A Randomized Trial Of Instructor-Led Training Versus Video Lesson In Training Health Care Providers In Proper Donning And Doffing Of Personal Protective Equipment

Disaster Medicine and Public Health Preparedness

Christensen, Liva; Rasmussen, Charlotte Schang; Benfield, Thomas; Franc, Jeffrey Michael

Abstract

Objective: This study compared live instructor-led training with video-based instruction in personal protective equipment (PPE) donning and doffing. It assessed the difference in performance between (1) attending 1 instructor-led training session in donning and doffing PPE at 1 month prior to assessment, and (2) watching training videos for 1 month.

Methods: This randomized controlled trial pilot study divided 21 medical students and junior doctors into 2 groups. Control group participants attended 1 instructor-led training session. Video group participants watched training videos demonstrating the same procedures, which they could freely watch again at home. After 1 month, a doctor performed a blind evaluation of performance using checklists.

Results: Nineteen participants were assessed after 1 month. The mean donning score was 84.8/100 for the instructor-led group and 88/100 for the video group; mean effect size was 3.2 (95% CI: -7.5 to 9.5). The mean doffing score was 79.1/100 for the instructor-led group and 73.9/100 for the video group; mean effect size was 5.2 (95% CI: -7.6 to 18).

Conclusion: Our study found no significant difference in donning and doffing scores between instructor-led and video lessons. Video training could be a fast and resource-efficient method of training in PPE donning and doffing in responding to the COVID-19 pandemic.

Keywords

personal protective equipment, coronavirus, video training, randomized trial

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

Consensus Guidelines For Managing The Airway In Patients With COVID-19

Anaesthesia

Cook, T. M.; El-Boghdadly, K.; McGuire, B.; McNarry, A. F.; Patel, A.; Higgs, A..

Abstract

Severe acute respiratory syndrome-corona virus-2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), is highly contagious. Airway management of patients with COVID-19 is high risk to staff and patients. We aimed to develop principles for airway management of patients with COVID-19 to encourage safe, accurate and swift performance. This consensus statement has been brought together at short notice to advise on airway management for patients with COVID-19, drawing on published literature and immediately available information from clinicians and experts. Recommendations on the prevention of contamination of healthcare workers, the choice of staff involved in airway management, the training required and the selection of equipment are discussed. The fundamental principles of airway management in these settings are described for: emergency tracheal intubation; predicted or unexpected difficult tracheal intubation; cardiac arrest; anaesthetic care; and tracheal extubation. We provide figures to support clinicians in safe airway management of patients with COVID-19. The advice in this document is designed to be adapted in line with local workplace policies.

Keywords

airway; anaesthesia; coronavirus; COVID-19; critical care; difficult airway; intubation

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

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

Coronavirus (Covid-19) outbreak on the cruise ship Diamond Princess

International maritime health
Volume 71, Issue 1

Dahl, E.

Introduction

The whole world has recently been following the media frenzy covering the quarantine of Diamond Princess, the first cruise ship that had an outbreak of coronavirus illness (Covid-19) on board. It developed soon after the occurrence of China’s Covid-19 outbreak, which — according to the World Health Organization (WHO) — “poses a very grave threat for the rest of the world” and should be viewed as “Public Enemy Number 1” [1]. Lasting more than 14 days, the ship quarantine is unprecedented for the cruise industry, and some maritime health issues of concern may be worth addressing already shortly after the interned passengers and crew had finally disembarked the vessel.

Keywords

coronavirus, COVID-19, outbreak, passengers, crew, cruise ship medicine

SARS-CoV-Encoded Small RNAs Contribute to Infection-Associated Lung Pathology

Cell Host and Microbes
Volume 21, Issue 3, 8 March 2017, Pages 344-355

Lucía Morales, Juan Carlos Oliveros, Raúl Fernandez-Delgado, Benjamin Robertten Oever, Luis Enjuanes, and Isabel Sola

Abstract

Severe acute respiratory syndrome coronavirus (SARS-CoV) causes lethal disease in humans, which is characterized by exacerbated inflammatory response and extensive lung pathology. To address the relevance of small non-coding RNAs in SARS-CoV pathology, we deep sequenced RNAs from the lungs of infected mice and discovered three 18–22 nt small viral RNAs (svRNAs). The three svRNAs were derived from the nsp3 (svRNA-nsp3.1 and -nsp3.2) and N (svRNA-N) genomic regions of SARS-CoV. Biogenesis of CoV svRNAs was RNase III, cell type, and host species independent, but it was dependent on the extent of viral replication. Antagomir-mediated inhibition of svRNA-N significantly reduced in vivo lung pathology and pro-inflammatory cytokine expression. Taken together, these data indicate that svRNAs contribute to SARS-CoV pathogenesis and highlight the potential of svRNA-N antagomirs as antivirals.

