Syndromic Panels or the Panels' Syndrome? A Perspective Through the Lens of Respiratory Tract Infections

Clinical Microbiology and Infection

Zanella, Marie-Céline; Meylan, Pascal; Kaiser, Laurent 

To the Editor,

We thank Brendish et al for their interest in our commentary and they rightly point out that it was not a systematic review. Our main intention was to provide food for thought and discussion regarding the use of panel assays in the light of some relevant publications. In particular, we aimed at discussing the limitations of their analytical aspects and clinical validation. We respectfully disagree with the statement that “The authors suggest that the increasing use of rapid, automated, syndromic molecular panels for respiratory viruses (RVs) should be abandoned in favor of more limited PCR testing for RVs”. As microbiologists and clinicians, we rather suggest that we have the responsibility to promote diagnostic stewardship in order to integrate these new technologies in clinical management, while considering their strengths and limitations. We also highlight the value of a multiple-step approach of testing that does not necessarily preclude their use.

Keywords

Epidemiology

The Anesthesiologist and COVID-19

Brazilian Journal of Anesthesiology (English Edition)

Vinícius CaldeiraQuintão, Cláudia MarquezSimões, Laís Helena Navarro eLima, Guilherme Antônio Moreira deBarros, Marcello FonsecaSalgado-Filho, Gabriel Magalhães NunesGuimarãesfRodrigo LealAlves, Ana Maria MenezesCaetano, André PratoSchmidt, Maria José Carvalho Carmona 

Abstract

In December 2019, China reported clusters of pneumonia in the city of Wuhan, epidemiologically related to transmission from animals. On December, 31, 2019, the Center for Disease Control and Prevention of China described a new coronavirus and announced the first stage of an outbreak. In addition to coronavirus SARS-CoV and coronavirus MERS-CoV, the world would be facing a new virus that was named SARS-CoV-2, which could lead to a severe acute respiratory syndrome and was named by the World Health Organization Covid-19 (Coronavirus Disease 2019).

Keywords

Epidemiology

The Coronavirus Pandemic: "The Show Must NOT Go On"

The International Journal of Occupational and Environmental Medicine
Volume 11, March 2020, Issue 2, pp 63-64

Habibzadeh, F.; Lang, T.

Abstract

This year, the Chinese New Year celebration coincided with the emergence of a SARS-CoV-2 outbreak in the country. The infection soon spread around the world, so that on March 11, 2020, the World Health Organization declared the outbreak a pandemic. In response, many mainstream journals soon began publishing important and relevant articles so that within a short period, numerous articles were available to the very busy health care workers fighting the disease in the front line of the battle. The virus was completely unknown. Most of health professionals were too busy to review the increasing number of published articles, some of which consisted of science intertwined with superstitions…

Keywords

Epidemiology

Covid-19: Hospitals Brace For Disaster As US Surpasses China In Number Of Cases

BMJ (Clinical Research ed.)
Volume 368, 2020, m1278-m1278

Dyer, Owen.

Introduction

The US has become the country with the most confirmed cases of covid-19 with 86 762 diagnoses on the morning of 27 March—more than China or Italy—and 1306 deaths. The rise in cases is steeper in the US than in any other large country. Almost half of US cases are in the state of New York while neighbouring New Jersey has the second-most cases. Texas and some other states now require people coming from New York to self-quarantine. But there are multiple cases in every US state and every sizeable city, with prominent clusters in New Orleans, Detroit, Chicago, Miami, Atlanta, and the Denver region.

Keywords

Epidemiology

The Eye and COVID-19 Pandemic

Clinical journal of the American Society of Nephrology: CJASN

Hoenig, Leonard J.

 

Introduction

The excellent update on the COVID-19 pandemic by Darlenski and Tsankov1 notes that the conjunctiva is a potential entry point for the infection. With respect to the eye, the American Academy of Ophthalmology has just released an advisory on SARS-CoV-2 stating that there have been several reports to suggest that the virus can cause a mild follicular conjunctivitis.

