA-NAS was higher in women versus men (7.07±2.99 vs 5.47±3.01; p<0.001), in patients treated with curative versus palliative intention (7.14±3.06 vs 5.99±3.06; p=0.01) and in individuals aged ≤65 years versus >65 years (6.73±2.96 vs 5.66±3.24; p=0.007).

CONCLUSIONS: For an actively treated patient with cancer, cancer remains the main life-threatening disease during the COVID-19 pandemic. The need for more attentive psychological care should be provided especially to female patients, patients with breast cancer, those under 65 years of age and treated with curative intention, as these factors are associated with a higher level of anxiety.

RevDate: 2020-10-24

Ryan DJ, Toomey S, Madden SF, et al (2020)

Use of exhaled breath condensate (EBC) in the diagnosis of SARS-COV-2 (COVID-19).

Thorax pii:thoraxjnl-2020-215705 [Epub ahead of print].

False negatives from nasopharyngeal swabs (NPS) using reverse transcriptase PCR (RT-PCR) in SARS-CoV-2 are high. Exhaled breath condensate (EBC) contains lower respiratory droplets that may improve detection. We performed EBC RT-PCR for SARS-CoV-2 genes (E, S, N, ORF1ab) on NPS-positive (n=16) and NPS-negative/clinically positive COVID-19 patients (n=15) using two commercial assays. EBC detected SARS-CoV-2 in 93.5% (29/31) using the four genes. Pre-SARS-CoV-2 era controls (n=14) were negative. EBC was positive in NPS negative/clinically positive patients in 66.6% (10/15) using the identical E and S (E/S) gene assay used for NPS, 73.3% (11/15) using the N/ORF1ab assay and 14/15 (93.3%) combined.

RevDate: 2020-10-24

Cevik M, Kuppalli K, Kindrachuk J, et al (2020)

Virology, transmission, and pathogenesis of SARS-CoV-2.

BMJ (Clinical research ed.), 371:m3862.

RevDate: 2020-10-24

Dennis JM, Mateen BA, Sonabend R, et al (2020)

Type 2 Diabetes and COVID-19-Related Mortality in the Critical Care Setting: A National Cohort Study in England, March-July 2020.

Diabetes care pii:dc20-1444 [Epub ahead of print].

OBJECTIVE: To describe the relationship between type 2 diabetes and all-cause mortality among adults with coronavirus disease 2019 (COVID-19) in the critical care setting.

RESEARCH DESIGN AND METHODS: This was a nationwide retrospective cohort study in people admitted to hospital in England with COVID-19 requiring admission to a high dependency unit (HDU) or intensive care unit (ICU) between 1 March 2020 and 27 July 2020. Cox proportional hazards models were used to estimate 30-day in-hospital all-cause mortality associated with type 2 diabetes, with adjustment for age, sex, ethnicity, obesity, and other major comorbidities (chronic respiratory disease, asthma, chronic heart disease, hypertension, immunosuppression, chronic neurological disease, chronic renal disease, and chronic liver disease).

RESULTS: A total of 19,256 COVID-19-related HDU and ICU admissions were included in the primary analysis, including 13,809 HDU (mean age 70 years) and 5,447 ICU (mean age 58 years) admissions. Of those admitted, 3,524 (18.3%) had type 2 diabetes and 5,077 (26.4%) died during the study period. Patients with type 2 diabetes were at increased risk of death (adjusted hazard ratio [aHR] 1.23 [95% CI 1.14, 1.32]), and this result was consistent in HDU and ICU subsets. The relative mortality risk associated with type 2 diabetes decreased with higher age (age 18-49 years aHR 1.50 [95% CI 1.05, 2.15], age 50-64 years 1.29 [1.10, 1.51], and age ≥65 years 1.18 [1.09, 1.29], P value for age-type 2 diabetes interaction = 0.002).

CONCLUSIONS: Type 2 diabetes may be an independent prognostic factor for survival in people with severe COVID-19 requiring critical care treatment, and in this setting the risk increase associated with type 2 diabetes is greatest in younger people.

RevDate: 2020-10-24

Acharya A, Gerring J, A Reeves (2020)

Is health politically irrelevant? Experimental evidence during a global pandemic.

BMJ global health, 5(10):.