Keywords

coronavirus, SARS-CoV, small viral RNAs, virus-host interaction, lung inflammatory pathology, antagomirs, deep sequencing, non-coding RNAs, innate immune response, antiviral

Bat-to-human: spike features determining ‘host jump’ of coronaviruses SARS-CoV, MERS-CoV, and beyond

Trends in Microbiology
Volume 23, Issue 8, August 2015, Pages 468-478

Guangwen Lu, Qihui Wang, George F. Gao

Abstract

Both severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) are zoonotic pathogens that crossed the species barriers to infect humans. The mechanism of viral interspecies transmission is an important scientific question to be addressed. These coronaviruses contain a surface-located spike (S) protein that initiates infection by mediating receptor-recognition and membrane fusion and is therefore a key factor in host specificity. In addition, the S protein needs to be cleaved by host proteases before executing fusion, making these proteases a second determinant of coronavirus interspecies infection. Here, we summarize the progress made in the past decade in understanding the cross-species transmission of SARS-CoV and MERS-CoV by focusing on the features of the S protein, its receptor-binding characteristics, and the cleavage process involved in priming.

Keywords

coronavirus, interspecies transmission, viral and host determinants, spike (S), SARS-CoV, MERS-CoV

Palmitoylation of SARS-CoV S protein is necessary for partitioning into detergent-resistant membranes and cell–cell fusion but not interaction with M protein

Virology
Volume 405, Issue 1, 15 September 2010, Pages 139-148

Corrin E., McBride Carolyn, E. Machamer

Abstract

Coronaviruses are enveloped RNA viruses that generally cause mild disease in humans. However, the recently emerged coronavirus that caused severe acute respiratory syndrome (SARS-CoV) is the most pathogenic human coronavirus discovered to date. The SARS-CoV spike (S) protein mediates virus entry by binding cellular receptors and inducing fusion between the viral envelope and the host cell membrane. Coronavirus S proteins are palmitoylated, which may affect function. Here, we created a non-palmitoylated SARS-CoV S protein by mutating all nine cytoplasmic cysteine residues. Palmitoylation of SARS-CoV S was required for partitioning into detergent-resistant membranes and for cell–cell fusion. Surprisingly, however, palmitoylation of S was not required for interaction with SARS-CoV M protein. This contrasts with the requirement for palmitoylation of mouse hepatitis virus S protein for interaction with M protein and may point to important differences in assembly and infectivity of these two coronaviruses.

Keywords

coronavirus, SARS-CoV, spike, palmitoylation, fusion, detergent-resistant membranes, trafficking

The Use of Bovine Serum Protein as an Oral Support Therapy Following Coronavirus Challenge in Calves

Journal of Dairy Science
Volume 85, Issue 5, May 2002, Pages 1249-1254

J. D. Arthington, C. A. Jaynes, H. D. Tyler, S. Kapil, and J. D. Quigley

Abstract

The objective of this experiment was to investigate the therapeutic efficacy of a supplemental bovine serum protein blend fed to calves challenged with virulent coronavirus. Twelve Holstein bull calves (approximately 3 wk of age) were allocated by initial body weight to Control (n = 5) and treated (n = 7) groups. On d 0, all calves were orally challenged with 1 × 107 plaque forming units of virulent coronavirus isolate. Infection was allowed to progress for 24 h before treatment was started. On d 1, treated calves began receiving 160 g of dry bovine serum powder (16 g IgG) mixed into milk replacer powder (67 g) at both an a.m. and p.m. feeding. Control calves received only milk replacer powder (227 g) at both feedings. Response to coronavirus challenge and dietary treatment was monitored prior to a.m. and p.m. feeding by the collection of multiple clinical measures. Fecal consistency was decreased by coronavirus challenge but was not affected by dietary treatment. Mean daily rectal temperature and heart rate were not affected by dietary treatment. Average packed cell volume was higher in treated calves than in control (35.0 and 27.0%). Coronavirus challenge resulted in an immediate increase in respiration rate, decreasing by d 7. Control calves tended to have a greater average respiration rate compared with treated (28.7 vs. 26.8 breaths/min). Treated calves had a higher average feed intake than control (0.57 vs. 0.44 kg/d). These data suggest that bovine-serum supplemented milk replacer may decrease the severity of disease in young calves exposed to coronavirus.

