COVID-19 drives new threat to bats in China

Infectious Disease Reports
Vol. 367, Issue 6485, pp. 1436

Zhao, H.

Introduction

As pandemic coronavirus disease 2019 (COVID-19) continues to accelerate, the French Health Minister, Olivier Véran, has confused matters by claiming on Twitter that anti-inflammatory drugs like ibuprofen or cortisone could aggravate the infection (1). However, scientific evidence does not indicate that nonsteroidal anti-inflammatory drug (NSAID) consumption puts patients who otherwise might have mild or asymptomatic infection by severe acute respiratory syndrome–coronavirus 2 (SARS-CoV-2)—the virus that causes COVID-19—at risk of more severe disease. People taking NSAIDs for other reasons should not stop doing so for fear of increasing their COVID-19 risk

Keywords

COVID-19, SARS-CoV-2, Treatment

With COVID-19, modeling takes on life and death importance

Science (New York, N.Y.)
Volume 367, 2020, Issue 6485, p 1414-1415

Enserink, M.; Kupferschmidt, K.

Introduction

Jacco Wallinga's computer simulations are about to face a high-stakes reality check. Wallinga is a mathematician and the chief epidemic modeler at the National Institute for Public Health and the Environment (RIVM), which is advising the Dutch government on what actions, such as closing schools and businesses, will help control the spread of the novel coronavirus in the country.

Keywords

Epidemiology

CT morphology of COVID-19: Case report and review of literature

RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin

Hamer, Okka Wilkea; Salzberger, Bernd; Gebauer, Johannes; Stroszczynski, Christian; Pfeifer, Michael.

Introduction

In December 2019 a clustering of pneumonia was reported for the first time in Wuhan, Hubei, China. A coronavirus was identified as the pathogen, which has since been given the name Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The disease caused by SARS-CoV-2 is called COVID-19 which has since spread worldwide. In Germany, the numbers continue to increase, and the level of COVID-19 lethality in Europe cannot yet be accurately estimated. However, lethality appears to be particularly higher in older patients compared to seasonal influenza. Based on experience in China, computed tomography (CT) is very helpful in COVID-19 in that it can produce an image that is suggestive for diagnosis, and the sensitivity of CT is in some cases higher than that of the current gold standard, real-time polymerase chain reaction (RT-PCR).

The aim of this article is to present a case with COVID-19 pneumonia and to provide an overview of the existing radiological literature on COVID-19.

Keywords

Clinical aspects, diagnosis, treatment

COVID-19, a UK perspective

European Journal of Emergency Medicine

Sriskandar, Joanna; Bloom, Benjamin.

Introduction

On 31 December 2019, the WHO was informed of new cases of pneumonia of unknown etiology. On 7 January 2020, a novel coronavirus was identified as the cause of the pneumonia. The organism has subsequently been named SARS-CoV-2 and the disease it causes COVID-19 [1]. By 22 January, Public Health England (PHE) published its first news report on the novel virus. On the 23 January 2020, the Emergency Department (ED) at Royal London Hospital swabbed its first potential COVID-19 patient. As of 9 March, in the UK, 24 641 people have tested negative, 319 tested positive and three people have died and were positive for SARS-CoV-2.

Keywords

COVID-19, SARS-CoV-2, Treatment

COVID-19 in a Long-Term Care Facility - King County, Washington, February 27-March 9, 2020

MMWR. Morbidity and Mortality Weekly Report
Volume 69, March 2020, Issue 12, p 339-342

McMichael, T. M.; Clark, S.; Pogosjans, S.; Kay, M.; Lewis, J.; Baer, A.; Kawakami, V.; Lukoff, M. D.; Ferro, J.; Brostrom-Smith, C.; Riedo, F. X.; Russell, D.; Hiatt, B.; Montgomery, P.; Rao, A. K.; Currie, D. W.; Chow, E. J.; Tobolowsky, F.; Bardossy, A. C.; Oakley, L. P.; Jacobs, J. R.; Schwartz, N. G.; Stone, N.; Reddy, S. C.; Jernigan, J. A.; Honein, M. A.; Clark, T. A.; Duchin, J. S.

Abstract

On February 28, 2020, a case of coronavirus disease (COVID-19) was identified in a woman resident of a long-term care skilled nursing facility (facility A) in King County, Washington.* Epidemiologic investigation of facility A identified 129 cases of COVID-19 associated with facility A, including 81 of the residents, 34 staff members, and 14 visitors; 23 persons died. Limitations in effective infection control and prevention and staff members working in multiple facilities contributed to intra- and interfacility spread. COVID-19 can spread rapidly in long-term residential care facilities, and persons with chronic underlying medical conditions are at greater risk for COVID-19-associated severe disease and death. Long-term care facilities should take proactive steps to protect the health of residents and preserve the health care workforce by identifying and excluding potentially infected staff members and visitors, ensuring early recognition of potentially infected patients, and implementing appropriate infection control measures.

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

COVID-19 Outbreak and Surgical Practice: Unexpected Fatality in Perioperative Period (Copy)

Annals of surgery

Aminian, Ali; Safari, Saeed; Razeghian-Jahromi, Abdolali; Ghorbani, Mohammad; Delaney, Conor P.

Abstract

Little is known about surgical practice in the initial phase of coronavirus disease 2019 (COVID-19) global crisis. This is a retrospective case series of 4 surgical patients (cholecystectomy, hernia repair, gastric bypass, and hysterectomy) who developed perioperative complications in the first few weeks of COVID-19 outbreak in Tehran, Iran in the month of February 2020. COVID-19 can complicate the perioperative course with diagnostic challenge and a high potential fatality rate. In locations with widespread infections and limited resources, the risk of elective surgical procedures for index patient and community may outweigh the benefit.