OBJECTIVE: To investigate how health issues affect voting behaviour by considering the COVID-19 pandemic, which offers a unique opportunity to examine this interplay.

DESIGN: We employ a survey experiment in which treatment groups are exposed to key facts about the pandemic, followed by questions intended to elicit attitudes toward the incumbent party and government responsibility for the pandemic.

SETTING: The survey was conducted amid the lockdown period of 15-26 April 2020 in three large democratic countries with the common governing language of English: India, the United Kingdom and the United States. Due to limitations on travel and recruitment, subjects were recruited through the M-Turk internet platform and the survey was administered entirely online. Respondents numbered 3648.

RESULTS: Our expectation was that respondents in the treatment groups would favour, or disfavour, the incumbent and assign blame to government for the pandemic compared with the control group. We observe no such results. Several reasons may be adduced for this null finding. One reason could be that public health is not viewed as a political issue. However, people do think health is an important policy area (>85% agree) and that government has some responsibility for health (>90% agree). Another reason could be that people view public health policies through partisan lenses, which means that health is largely endogenous, and yet we find little evidence of polarisation in our data. Alternatively, it could be that the global nature of the pandemic inoculated politicians from blame and yet a majority of people do think the government is to blame for the spread of the pandemic (~50% agree).

CONCLUSIONS: While we cannot precisely determine the mechanisms at work, the null findings contained in this study suggest that politicians are unlikely to be punished or rewarded for their failures or successes in managing COVID-19 in the next election.

TRIAL REGISTRATION: Initial research hypotheses centred on expected variation between two treatments, as set forth in a detailed pre-analysis plan, registered at E-Gap: http://egap.org/registration/6645. Finding no difference between the treatments, we decided to focus this paper on the treatment/control comparison. Importantly, results that follow the pre-analysis plan strictly are entirely consistent with results presented here: null findings obtained throughout.

RevDate: 2020-10-24

Wilson SL, C Wiysonge (2020)

Social media and vaccine hesitancy.

BMJ global health, 5(10):.

BACKGROUND: Understanding the threat posed by anti-vaccination efforts on social media is critically important with the forth coming need for world wide COVID-19 vaccination programs. We globally evaluate the effect of social media and online foreign disinformation campaigns on vaccination rates and attitudes towards vaccine safety.

METHODS: Weuse a large-n cross-country regression framework to evaluate the effect ofsocial media on vaccine hesitancy globally. To do so, we operationalize social media usage in two dimensions: the use of it by the public to organize action(using Digital Society Project indicators), and the level of negative lyoriented discourse about vaccines on social media (using a data set of all geocoded tweets in the world from 2018-2019). In addition, we measure the level of foreign-sourced coordinated disinformation operations on social media ineach country (using Digital Society Project indicators). The outcome of vaccine hesitancy is measured in two ways. First, we use polls of what proportion ofthe public per country feels vaccines are unsafe (using Wellcome Global Monitor indicators for 137 countries). Second, we use annual data of actual vaccination rates from the WHO for 166 countries.

RESULTS: We found the use of social media to organise offline action to be highly predictive of the belief that vaccinations are unsafe, with such beliefs mounting as more organisation occurs on social media. In addition, the prevalence of foreign disinformation is highly statistically and substantively significant in predicting a drop in mean vaccination coverage over time. A 1-point shift upwards in the 5-point disinformation scale is associated with a 2-percentage point drop in mean vaccination coverage year over year. We also found support for the connection of foreign disinformation with negative social media activity about vaccination. The substantive effect of foreign disinformation is to increase the number of negative vaccine tweets by 15% for the median country.

CONCLUSION: There is a significant relationship between organisation on social media and public doubts of vaccine safety. In addition, there is a substantial relationship between foreign disinformation campaigns and declining vaccination coverage.

RevDate: 2020-10-24

Wedig IJ, Duelge TA, SJ Elmer (2020)

Infographic. Stay physically active during COVID-19 with exercise as medicine.

British journal of sports medicine pii:bjsports-2020-103282 [Epub ahead of print].

RevDate: 2020-10-24

Iacobucci G (2020)

Covid-19: Government shelves plans to invest £100bn in mass testing.

BMJ (Clinical research ed.), 371:m4112.

