Neurosurgery During The COVID-19 Pandemic: Update From Lombardy, Northern Italy

Acta Neurochirurgica

Zoia, Cesare; Bongetta, Daniele; Veiceschi, Pierlorenzo; Cenzato, Marco; Di Meco, Francesco; Locatelli, Davide; Boeris, Davide; Fontanella, Marco M.

Introduction

Since February, 21st 2020, when the first person infected was reported in Lombardy, Italy rapidly became home to a massive Coronavirus Disease 2019 (COVID-19) outbreak. Currently, on 21th March, 53,578 COVID-19 cases have been confirmed in Italy. 6072 patients are now hospitalized. The number of deaths has risen to 4825 while 6072 were declared healed [4]. This data shows that Italy is, currently, the second most affected nation in the world by the epidemic, second only to China

Keywords

RCT; Clinical aspects, diagnosis, treatment

Special Attention To Nurses’ Protection During The COVID-19 Epidemic

Critical Care

Huang, Lishan; Lin, Guanwen; Tang, Li; Yu, Lingna; Zhou, Zhilai

 

Abstract

As of March 8, 2020, the novel coronavirus disease 2019 (COVID-19) had caused 80,815 human infections and 3073 deaths in China, including more than 3000 infections among medical staff. Guangdong Second Provincial General Hospital (Guangzhou, Guangdong Province, China), a provincial emergency hospital, has treated more than 35 confirmed cases of COVID-19 and more than 260 suspected cases. Most of nurses’ work involves direct contact with patients. As nurses have high vulnerability to COVID-19, it is necessary to establish hospital-specific protocols to reduce the risk of nurses’ infection in interactions with COVID-19 patients. Our hospital has maintained a “zero nurse infection” rate while battling SARS in 2003 and during the present COVID-19 epidemic. The following are the key measures implemented in our hospital.

Keywords

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

Clinical Observation And Management Of COVID-19 Patients

Emerging Microbes & Infections
Volume 9, 2020, Issue 1,`pp 687-690

Li, T.; Lu, H.; Zhang, W.

Abstract

Three leading infectious disease experts in China were invited to share their bedside observations in the management of COVID-19 patients. Professor Taisheng Li was sent to Wuhan to provide frontline medical care. He depicts the clinical course of SARS-CoV-2 infection. Furthermore, he observes the significant abnormality of coagulation function and proposes that the early intravenous immunoglobulin and low molecular weight heparin anticoagulation therapy are very important. Professor Hongzhou Lu, a leader in China to try various anti-viral drugs, expresses concern on the quality of the ongoing clinical trials as most trials are small in scale and repetitive in nature, and emphasizes the importance of the quick publication of clinical trial results. Regarding the traditional Chinese medicine, Professor Lu suggests to develop a creative evaluation system because of the complicated chemical compositions. Professor Wenhong Zhang is responsible for Shanghai's overall clinical management of the COVID-19 cases. He introduces the team approach to manage COVID-19 patients. For severe or critically ill patients, in addition to the respiratory supportive treatment, timely multiorgan evaluation and treatment is very crucial. The medical decisions and interventions are carefully tailored to the unique characteristics of each patient.

Keywords

Clinical aspects, diagnosis, treatment

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

SARS-CoV-2 Infection in a Pediatric Department in Milan: A Logistic Rather Than a Clinical Emergency

The Pediatric Infectious Disease Journal

Chidini, Giovanna; Villa, Cristina; Calderini, Edoardo; Marchisio, Paola; De Luca, Daniele

Introduction

The number of subjects infected with SARS-Cov-2 is dramatically increasing in Lombardy, Northern Italy, since February 21, 2020, leading to an infection chain that represents the largest coronavirus disease 2019 (CoVID-19) outbreak in Europe to date. Nowadays, few SARS-Cov-2–positive children have been admitted to pediatric departments. In winter season, a huge number of children with acute respiratory failure needs to be hospitalized in pediatric ward/ pediatric intensive care units if ventilated. This setting could be very difficult to have clinical criteria aiming to isolate suspected SARS-CoVID-2 children to avoid spreading of infection among health care professionals, other patients and visitors. The aim of this report is to document our experience in facing pediatric CoVID-19 emergency in Milan.

