Annals of Emergency Medicine
Volume 75, Issue 4, April 2020, Page 556.
Since the emergence of a cluster of patients with pneumonia caused by a novel coronavirus (COVID-19) in Wuhan, Hubei, China, in December 2019, emergency departments (EDs) in China have instituted special measures to manage patients with potential exposure to the virus. We describe our initial experience in managing the current outbreak caused by COVID-19…
Epidemiology
Infection Control & Hospital Epidemiology
Our healthcare system faces an unprecedented strain as it struggles with the coronavirus disease 2019 (COVID-19) pandemic. With cases now reported in 53 states and territories, community spread is either already occurring or imminent in most localities. Most healthcare systems are experiencing limited access to diagnostic tests accompanied by delays in test results of more than 24 hours.1 Trials to assess potential treatments are underway, with mounting difficulty in acquiring agents as the demand for them increases.
Clinical aspects, diagnosis, treatment
International Journal of Clinical Pharmacy
The coronavirus disease 19 (COVID-19) is quickly spreading across China and globally. Pharmacy services are an important pillar in public health to prevent and contain the COVID-19 pandemic. Chinese pharmacists have acted swiftly in the public health response in China, such as drafting professional service guidance to pharmacists and pharmacies, establishing emergency drug formularies, monitoring and resolving drug shortages, establishing remote pharmacy services to prevent human-to-human infections, providing event-driven pharmaceutical care, educating the public on infection prevention and disease management, and participating in clinical trials and drug evaluation. This commentary reviews the unique needs of pharmacy services in the COVID-19 pandemic, and shares our experiences with the international pharmacy community in the response to these needs.
China, Coronavirus, COVID-19, Pharmaceutical care, Pharmacists, Pharmacy service, Public health
Xenotransplantation
Coronaviruses (CoVs) have recently received an extraordinary level of global attention due to the discovery of a novel high pathogenic human coronavirus (CoV) in China in December 2019. CoVs are positive‐sense RNA viruses that belong to the subfamily Orthocoronavirinae in the family Coronaviridae (Source: International Committee on Taxonomy of Viruses—ICTV, Taxonomy history: Orthocoronavirinae. Accessed January 24, 2020). This family can be divided into four genera, α‐CoVs, β‐CoVs, γ‐CoVs, and δ‐CoVs. CoV in humans are common, often associated with mild cold symptoms, and include the α‐CoVs HCoV‐229E and HCoV‐NL63, and the β‐CoVs HCoV‐OC43 and HCoV‐HKU1. In addition, to date three high pathogenic CoVs (all β‐CoVs) are recognized in humans and characterized by moderate (MERS‐CoV) or high (SARS‐CoV, SARS‐CoV‐2) transmission rates and association with mortality.
Epidemiology
Anatolia
The novel coronavirus (COVID-19) has been declared a public health emergency of international concern by the World Health Organization. This pandemic has since saturated the headlines of major international media channels that disseminate information to global citizens. However, some media coverage of COVID-19 has negatively influenced Chinese travellers’ mental health due to the outbreak having been labelled “Chinese virus pandemonium.” Key world leaders have also parroted such sensationalism; for example, President Donald Trump called COVID-19 the “Chinese virus”. This discriminatory labelling has resulted in violent attacks on Chinese international travellers and students. This perspective article explores how misleading and discriminatory media reports may affect the mental well-being of ethnically Chinese travellers during the global COVID-19 pandemic.
COVID-19 outbreak, misleading information, media coverage, mental health, psychological well-being
Asian Journal of Psychiatry
Volume 50, April 2020, 102047
Coronavirus disease or commonly known as COVID19 is the news of every single second since it originated from Wuhan, China (Wang et al., 2020), which is declared as a pandemic disease by World Health Organization, said to be caused by a new strain of the virus. The disease is said to spread through droplets of saliva or discharge from the nose of an infected person, particularly when he/she sneezes or coughs (World Health Organization, 2020). Though the human coronaviruses have been recognized now for many years, the lack of immunity to the identified new strain, there is a large portion of the population susceptible to it (Goyal et al., 2020). Besides, the latest trend of the exponential increase in the infected people, with a steep rise of 69.17 % within three days from 21st March 2020 to 23rd March 2020 (Kiprosh, 2020), and because of the lack of preventive vaccine (El Zowalaty and Järhult, 2020), there has been a high panic situation amongst the local public.