RevDate: 2020-10-24

Charoenwong B, Kwan A, V Pursiainen (2020)

Social connections with COVID-19-affected areas increase compliance with mobility restrictions.

Science advances pii:sciadv.abc3054 [Epub ahead of print].

We study the role of social connections in U.S. households' compliance with mobility restrictions imposed in response to the COVID-19 pandemic, using aggregated and anonymized Facebook data on social connections and mobile phone data for measuring social distancing at the county level. Relative to average, a one-standard-deviation increase in social connections with China and Italy - the first countries with major outbreaks of the virus - is associated with a nearly 50% increase in the estimated effect of mobility restrictions. Our results are not driven by traveler risk, as areas at higher risk from COVID-19 generally comply with restrictions more and are less affected by social connections. Social connections with counties with a less educated population, higher Trump vote share, and higher fraction of climate change deniers are associated with increased effects of mobility restrictions. Our findings are consistent with social networks contributing to people's information acquisition about the pandemic.

RevDate: 2020-10-24

Goyal A, Cardozo-Ojeda EF, JT Schiffer (2020)

Potency and timing of antiviral therapy as determinants of duration of SARS-CoV-2 shedding and intensity of inflammatory response.

Science advances pii:sciadv.abc7112 [Epub ahead of print].

To impact the COVID-19 pandemic, lifesaving antiviral therapies must be identified. The number of clinical trials that can be performed is limited. We developed mathematical models to project multiple therapeutic approaches. Our models recapitulate off-treatment viral dynamics and predict a three-phase immune response. Simulated treatment with remdesivir, selinexor, neutralizing antibodies or cellular immunotherapy demonstrates that rapid viral elimination is possible if in vivo potency is sufficiently high. Therapies dosed soon after peak viral load when symptoms develop, may decrease shedding duration and immune response intensity, but have little effect on viral area under the curve (AUC), which is driven by high early viral loads. Potent therapy dosed prior to viral peak during pre-symptomatic infection, could lower AUC. Drug resistance may emerge with a moderately potent agent dosed before viral peak. Our results support early treatment for COVID-19 if shedding duration and not AUC is most predictive of clinical severity.

RevDate: 2020-10-24

Chahal R, Kirshenbaum JS, Miller JG, et al (2020)

Higher Executive Control Network Coherence Buffers Against Puberty-Related Increases in Internalizing Symptoms During the COVID-19 Pandemic.

Biological psychiatry. Cognitive neuroscience and neuroimaging pii:S2451-9022(20)30245-7 [Epub ahead of print].

BACKGROUND: Early pubertal maturation has been posited to be a biopsychosocial risk factor for the onset of internalizing psychopathology in adolescence; further, early-maturing youths exhibit heightened reactivity to stressful events. School closures and enforced social distancing, as well as health and financial uncertainties, during the COVID-19 pandemic are expected to adversely affect mental health in youths, particularly adolescents who are already at risk for experiencing emotional difficulties. The executive control network (ECN) supports cognitive processes required to successfully navigate novel challenges and regulate emotions in stressful contexts.

METHODS: We examined whether functional coherence of the ECN, measured using resting-state functional magnetic resonance imaging 5 years before the pandemic (T1), is a neurobiological marker of resilience to increases in the severity of internalizing symptoms during COVID-19 in adolescents who were in more advanced stages of puberty at T1 relative to their same-age peers (N = 85, 49 female).

RESULTS: On average, participants reported an increase in symptoms from the 3 months before pandemic to the 2 most recent weeks during the pandemic. We found that early-maturing youths exhibited greater increases in internalizing symptoms during the pandemic if their ECN coherence was low; in contrast, relative pubertal stage was not associated with changes in internalizing symptoms in adolescents with higher ECN coherence at T1.

CONCLUSIONS: These findings highlight the role of the functional architecture of the brain that supports executive functioning in protecting against risk factors that may exacerbate symptoms of internalizing psychopathology during periods of stress and uncertainty.

RevDate: 2020-10-24

Thai-Van H, Bakhos D, Bouccara D, et al (2020)

Telemedicine in Audiology. Best practice recommendations from the French Society of Audiology (SFA) and the French Society of Otorhinolaryngology-Head and Neck Surgery (SFORL).