Keywords

Epidemiology

Managing Oncology Services During a Major Coronavirus Outbreak: Lessons From the Saudi Arabia Experience

JCO Global Oncology
Volume 6, Page 518-524

g Jia, Xiaowen Hu, Feng Yang, Xin Song, Liyan Dong, Jingfei Zhang, Fachun Jiang and Ruqin G

Abstract

Outbreaks of infectious etiology, particularly those caused by a novel virus that has no known treatment or vaccine, may result in the interruption of medical care provided to patients with cancer and put them at risk for undertreatment in addition to the risk of being exposed to infection, a life-threatening event among patients with cancer. This article describes the approach used to manage patients with cancer during a large-scale Middle East respiratory syndrome-coronavirus hospital outbreak in Saudi Arabia to ensure continuity of care and minimize harm from treatment interruption or acquiring infection. The approach taken toward managing this high-risk situation (COVID-19) could be easily adopted by health care organizations and would be helpful to ensure readiness for the occurrence of future outbreaks of different infectious etiologies like those recent episodes of new coronavirus.

Keywords

Opinion piece; Clinical aspects, diagnosis, treatment

Analysis of clinical characteristics and laboratory findings of 95 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a retrospective analysis

Respiratory Research

Zhang, Gemin; Zhang, Jie; Wang, Bowen; Zhu, Xionglin; Wang, Qiang; Qiu, Shiming.

Abstract

Background

Since December 2019, 2019 novel coronavirus pneumonia emerged in Wuhan city and rapidly spread throughout China and even the world. We sought to analyse the clinical characteristics and laboratory findings of some cases with 2019 novel coronavirus pneumonia .

Methods

In this retrospective study, we extracted the data on 95 patients with laboratory-confirmed 2019 novel coronavirus pneumonia in Wuhan Xinzhou District People’s Hospital from January 16th to February 25th, 2020. Cases were confirmed by real-time RT-PCR and abnormal radiologic findings. Outcomes were followed up until March 2th, 2020.

Results

Higher temperature, blood leukocyte count, neutrophil count, neutrophil percentage, C-reactive protein level, D-dimer level, alanine aminotransferase activity, aspartate aminotransferase activity, α - hydroxybutyrate dehydrogenase activity, lactate dehydrogenase activity and creatine kinase activity were related to severe 2019 novel coronavirus pneumonia and composite endpoint, and so were lower lymphocyte count, lymphocyte percentage and total protein level. Age below 40 or above 60 years old, male, higher Creatinine level, and lower platelet count also seemed related to severe 2019 novel coronavirus pneumonia and composite endpoint, however the P values were greater than 0.05, which mean under the same condition studies of larger samples are needed in the future.

Conclusion

Multiple factors were related to severe 2019 novel coronavirus pneumonia and composite endpoint, and more related studies are needed in the future.

Keywords

Epidemiological study; Clinical aspects, diagnosis, treatment; Epidemiology

Strengthening China's Public Health Response System: From SARS to COVID-19

American Journal of Public Health

Bouey, Jennifer.

Abstract

Today, the world is experiencing a pandemic caused by a novel coronavirus. COVID-19 is the third disease from a coronavirus to cause a global outbreak, after severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), and the second that emerged from China. During the 17 years between the SARS and the COVID-19 outbreaks, China has quadrupled its share of the world economy, lifted hundreds of millions of people out of poverty, and established a national health insurance system covering 95% of its 1.4 billion people. Will China's public health response to a coronavirus epidemic be different this time? (Am J Public Health. Published online ahead of print March 26, 2020: e1-e2. doi:10.2105/AJPH.2020.305654).

Keywords

Epidemiology, COVID-19, SARS-CoV-2, Treatment

The different clinical characteristics of coronavirus disease cases between children and their families in China - the character of children with COVID-19

Emerging microbes & infections
Volume 9, 2020, Issue 3, pp 707-713

Su, L.; Ma, X.; Yu, H.; Zhang, Z.; Bian, P.; Han, Y.; Sun, J.; Liu, Y.; Yang, C.; Geng, J.; Gai, Z.