Keywords

bovine serum, coronavirus, calf

ECG changes after rabbit coronavirus infection

Journal of Electrocardiology
Volume 32, Issue 1, January 1999, Pages 21-32

Lorraine K.Alexander DRPH, Bruce W.Keene DVM, Boyd L.Yount BS, Joachim Dieter Geratz MD, J.David Small DVM, MPH, Ralph S.Baric PhD

Abstract

This study examines the electrocardiographic (ECG) changes following rabbit coronavirus (RbCV) infection. We have shown that infection with RbCV results in the development of myocarditis and congestive heart failure and that some survivors of RbCV infection go on to develop dilated cardiomyopathy in the chronic phase. Serial ECGs were recorded on 31 RbCV-infected rabbits. Measurements of heart rate; P-R interval; QRS duration; QTc interval; and P-, QRS-, and T-wave voltages were taken. The recordings were also examined for disturbances of conduction, rhythm, and repolarization. The acute and subacute phases were characterized by sinus tachycardia with depressed R- and T-wave voltages as well as disturbances of conduction, rhythm, and repolarization. In most animals in the chronic phase, the sinus rate returned to near-baseline values with resolution of the QRS voltage changes. The ECG changes observed during RbCV infection are similar to the spectrum of interval/segment abnormalities, rhythm disturbances, conduction defects, and myocardial pathology seen in human myocarditis, heart failure, and dilated cardiomyopathy. Because animals often died suddenly in the absence of severe clinical signs of congestive heart failure during the acute phase, RbCV infection may increase ventricular vulnerability, resulting in sudden cardiac death. RbCV infection may provide a rare opportunity to study sudden cardiac death in an animal model in which the ventricle is capable of supporting ventricular fibrillation, and invasive techniques monitoring cardiac function can be performed.

Keywords

coronavirus, myocarditis, heart failure, ECG

Coronavirus, Infection and Immunity

Encyclopedia of Immunology (Second Edition)
1998, Pages 658-661

HelmutWege

Abstract

The family of Coronaviridae was defined around 1968, primarily by morphologic criteria. The virions are pleomorphic to spherical-shaped particles (120–160 nm diameter), which are surrounded by a fringe of club- or pear-shaped surface projections (12–24 nm long; Figure 1). The virus has a lipid envelope and contains a single-stranded RNA genome of positive polarity. Coronaviruses infect humans, mammals and birds. Based on molecular criteria, the toroviruses represent a second genus within this family. Furthermore, evolutionary relationships to the Arteriviridae are discussed within the concept of a ‘coronavirus-like’ superfamily.

Keywords

Coronaviridae,  virions, coronavirus, Arteriviridae

Roles in Cell-to-Cell Fusion of Two Conserved Hydrophobic Regions in the Murine Coronavirus Spike Protein

Virology
Volume 244, Issue 2, 10 May 1998, Pages 483-494

Zongli Luo, Susan R.Weiss

Abstract

The spike (S) protein of coronavirus, mouse hepatitis virus (MHV), mediates attachment and fusion during viral entry and cell-to-cell fusion later in infection. By analogy with other viral proteins that induce cell fusion the MHV S protein would be expected to have a hydrophobic stretch of amino acids that serves as a fusion peptide. Sequence analysis suggests that the S protein falls within the group of fusion proteins having internal rather than N-terminal fusion peptides. Based on the features of known viral fusion peptides, we identified two regions (PEP1 and PEP2) of MHV-A59 S2 as possible fusion peptides. Site-directed mutagenesis and an in vitrocell-to-cell fusion assay were used to evaluate the roles of PEP1 and PEP2, as well as a third previously identified putative fusion domain (PEP3) in membrane fusion. Substitution of bulky hydrophobic residues with charged residues within PEP1 affects the fusion activity of the S protein without affecting processing and surface expression. Similar substitutions within PEP2 result in a fusion-negative phenotype; however, these mutant S proteins also exhibit defects in protein processing and surface expression which likely explain the loss of the ability to induce fusion. Thus PEP1 remains a candidate fusion peptide, while PEP2 may play a significant role in the overall structure or oligomerization of the S protein. PEP3 is an unlikely putative fusion peptide since it is not conserved among coronaviruses and nonconservative amino acid substitutions in PEP3 have minimal effects on cell-to-cell fusion.

Keywords

cell-to-cell, coronavirus, mouse hepatitis virus, protein