OBJECTIVES: Access to diagnosis and treatments for auditory disorders and related pathologies has regressed in France during the COVID-19 pandemic, posing a risk to the patient's chance of recovery. This best practice recommendations guide aims to list the existing technological solutions for the remote examination of a patient with hearing complaint, and to outline their benefits and, where applicable, their limitations.

METHODS: The recommendations were developed both from the clinical experience of the medical experts who drafted the guide, and from an extensive review of the literature dealing with clinical practice recommendations for tele-audiology. Tele-audiometry solutions were identified on the basis of a search engine query carried out in April 2020, prior to verification of their availability on the European market.

RESULTS: Video otoscopy solutions allow for the teletransmission of images compatible with a high-quality diagnosis, either by connecting via internet to a tele-health platform or using a smartphone or a tablet with an iOS or Android operating system. Using the same telecommunication methods, it is possible to remotely conduct a pure-tone audiometry test in accordance with standard practice, a speech-in-quiet or a speech-in-noise audiometry test, as well as objective measures of hearing. Clinical and paraclinical examinations can be accessed by the physician to be interpreted on a deferred basis (asynchronous tele-audiology). Examinations can also be conducted in real time in a patient, at any age of life, as long as a caregiver can be present during the installation of the transducers or the acoumetry. Tele-audiology solutions also find application in the remote training of future healthcare professionals involved in the management of deafness and hearing impairment.

CONCLUSION: Under French law, tele-otoscopy is a medical procedure that is either a tele-expertise (asynchronous adive) or a teleconsultation act (synchronous advice). Subjective and objective evaluation of the patient's hearing functions can be done remotely provided that the listed precautions are respected.

RevDate: 2020-10-24

Boon IS, Lim JS, Au Yong TPT, et al (2020)

Digital healthcare and shifting equipoise in radiation oncology: The butterfly effect of the COVID-19 pandemic.

Journal of medical imaging and radiation sciences pii:S1939-8654(20)30311-8 [Epub ahead of print].

RevDate: 2020-10-24

Hughes BA, Hassan S, Stallard J, et al (2020)

Plastic physicians: The surgical salamanders of the COVID-19 pandemic.

Journal of plastic, reconstructive & aesthetic surgery : JPRAS pii:S1748-6815(20)30462-9 [Epub ahead of print].

At the time of writing, coronavirus disease-2019 (COVID-19) has affected 6.42 million people globally and over 380,000 deaths, with the United Kingdom now having the highest death rate in Europe. The plastic surgery department at Leeds Teaching Hospitals put necessary steps in place to maintain an excellent urgent elective and acute service whilst also managing COVID-positive medical patients in the ward. We describe the structures and pathways implemented together with complex decision-making, which has allowed us to respond early and effectively. We hope these lessons will prove a useful tool as we look to open conversations around the recovery of normal activity.

RevDate: 2020-10-24

Rascón-Ramírez FJ, Carrascosa-Granada ÁM, Vargas-Jiménez AC, et al (2020)

Supra and infratentorial massive strokes in previously healthy young patients with SARS-CoV-2. The role of neurosurgery.

The coronavirus disease 2019 (COVID-19) has amazed by its distinct forms of presentation and severity. COVID-19 patients can develop large-scale ischemic strokes in previously healthy patients without risk factors, especially in patients who develop an acute respiratory distress syndrome (SARS-CoV-2). We hypothesize that ischemic events are usually the result of the combined process of a pro-inflammatory and pro-coagulant state plus vascular endothelial dysfunction probably potentiated by hypoxia, hemodynamic instability, and immobilization, as reported in other cases. To the best of our knowledge, we report the first case of partial obstruction of a vertebral artery in a patient with COVID-19. Decompressive surgery remains a life-saving maneuver in these patients (as in other non-COVID-19 strokes) and requires further investigation.

RevDate: 2020-10-24

Lowe J, S Shen (2020)

Off the Shelf: Rapid Deployment of an Emergency Department Telemedicine Platform Using Readily Available Consumer Products.

The Journal of emergency medicine pii:S0736-4679(20)30959-8 [Epub ahead of print].

BACKGROUND: For 20 years, telemedicine has been waiting in the wings for its time in the spotlight. The Coronavirus Disease 2019 (COVID-19) pandemic, with its emphasis on personal protective equipment (PPE) and reducing high-risk contacts, was the catalyst needed to bring telemedicine into mainstream consciousness and acceptance.