Abstract

This study aims to analyze the different clinical characteristics between children and their families infected with severe acute respiratory syndrome coronavirus 2. Clinical data from nine children and their 14 families were collected, including general status, clinical, laboratory test, and imaging characteristics. All the children were detected positive result after their families onset. Three children had fever (22.2%) or cough (11.2%) symptoms and six (66.7%) children had no symptom. Among the 14 adult patients, the major symptoms included fever (57.1%), cough (35.7%), chest tightness/pain (21.4%), fatigue (21.4%) and sore throat (7.1%). Nearly 70% of the patients had normal (71.4%) or decreased (28.6%) white blood cell counts, and 50% (7/14) had lymphocytopenia. There were 10 adults (71.4%) showed abnormal imaging. The main manifestations were pulmonary consolidation (70%), nodular shadow (50%), and ground glass opacity (50%). Five discharged children were admitted again because their stool showed positive result in SARS-CoV-2 PCR. COVID-19 in children is mainly caused by family transmission, and their symptoms are mild and prognosis is better than adult. However, their PCR result in stool showed longer time than their families. Because of the mild or asymptomatic clinical process, it is difficult to recognize early for pediatrician and public health staff.

Keywords

Epidemiology

Angiotensin Converting Enzyme 2 As The Molecular Bridge Between Epidemiologic And Clinical Features Of COVID-19

Canadian Journal of Cardiology

Bombardini, Tonino; Picano, Eugenio

Introduction

Pre-existent cardiovascular disease is a recognized risk factor for COVID-19 infection (1). COVID-19 spike protein uses the angiotensin-converting-enzyme 2 (ACE2) as the binding site to enter the host cell in tongue, bronchi and lungs. Any condition enhancing the expression of ACE2 would increase the vulnerability to infection. Heart failure, coronary artery disease, hypertension, diabetes, ACE inhibitors (ACEi) or angiotensin receptor blockers (ARBs) increase the expression of ACE2, which can be considered nature's endogenous ACE inhibitor at the cellular level. The renin-angiotensin system has 2 arms (Figure, upper panel): the pressor (conventional) arm, composed of Angiotensin II, angiotensin-converting-enzyme (ACE), Angiotensin II-type 1 receptor (AT1R), and the depressor (non conventional) arm consisting of Angiotensin 1-7, ACE2, MAS receptor (MAS R) and Angiotensin II, type 2 receptor (AT2R) (2). The ACE2 (the "good" guy, possibly "the best of enzymes") arm opposes the conventional arm and has beneficial effects in heart failure and acute respiratory distress syndrome (ARDS) (3). COVID-19 spike protein is the "ugly" character in the play. It uses the "good" ACE2 as the binding site. While ACE is detectable in the entire capillary network of the alveoli in the human lung, ACE2 is primarily produced in club cells of distal bronchioles and type 2 pneumocytes in alveolar epithelium. Both cell types are involved in preventing ARDS.

Keywords

Epidemiology

Suggestions for safety and protection control in Department of Nuclear Medicine during the outbreak of COVID-19 (Copy)

European journal of nuclear medicine and molecular imaging

Zhang, X.; Shao, F.; Lan, X.

Body

Dear Sir,

Since December 2019, a novel coronavirus disease named COVID-19 broke out in Wuhan, Hubei province, China, and then spread throughout the country. At present, growing cases have been found in other countries with a rapid growth rate, and the world moves closer toward worldwide spread of the virus. European Centre for Disease Prevention and Control (EDCD) had raised the risk infection level of COVID-19 from medium to high for its severe situation. The virus spread rapidly from person to person through the droplets of respiratory and close contact, and everyone can be infected. The common clinical symptoms of COVID-19 include fever, cough, and myalgia or fatigue. Old men with comorbidities are more likely to have severe or even fatal respiratory diseases, such as acute respiratory distress syndrome. In our department, four highly suspected patients with COVID-19 underwent [18F]-FDG PET/CT in January 2020. PET and SPECT are routine examinations for clinical diagnosis of various diseases and appropriate protective measures should be carried out during this epidemic...