Critical Care
Volume 24, Issue 1, Page 119
Since December 2019, the first case of a novel coronavirus (COVID-19) infection pneumonia was detected in Wuhan, and the outbreak has been spreading rapidly in the world. As of February 18, 2020, a total of 73,332 cases of confirmed COVID-19 infection have been detected in the world as reported by the WHO [1, 2]. Given that the asymptomatic persons are potential sources of COVID-19 infection [3], we report a familial cluster case of five patients infected with COVID-19 from an asymptomatic confirmed case in Beijing. We obtained the data of patients, which included demographic, epidemiological, and clinical features; chest radiography; laboratory test; and outcomes. Laboratory confirmation of COVID-19 was detected in the first hospital admission and verified by the Beijing Center for Disease Control and Prevention (CDC).
Epidemiology
Journal of Public Health
The COVID-19 outbreak in China appears to reach the late stage since late March 2020, and a stepwise restoration of economic operations is implemented. Risk assessment for such economic restoration is of significance. Here, we estimated the probability of COVID-19 resurgence caused by work resuming in typical provinces/cities and found that such probability is very limited (<5% for all the regions except Beijing). Our work may inform provincial governments to make risk level-based, differentiated control measures.
Clinical aspects, diagnosis, treatment
Science
COVID-19, caused by the new pandemic coronavirus, is strangely—and tragically—selective. Only some infected people get sick, and although most of the critically ill are elderly or have complicating problems such as heart disease, some killed by the disease are previously healthy and even relatively young. Researchers are now gearing up to scour the patients’ genomes for DNA variations that explain this mystery. The findings could be used to identify those most at risk of serious illness and those who might be protected, and they might also guide the search for new treatments.
Clinical Aspects, Diagnosis, Treatment
The New England Journal of Medicine
The absence of COVID-19 testing for NHS staff is causing huge workforce shortages by forcing doctors to self-isolate even if they do not have the virus, the head of the BMA has warned.
The government’s advice is for people with COVID-19 symptoms to stay at home for seven days, but for all other household members who remain well to isolate for 14 days. The BMA council chairman, Chaand Nagpaul, said that the lack of testing for staff was “counter-intuitive” as it was likely to be forcing more staff than necessary to stay away from hospitals and GP surgeries because they do not know if they are infected.
Epidemiology
The Lancet
We would like to express our concern about the limited capacity of actions taken by the Spanish Government to successfully control the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak and end the exponential growth phase of new cases. The measures taken so far, consisting primarily of partial restriction mobility, are in the right direction, although some researchers have warned about the pressure placed on the building blocks of the health system.
Epidemiology
QJM: An International Journal of Medicine
Prevalent comorbidities for the development of severe pneumonia requiring intensive care unit treatment, acute respiratory distress syndrome (ARDS), and death from Coronavirus disease 2019 (COVID-19) include hypertension, diabetes and cardiovascular disease [1,2]. We posit that drugs commonly used in the treatment of those comorbidities may actually increase the risk of severe pneumonia, ARDS and mortality in the setting of COVID-19; the drugs of primary concern include angiotensin receptor blockers (ARBs) used for blood pressure lowering and statins used for cholesterol lowering.
COVID-19, SARS-CoV-2, Treatment
Radiology
The Coronavirus Disease 2019 (COVID-19) pandemic is evolving rapidly in the United States, widely disrupting personal and professional life, including that of radiology trainees. Reducing the rate at which COVID-19 cases are diagnosed, so-called “flattening the curve,” is a goal both for the public to alleviate strain on the healthcare system, and for healthcare providers to stabilize our workforce. As residents and fellows at multiple institutions throughout the country working in both diagnostic and interventional radiology, the authors of this report provide an overview of major problems that our colleagues and training programs currently face and offer some potential solutions (Figure). We hope this report may serve as a starting point for radiology training programs to proactively assess the impact of the current pandemic on their resident and fellow trainees.
Ethics, social science, economics
The Lancet
Radiologists have watched the coronavirus disease 2019 (COVID-19) pandemic unfold, wondering if and how imaging could be useful for diagnosis. Perhaps imaging could aid in screening or accelerate the speed of diagnosis, especially with shortages of RT-PCR.