OBJECTIVES: We first review some of the key factors that precipitated this abrupt alteration of the perception of telemedicine. We then detail the creation of a department-wide telemedicine network using off-the-shelf consumer products. Our goal was to very rapidly install a system that was familiar to end-users for the purpose of reducing high-risk contacts and conserving PPE. Sourcing from the consumer realm proved to be advantageous over enterprise-level equipment when these goals were desired.

DISCUSSION: After a rollout of 1.5 weeks from zero to fully operational, we showed an immediate decrease in high-risk contacts and PPE use. All 80 rooms plus all triage areas in our department were outfitted with Apple iPads running Zoom. User adoption was high and telemedicine use increased from ∼17 to ∼90 instances a day, a 429% increase. We saw a decrease in high-risk contacts of about 75%, with a concomitant cost savings in PPE.

CONCLUSIONS: We propose that the use of consumer products sourced from local vendors is a viable solution for telemedicine systems focusing on speed, reducing costs, and ease of deployment. Future work will focus on studying its performance characteristics vs. other systems in an evolving landscape.

RevDate: 2020-10-24

Wendt DC, Marsan S, Parker D, et al (2020)

Commentary on the impact of the COVID-19 pandemic on opioid use disorder treatment among Indigenous communities in the United States and Canada.

Journal of substance abuse treatment pii:S0740-5472(20)30422-0 [Epub ahead of print].

This commentary focuses on how some Indigenous communities in the United States (U.S.) and Canada are addressing the opioid epidemic within the context of the COVID-19 pandemic, from the perspective of the co-authors as researchers, clinicians, and pharmacists working within or among Indigenous communities in three eastern Canadian provinces and two western U.S. states. The pandemic has likely exacerbated opioid use problems among Indigenous communities, especially for individuals with acute distress or comorbid mental illness, or who are in need of withdrawal management or residential services. In response to the pandemic, we discuss first how greater prescription flexibility has facilitated and even increased access to medications for opioid use disorder. Second, we describe how Indigenous-serving clinics have expanded telemedicine services, albeit not without some challenges. Third, we note challenges with restricted participation in traditional Indigenous healing practices that can be helpful for addiction recovery. Fourth, we mention providers' worries about the pandemic's impact on their patients' mental health and safety. We argue that certain treatment transformations may be helpful even after the pandemic is over, through enhancing access to community-grounded treatment, decreasing stigma, and promoting patient self-efficacy.

RevDate: 2020-10-24

Coudeville L, Gomez GB, Jollivet O, et al (2020)

Exploring uncertainty and risk in the accelerated response to a COVID-19 vaccine: Perspective from the pharmaceutical industry.

Vaccine pii:S0264-410X(20)31328-1 [Epub ahead of print].

RevDate: 2020-10-24

Marino LV, Valla FV, Tume LN, et al (2020)

Considerations for nutrition support in critically ill children with COVID-19 and paediatric inflammatory multisystem syndrome temporally associated with COVID-19.

Clinical nutrition (Edinburgh, Scotland) pii:S0261-5614(20)30534-3 [Epub ahead of print].

There are reports of children COVID-19 or COVID-19 like symptoms with hyperinflammatory multisystem syndrome, ARDS, gastrointestinal and atypical Kawasaki disease presenting to PICU worldwide temporally associated with COVID-19, for which there are important nutrition support considerations. As a result, the European Society of Pediatric and Neonatal Intensive Care - Metabolism, Endocrine and Nutrition group (ESPNIC-MEN) and paediatric nutritionists working in PICUs are being consulted regarding nutrition management of critically ill children with COVID-19 or COVID-19 like symptoms. Therefore, the aim of this short report is to provide a summary of nutrition support recommendations for critically ill children with COVID-19. They are based on the ESPNIC-MEN section recommendations published in January 2020 and surviving sepsis recommendations from February 2020.

RevDate: 2020-10-24

Bonucci M, Raggi R, RA Vacca (2020)

Polydatin and its potential protective effect on COVID-19.