Keywords

Opinion piece; Epidemiology

COVID-19: ban 'orientalism' by critics of wildlife trade

Infectious Disease Reports
Volume 12, March 2020, Issue 1, 8543

Pagani-Nunez, E.

Correspondence

Western voices claim that China needs “to discredit engrained cultural beliefs” to make the country’s ban on wildlife trade workable.

Keywords

COVID-19, SARS-CoV-2, Wildlife

How blood from coronavirus survivors might save lives

Nature

Maxmen, A.

News

Hospitals in New York City are gearing up to use the blood of people who have recovered from COVID-19 as a possible antidote for the disease. Researchers hope that the century-old approach of infusing patients with the antibody-laden blood of those who have survived an infection will help the metropolis — now the US epicentre of the outbreak — to avoid the fate of Italy, where intensive-care units (ICUs) are so crowded that doctors have turned away patients who need ventilators to breathe.

Keywords

Normative guidance; Clinical aspects, diagnosis, treatment

Football cannot restart soon during the COVID-19 emergency! A critical perspective from the Italian experience and a call for action

British journal of sports medicine

Corsini, A.; Bisciotti, G. N.; Eirale, C.; Volpi, P.

Introduction

In early 2020, the world is facing a global emergency called COVID-19 (coronavirus disease 2019). On 11 March 2020, the WHO has declared the ‘Pandemic state’ calling the governments to take ‘urgent and aggressive action’ to delay and mitigate the peak of infection.

The seriousness of the situation is evidenced by the extreme uncertainty of the measures taken by the governments of the various countries to stem the pandemic spread.

From 8 March 2020, the Italian Government implemented extraordinary measures to decrease the pathogen spread, targeting social distancing between individuals. The law focused on closing the commercial business, limiting the sporting activities and decreasing the opportunity for social gatherings. The most important issue has been the sharp increase in the number of people infected which is causing a significant increase in acute respiratory failure cases (severe acute respiratory syndrome coronavirus 2 (SARS-COV-2)) and acute respiratory distress syndrome requiring hospital admission and intensive care treatment. Contrary from what was thought at the beginning, young people are also affected by the disease and can develop the severe respiratory conditions mentioned above.

Initially, despite the outbreak phenomenon, professional sports were not stopped, and on 11 March 2020, the first football player belonging to Italian Serie A tested positive …

Keywords

Epidemiology

Routes for COVID-19 importation in Brazil

Journal of travel medicine

Candido, D. D. S.; Watts, A.; Abade, L.; Kraemer, M. U. G.; Pybus, O. G.; Croda, J.; Oliveira, W.; Khan, K.; Sabino, E. C.; Faria, N. R.

Abstract

The global outbreak caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has been declared a pandemic by the WHO. As the number of imported SARS-CoV-2 cases is on the rise in Brazil, we use incidence and historical air travel data to estimate the most important routes of importation into the country.

Keywords

Coronavirus, brazil, disease outbreaks, severe acute respiratory syndrome, air travel, pandemics, sars-cov-2, covid-19

Immediate Health Surveillance Response to COVID-19 Epidemic

Epidemiologia e servicos de saude: revista do Sistema Unico de Saude do Brasil
Volume 29, 2020, Issue 1, e2020002

Croda, J. H. R.; Garcia, L. P.

Introduction

On December 31st 2019 the World Health Organization (WHO) was notified of the occurrence of a pneumonia outbreak in the city of Wuhan, Hubei Province, People’s Republic of China. The etiological agent was rapidly identified as a novel coronavirus: SARS-COV-2 The outbreak began in a seafood and live animals market and, as at the date of this publication, the animal reservoir is unknown.

The first Emergency Committee meeting about the novel coronavirus outbreak in China, convened by WHO in accordance with the International Health Regulations (IHR) (2005), was held on January 23rd 2020. Consensus was not reached by that meeting as to whether the event was a Public Health Emergency of International Concern (PHEIC). At its second meeting, held on January 30th, the number of cases and countries reporting confirmed cases were seen to have increased and this lead to the outbreak being declared a PHEIC…

Keywords

Epidemiology

An Ounce of Prevention: Coronavirus (COVID-19) and Mass Gatherings

Cureus
Volume 12, Issue 3, 27345

Escher, A. R., Jr.