Some radiology literature suggests a pivotal role for CT. Ai and colleagues report on 1014 patients who received both RT-PCR and CT in Wuhan, China, during their epidemic. They found that 97% of cases with RT-PCR-confirmed diagnoses had CT findings of pneumonia, and conclude, “CT imaging has high sensitivity for diagnosis of COVID-19”. Other investigators are less optimistic. Inui and colleagues reviewed CT scans of 112 cases of RT-PCR-confirmed COVID-19 from the Diamond Princess cruise ship. Less than two-thirds (61%) of cases had lung opacities on CT; 20% of symptomatic patients had negative CTs.
Clinical aspects, diagnosis, treatment
Circulation
The coronavirus disease 2019 (COVID-19) outbreak in China commenced in Wuhan in December, 2019. The virus spread rapidly due to its robust capacity for human-to-human transmission, long incubation period, and asymptomatic infection characteristics. In the early stages of the outbreak, it was inferred that the nosocomial infection rate could reach 41% without rapid intervention [1]. On January 20, 2020, the Chinese National Health Commission announced that COVID-19 had been included in the list of Class B infectious diseases categorized by the Chinese Law on the Prevention and Control of Infectious Diseases, and should be managed as a Class A infectious disease (for categorization and management principles of infectious diseases, please see Supplemental material I). Strict quarantine measures have been undertaken in Hubei province and other regions of China.
Clinical aspects, diagnosis, treatment
Journal of the Formosan Medical Association
An outbreak of novel coronavirus, severe acute respiratory syndrome corona-virus 2 (SARS-CoV-2) began in Wuhan, China, has spread rapidly. The disease caused by SARS CoV-2 was named as coronavirus disease 2019 (COVID-19) by the World Health Organization. Chest computed tomography (CT) is easily available and is highly strongly recommended for screening patients for rapid confirmation of SARS-CoV-2 infected COVID-19. We report a case with COVID-19 pneumonia which has outlined the main patterns of evolution seen on CT imaging though real-time fluorescence polymerase chain reaction results were negative for a total of four times.
Clinical aspects, diagnosis, treatment
Multiple Sclerosis and Related Disorders
Maria was distraught after reading about the ‘potential’ epidemic, yet to happen, and the horror stories on Facebook needing reassurance and certainty about what she should do. She requested an urgent appoint- ment to review her treatment plan. Maria was a 26-year-old woman with relapsing multiple sclerosis who had recently experienced brainstem relapse with double vision and ataxia despite treatment with pegylated interferon-beta for the last 18 months. A brain MRI performed one month prior had shown 16 new T2 lesions, four of which were enhancing. One of the enhancing lesions was at the pontomedullary junction and was certainly the cause of her relapse. Treatment was to be escalated to ocrelizumab with the first dose in a week's time. In view of the emerging coronavirus pandemic, she was questioning whether or not she should go ahead with ocrelizumab. This was despite only a handful of confirmed COVID-19 cases in the country and none in her town and region.
Clinical aspects, diagnosis, treatment
The European respiratory journal
We read with interest the excellent Association guidelines for the anaesthetic management of patients during a COVID-19 outbreak. We concur with these guidelines, which are not dissimilar to our hospital's protocols since Singapore reported its first case of COVID-19 on 23 January 2020. To date, there have been 226 confirmed cases in Singapore with no deaths reported. We are preparing for many more when community transmission becomes widespread and every patient presenting for surgery becomes a potential asymptomatic infected case. We would like to highlight additional anaesthetic considerations in this COVID-19 pandemic. Our discussion is limited to patients not known to be COVID infected.
Clinical aspects, diagnosis, treatment
Annals of Internal Medicine
The rapidly expanding coronavirus disease 2019 (COVID-19) (SARS–CoV-2) acute respiratory pandemic has assaulted all aspects of daily life. As of 25 March 2020, there were more than 450 000 cases worldwide. In the absence of a vaccine or a therapeutic agent, a “social distancing” strategy is the primary intervention to hamper the spread of infection. A major fear of most governments and individuals is the heavy impact on the health care delivery system. Cumbersome diagnostic testing, inadequate protective supplies for frontline providers and first responders, and limited hospital capacity—including intensive care—have all conspired to create an environment compared to warfare.
Epidemiology; Ethics, social science, economics
The European respiratory journal
The COVID-19 outbreak has resulted in the consideration of videolaryngoscopy (VL) for tracheal intubation of patients during an outbreak. Benefits of VL compared with a standard curved Macintosh (MAC) blade include postural advantages, improved view for the laryngoscopist and assistants, enhanced supervision and easier management of unanticipated difficult airways.
Infection prevention and control