RevDate: 2020-10-24

Khosravi B, Aghaghazvini L, Sorouri M, et al (2020)

Predictive value of initial CT scan for various adverse outcomes in patients with COVID-19 pneumonia.

Heart & lung : the journal of critical care pii:S0147-9563(20)30398-8 [Epub ahead of print].

BACKGROUND: Chest computed tomography (CT) scan is frequently used in the diagnosis of COVID-19 pneumonia.

OBJECTIVES: This study investigates the predictive value of CT severity score (CSS) for length-of-stay (LOS) in hospital, initial disease severity, ICU admission, intubation, and mortality.

METHODS: In this retrospective study, initial CT scans of consecutively admitted patients with COVID-19 pneumonia were reviewed in a tertiary hospital. The association of CSS with the severity of disease upon admission and the final adverse outcomes was assessed using Pearson's correlation test and logistic regression, respectively.

RESULTS: Total of 121 patients (60±16 years), including 54 women and 67 men, with positive RT-PCR tests were enrolled. We found a significant but weak correlation between CSS and qSOFA, as a measure of disease severity (r: 0.261, p = 0.003). No significant association was demonstrated between CSS and LOS. Patients with CSS>8 had at least three-fold higher risk of ICU admission, intubation, and mortality.

CONCLUSIONS: CSS in baseline CT scan of patients with COVID-19 pneumonia can predict adverse outcomes and is weakly correlated with initial disease severity.

RevDate: 2020-10-24

Olry de Labry-Lima A, Bermúdez-Tamayo C, Martinez-Olmos J, et al (2020)

The use of masks to protect against respiratory infections: an umbrella review.

Enfermedades infecciosas y microbiologia clinica pii:S0213-005X(20)30262-7 [Epub ahead of print].

INTRODUCTION: The global health emergency caused by the current COVID-19 pandemic is resulting in a huge challenge at all levels. The use of masks may reduce the spread of the infection by minimising the excretion of Flügge droplets. The objective of this study was to compile the evidence available on the use of masks in relation to respiratory infections.

METHODOLOGY: An umbrella review (review of systematic reviews) was conducted. Two reviewers independently carried out the screening process, data extraction and data analysis. Discrepancies were resolved with a third reviewer, and the assessment of the risk of bias of the studies was carried out using the AMSTAR 2 tool. The Rayyan QCRI program was used for the screening process.

RESULTS: A total of eight systematic reviews were included. The studies analysed the use of masks in the general population, in long-term care facilities, in hospitals and at mass gatherings, and compared the effectiveness thereof in preventing infection. The results of this review revealed that the use of masks is associated with a protective effect against respiratory infections in healthcare facilities, in long-term care facilities and at mass gatherings.

CONCLUSIONS: In light of the results, it seems reasonable to recommend the use of masks to the general population, but this use should be accompanied by a training programme to improve compliance, as not using them properly may increase the risk of infection.

RevDate: 2020-10-24

Borzée A, McNeely J, Magellan K, et al (2020)

COVID-19 Highlights the Need for More Effective Wildlife Trade Legislation.

Trends in ecology & evolution pii:S0169-5347(20)30259-7 [Epub ahead of print].

Zoonosis-based epidemics are inevitable unless we revisit our relationship with the natural world, protect habitats, and regulate wildlife trade, including live animals and non-sustenance products. To prevent future zoonoses, governments must establish effective legislation addressing wildlife trade, protection of habitats, and reduction of the wildlife-livestock-human interface.

RevDate: 2020-10-24

Li M, Zhang Z, Cao W, et al (2020)

Identifying novel factors associated with COVID-19 transmission and fatality using the machine learning approach.

The Science of the total environment pii:S0048-9697(20)36339-7 [Epub ahead of print].

The COVID-19 virus has infected more than 38 million people and resulted in more than one million deaths worldwide as of October 14, 2020. By using the logistic regression model, we identified novel critical factors associated with COVID19 cases, death, and case fatality rates in 154 countries and in the 50 U.S. states. Among numerous factors associated with COVID-19 risk, economic inequality enhanced the risk of COVID-19 transmission. The per capita hospital beds correlated negatively with COVID-19 deaths. Blood types B and AB were protective factors for COVID-19 risk, while blood type A was a risk factor. The prevalence of HIV and influenza and pneumonia was associated with reduced COVID-19 risk. Increased intake of vegetables, edible oil, protein, vitamin D, and vitamin K was associated with reduced COVID-19 risk, while increased intake of alcohol was associated with increased COVID-19 risk. Other factors included age, sex, temperature, humidity, social distancing, smoking, health investment, urbanization level, and race. High temperature is a more compelling factor mitigating COVID-19 transmission than low temperature. Our comprehensive identification of the factors affecting COVID-19 transmission and fatality may provide new insights into the COVID-19 pandemic and advise effective strategies for preventing and migrating COVID-19 spread.