Abstract

Widespread, non-stop, and often sensational coverage of the coronavirus (COVID-19) has caught many governments flat-footed in efforts to protect the health and safety of their citizens. In response to the current global health event, the World Health Organization (WHO) declared COVID-19 a pandemic. Mass gatherings present a historic challenge in protecting the health and safety of attendees. The majority of the prominent mass gatherings are religious in nature. Global sporting events, such as the Olympics and the World Cup, pose unique health risks to attendees and host nations. Deferment or cancellation of such mass gatherings may exert an extraordinary economic loss to the host nation. Universal adoption of best practices for infection control is the surest way for governments to prepare for mass gatherings. In these uncertain times, it is up to intergovernmental organizations to be the voice of reason.

Keywords

COVID-19, Epidemiology

Serological and molecular findings during SARS-CoV-2 infection: the first case study in Finland, January to February 2020

Euro surveillance: European communicable disease bulletin

Haveri, A.; Smura, T.; Kuivanen, S.; Osterlund, P.; Hepojoki, J.; Ikonen, N.; Pitkapaasi, M.; Blomqvist, S.; Ronkko, E.; Kantele, A.; Strandin, T.; Kallio-Kokko, H.; Mannonen, L.; Lappalainen, M.; Broas, M.; Jiang, M.; Siira, L.; Salminen, M.; Puumalainen, T.; Sane, J.; Melin, M.; Vapalahti, O.; Savolainen-Kopra, C.

Abstract

The first case of coronavirus disease (COVID-19) in Finland was confirmed on 29 January 2020. No secondary cases were detected. We describe the clinical picture and laboratory findings 3-23 days since the first symptoms. The SARS-CoV-2/Finland/1/2020 virus strain was isolated, the genome showing a single nucleotide substitution to the reference strain from Wuhan. Neutralising antibody response appeared within 9 days along with specific IgM and IgG response, targeting particularly nucleocapsid and spike proteins.

Keywords

Clinical aspects, diagnosis, treatment; Epidemiology

Potential therapeutic options for coronavirus disease 2019: using knowledge of past outbreaks to guide future treatment

Chinese medical journal

Lin, J.; Ouyang, J.; Peng, X. R.; Isnard, S.; Fombuena, B.; Routy, J. P.; Chen, Y. K.

Introduction

In December 2019, initial cases of the novel coronavirus (2019-nCov) infection, termed Coronavirus Disease 2019 (COVID-19), were first reported in Wuhan, China. In humans, infections with the human coronavirus 229E, OC43, NL63 and HKU1 usually result in mild, self-limiting upper respiratory tract infections. However, other variants have rapid transmission rates and can cause severe respiratory syndrome and death. These variants include severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome coronavirus (MERS-CoV), and the current 2019-nCov…

Keywords

By Comparative study, RCT; Normative guidance; Clinical aspects, diagnosis, treatment; Epidemiology

Human Coronaviruses: General Features

Reference Module in Biomedical Sciences
2019

ARTICLE IN PRESS

Xin Li, Hayes K. H. Luk, Susanna K. P. Lau, Patrick C. Y. Woo

Abstract

Human coronaviruses (HCoVs), including HCoV-229E, HCoV-OC43, HCoV-NL63, and HCoV-HKU1, are traditionally known to cause symptoms of common cold with only moderate clinical impact. Severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), on the other hand, have strike humans in the past two decades as highly fatal human pathogens leading to considerable mortality and economic loss. This article summaries the updates on the structure, genome organization, replication and clinical features of human coronaviruses. Recent studies also shed light upon the zoonotic origin of emerging human pathogens including SARS-CoV and MERS-CoV, providing insight for future surveillance and intervention.

Keywords

Epidemiology, Genome, Human coronavirus, MERS, Replication, SARS, Structure