Keywords

Clinical aspects, diagnosis, treatment

Epidemiological, clinical and virological characteristics of 74 cases of coronavirus-infected disease 2019 (COVID-19) with gastrointestinal symptoms

Gut

Jin, X.; Lian, J. S.; Hu, J. H.; Gao, J.; Zheng, L.; Zhang, Y. M.; Hao, S. R.; Jia, H. Y.; Cai, H.; Zhang, X. L.; Yu, G. D.; Xu, K. J.; Wang, X. Y.; Gu, J. Q.; Zhang, S. Y.; Ye, C. Y.; Jin, C. L.; Lu, Y. F.; Yu, X.; Yu, X. P.; Huang, J. R.; Xu, K. L.; Ni, Q.; Yu, C. B.; Zhu, B.; Li, Y. T.; Liu, J.; Zhao, H.; Zhang, X.; Yu, L.; Guo, Y. Z.; Su, J. W.; Tao, J. J.; Lang, G. J.; Wu, X. X.; Wu, W. R.; Qv, T. T.; Xiang, D. R.; Yi, P.; Shi, D.; Chen, Y.; Ren, Y.; Qiu, Y. Q.; Li, L. J.; Sheng, J.; Yang, Y.

Abstract

OBJECTIVE: The SARS-CoV-2-infected disease (COVID-19) outbreak is a major threat to human beings. Previous studies mainly focused on Wuhan and typical symptoms. We analysed 74 confirmed COVID-19 cases with GI symptoms in the Zhejiang province to determine epidemiological, clinical and virological characteristics.

DESIGN: COVID-19 hospital patients were admitted in the Zhejiang province from 17 January 2020 to 8 February 2020. Epidemiological, demographic, clinical, laboratory, management and outcome data of patients with GI symptoms were analysed using multivariate analysis for risk of severe/critical type. Bioinformatics were used to analyse features of SARS-CoV-2 from Zhejiang province. RESULTS: Among enrolled 651 patients, 74 (11.4%) presented with at least one GI symptom (nausea, vomiting or diarrhoea), average age of 46.14 years, 4-day incubation period and 10.8% had pre-existing liver disease. Of patients with COVID-19 with GI symptoms, 17 (22.97%) and 23 (31.08%) had severe/critical types and family clustering, respectively, significantly higher than those without GI symptoms, 47 (8.14%) and 118 (20.45%). Of patients with COVID-19 with GI symptoms, 29 (39.19%), 23 (31.08%), 8 (10.81%) and 16 (21.62%) had significantly higher rates of fever >38.5 degrees C, fatigue, shortness of breath and headache, respectively. Low-dose glucocorticoids and antibiotics were administered to 14.86% and 41.89% of patients, respectively. Sputum production and increased lactate dehydrogenase/glucose levels were risk factors for severe/critical type. Bioinformatics showed sequence mutation of SARS-CoV-2 with m(6)A methylation and changed binding capacity with ACE2.

CONCLUSION: We report COVID-19 cases with GI symptoms with novel features outside Wuhan. Attention to patients with COVID-19 with non-classic symptoms should increase to protect health providers.

Keywords

Clinical aspects, diagnosis, treatment

Unrevealing sequence and structural features of novel coronavirus using in silico approaches: The main protease as molecular target

EXCLI journal
Volume 19, March 2020, pp 400-409

Ortega, J. T.; Serrano, M. L.; Pujol, F. H.; Rangel, H. R.

Abstract

Direct-acting antivirals are effective tools to control viral infections. SARS-CoV-2 is a coronavirus associated with the epidemiological outbreak in late 2019. Previous reports showed that HIV-1 protease inhibitors could block SARS-CoV main protease. Based on that and using an in silico approach, we evaluated SARS-CoV-2 main protease as a target for HIV-1 protease inhibitors to reveal the structural features related to their antiviral effect. Our results showed that several HIV inhibitors such as lopinavir, ritonavir, and saquinavir produce strong interaction with the active site of SARS-CoV-2 main protease. Furthermore, broad library protease inhibitors obtained from PubChem and ZINC (www.zinc.docking.org) were evaluated. Our analysis revealed 20 compounds that could be clustered into three groups based on their chemical features. Then, these structures could serve as leading compounds to develop a series of derivatives optimizing their activity against SARS-CoV-2 and other coronaviruses. Altogether, the results presented in this work contribute to gain a deep understanding of the molecular pharmacology of SARS-CoV-2 treatment and validate the use of protease inhibitors against SARS-CoV-2.

Keywords

Clinical aspects, diagnosis, treatment