RevDate: 2020-10-24

Dunker S, Hornick T, Szczepankiewicz G, et al (2020)

No SARS-CoV-2 detected in air samples (pollen and particulate matter) in Leipzig during the first spread.

The Science of the total environment pii:S0048-9697(20)36411-1 [Epub ahead of print].

The SARS-CoV-2 pandemic co-occurred with pollen season in Europe 2020 and recent studies suggest a potential link between both. Air samples collected at our measuring station in Leipzig and purified pollen were analyzed for SARS-CoV-2 typical signals or for virus-induced cytopathic effects, to test if the virus could bind to bioaerosols and if so, whether these complexes are infectious. The results show that neither our air samples nor purified pollen were infectious or could act as carrier for virus particles.

RevDate: 2020-10-24

Patel M, Chaubey AK, Pittman CU, et al (2020)

Coronavirus (SARS-CoV-2) in the environment: Occurrence, persistence, analysis in aquatic systems and possible management.

The Science of the total environment pii:S0048-9697(20)36227-6 [Epub ahead of print].

The year 2020 brought the news of the emergence of a new respiratory disease (COVID-19) from Wuhan, China. The disease is now a global pandemic and is caused by a virus named SARS-CoV-2 by international bodies. Important viral transmission sources include human contact, respiratory droplets and aerosols, and through contact with contaminated objects. However, viral shedding in feces and urine by COVID-19-afflicted patients raises concerns about SARS-CoV-2 entering aquatic systems. Recently, targeted SARS-CoV-2 genome fragments have been successfully detected in wastewater, sewage sludge and river waters around the world. Wastewater-based epidemiology (WBE) studies can provide early detection and assessment of COVID-19 transmission and the growth of active cases within given wastewater catchment areas. WBE surveillance's ability to detect the growth of cases was demonstrated. Was this science applied throughout the world as this pandemic spread throughout the globe? Wastewater treatment efficacy for SARS-CoV-2 removal and risk assessments associated with treated water are reported. Disinfection strategies using chemical disinfectants, heat and radiation for deactivating and destroying SARS-CoV-2 are explained. Analytical methods of SARS-CoV-2 detection are covered. This review provides a more complete overview of the present status of SARS-CoV-2 and its consequences in aquatic systems. So far, WBE programs have not yet served to provide the early alerts to authorities that they have the potential to achieve. This would be desirable in order to activate broad public health measures at earlier stages of local and regional stages of transmission.

RevDate: 2020-10-24

Gruetzmacher K, Karesh WB, Amuasi JH, et al (2020)

The Berlin principles on one health - Bridging global health and conservation.

The Science of the total environment pii:S0048-9697(20)36449-4 [Epub ahead of print].

For over 15-years, proponents of the One Health approach have worked to consistently interweave components that should never have been separated and now more than ever need to be re-connected: the health of humans, non-human animals, and ecosystems. We have failed to heed the warning signs. A One Health approach is paramount in directing our future health in this acutely and irrevocably changed world. COVID-19 has shown us the exorbitant cost of inaction. The time to act is now.

RevDate: 2020-10-24

Lim ST, Kelly M, S Johnston (2020)

Re: 'Readability of online patient education material for the novel coronavirus disease (COVID-19): a cross-sectional health literacy study'.

RevDate: 2020-10-24

Kahan BD (2020)

COVID-19 Minisymposium: Toward a Strategic Roadmap.

RevDate: 2020-10-24

Ulrich CM, Rushton CH, C Grady (2020)

Nurses confronting the coronavirus: Challenges met and lessons learned to date.

Nursing outlook pii:S0029-6554(20)30659-X [Epub ahead of print].

BACKGROUND: Registered nurses are an essential workforce group across the globe. They use their expertise and skill sets every day in clinical practice to protect, promote, and advocate on behalf of patients and families under their care.

PURPOSE: In this article we discuss the physical, emotional, and moral stresses that nurses are experiencing in their day-to-day practice settings created by the novel coronavirus.

DISCUSSION AND CONCLUSION: We consider the demands placed on nurses by unexpected patient surges within hospital environments and inadequate personal protective equipment and other critical resources, challenging nurses' ability to meet their professional and ethical obligations. We also share our thoughts on supporting nurses and others now, and ideas for needed healing for both individuals and organizations as we move forward. Finally, we argue for the need for substantive reform of institutional processes and systems that can deliver quality care in the future when faced with another devastating humanitarian and public health crises.

RevDate: 2020-10-24

Yu W, Ou X, Liu X, et al (2020)

ACE2 contributes to the maintenance of mouse epithelial barrier function.

Biochemical and biophysical research communications pii:S0006-291X(20)31906-9 [Epub ahead of print].

BACKGROUND: The whole world was hit hard by the coronavirus disease-19 (COVID-19). Given that angiotensin I converting enzyme 2 (ACE2) is the viral entry molecule, understanding ACE2 has become a major focus of current COVID-19 research. ACE2 is highly expressed in the gut, but its role has not been fully understood and thus COVID-19 treatments intending to downregulate ACE2 level may cause untoward side effects. Gaining insight into the functions of ACE2 in gut homeostasis therefore merits closer examination, and is beneficial to find potential therapeutic alternatives for COVID-19.

METHODS: We took advantage of Ace2 knockout out mice and isolated intestinal organoids to examine the role of ACE2 in intestinal stemness. Inflammatory bowel disease (IBD) mouse model was established by 4% dextran sodium sulfate. LGR5 and KI67 levels were quantitated to reflect the virtue of intestinal stem cells (ISCs). FITC-dextran 4 (FD-4) assay was used to assess intestinal barrier function.

RESULTS: Western blotting identified the expression of ACE2 in colon, which was consistent with the results of immunofluorescence and RT-PCR. Moreover, Ace2-/- organoids showed decreased LRG5 and KI67 levels, and elevated calcium concentration. Furthermore, the permeability of ace2-/- organoids was markedly increased compared with ace2+/+ organoids. Collectively, ace2-/- mice were more susceptible than ace2+/+ mice to IBD, including earlier bloody stool, undermined intestinal architecture and more pronounced weight loss.

CONCLUSIONS: Our data reveal that ACE2 contributes to the proliferation of intestinal stem cells and hence orchestrates the mucosal homeostasis.

RevDate: 2020-10-24

Fantini J, Chahinian H, N Yahi (2020)

Leveraging coronavirus binding to gangliosides for innovative vaccine and therapeutic strategies against COVID-19.

Biochemical and biophysical research communications pii:S0006-291X(20)31924-0 [Epub ahead of print].

Covid-19 is an infectious respiratory disease due to a coronavirus named SARS-CoV-2. A critical step of the infection cycle is the binding of the virus spike S protein to the cellular ACE-2 receptor. This interaction involves a receptor binding domain (RBD) located at the center of the S trimer, whereas the lateral N-terminal domain (NTD) displays a flat ganglioside binding site that enables the virus to bind to lipid rafts of the plasma membrane, where the ACE-2 receptor resides. S protein binding to lipid rafts can be blocked by hydroxychloroquine, which binds to gangliosides, and by azithromycin, which binds to the NTD. Based on these data, we identified the NTD of SARS-CoV-2 as a promising target for both therapeutic and vaccine strategies, a notion later supported by the discovery, in convalescent Covid-19 patients, of a neutralizing antibody (4A8) that selectively binds to the NTD. The 4A8 epitope overlaps the ganglioside binding domain, denying any access of the virus to lipid rafts when the antibody is bound to the S protein. Thus, our data explain why antibody binding to the tip of the NTD results in SARS-CoV-2 neutralization. The high level of conservation of the ganglioside binding domain of SARS-CoV-2 (100% identity in 584 of 600 isolates analyzed worldwide) offers unique opportunities for innovative vaccine/therapeutic strategies.

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

Electronic Scholarly Publishing
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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 )