Keywords

Clinical aspects, diagnosis, treatment

Should Scientists Infect Healthy People with the Coronavirus to Test Vaccines?

Nature

Callaway, Ewen

Introduction

As hundreds of millions of people, maybe billions, avoid social contact to spare themselves and their communities from coronavirus, researchers are discussing a dramatic approach to research that could help end the pandemic: infecting a handful of healthy volunteers with the virus to rapidly test a vaccine.

Keywords

Clinical aspects, diagnosis, treatment

COVID-19: faecal-oral transmission?

Nature reviews. Gastroenterology & hepatology

Hindson, J.

Research Highlights

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, which causes coronavirus disease 2019 (COVID-19), first emerged in China in December 2019 and has now spread worldwide, with a reported 351,731 confirmed cases and 15,374 deaths as of 23 March 2020 according to John Hopkins University. The infection is typically characterized by respiratory symptoms, which indicates droplet transmission.

Keywords

COVID-19, SARS-CoV-2, Treatment

Tilorone: a Broad-Spectrum Antiviral Invented in the USA and Commercialized in Russia and beyond

Pharmaceutical research
Volume 37, 2020, Issue 4, 71

Ekins, S.; Lane, T. R.; Madrid, P. B.

Abstract

For the last 50 years we have known of a broad-spectrum agent tilorone dihydrochloride (Tilorone). This is a small-molecule orally bioavailable drug that was originally discovered in the USA and is currently used clinically as an antiviral in Russia and the Ukraine. Over the years there have been numerous clinical and non-clinical reports of its broad spectrum of antiviral activity. More recently we have identified additional promising antiviral activities against Middle East Respiratory Syndrome, Chikungunya, Ebola and Marburg which highlights that this old drug may have other uses against new viruses. This may in turn inform the types of drugs that we need for virus outbreaks such as for the new coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Tilorone has been long neglected by the west in many respects but it deserves further reassessment in light of current and future needs for broad-spectrum antivirals.

Keywords

Antiviral, broad spectrum, interferon inducers, respiratory virus infections

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

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

Characteristic ECG Manifestations in Patients with COVID-19

Canadian Journal of Cardiology

He, Jia; Wu, Bo; Chen, Yaqin; Tang, Jianjun; Liu, Qiming; Zhou, Shenghua; Chen, Chen; Qin, Qingwu; Huang, Kang; Lv, Jianlei; Chen, Yan; Peng, Daoquan.

Abstract

Cardiac involvement has been reported in patients with COVID-19, which may be reflected by ECG changes. Two COVID-19 cases in our report exhibited different ECG manifestations as the disease caused deterioration. The first case presented temporary SIQIIITIII morphology followed by reversible nearly complete atrioventricular block, while the second demonstrated ST segment elevation accompanied by multifocal ventricular tachycardia. The underlying mechanisms of these electrocardiographic abnormalities in the severe stage of COVID-19 may be attributed to hypoxia and inflammatory damage incurred by the virus.

Keywords

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

Comorbidity and its impact on 1590 patients with Covid-19 in China: A Nationwide Analysis

European Journal of Neurology

Guan, Wei-Jie; Liang, Wen-Hua; Zhao, Yi; Liang, Heng-Rui; Chen, Zi-Sheng; Li, Yi-Min; Liu, Xiao-Qing; Chen, Ru-Chong; Tang, Chun-Li; Wang, Tao; Ou, Chun-Quan; Li, Li; Chen, Ping-Yan; Sang, Ling; Wang, Wei; Li, Jian-Fu; Li, Cai-Chen; Ou, Li-Min; Cheng, Bo; Xiong, Shan; Ni, Zheng-Yi; Xiang, Jie; Hu, Yu; Liu, Lei; Shan, Hong; Lei, Chun-Liang; Peng, Yi-Xiang; Wei, Li; Liu, Yong; Hu, Ya-Hua; Peng, Peng; Wang, Jian-Ming; Liu, Ji-Yang; Chen, Zhong; Li, Gang; Zheng, Zhi-Jian; Qiu, Shao-Qin; Luo, Jie; Ye, Chang-Jiang; Zhu, Shao-Yong; Cheng, Lin-Ling; Ye, Feng; Li, Shi-Yue; Zheng, Jin-Ping; Zhang, Nuo-Fu; Zhong, Nan-Shan; He, Jian-Xing.

Abstract

BACKGROUND: The coronavirus disease 2019 (Covid-19) outbreak is evolving rapidly worldwide. OBJECTIVE: To evaluate the risk of serious adverse outcomes in patients with coronavirus disease 2019 (Covid-19) by stratifying the comorbidity status. METHODS: We analysed the data from 1590 laboratory-confirmed hospitalised patients 575 hospitals in 31 province/autonomous regions/provincial municipalities across mainland China between December 11(th), 2019 and January 31(st), 2020. We analyse the composite endpoints, which consisted of admission to intensive care unit, or invasive ventilation, or death. The risk of reaching to the composite endpoints was compared according to the presence and number of comorbidities. RESULTS: The mean age was 48.9 years. 686 patients (42.7%) were females. Severe cases accounted for 16.0% of the study population. 131 (8.2%) patients reached to the composite endpoints. 399 (25.1%) reported having at least one comorbidity. The most prevalent comorbidity was hypertension (16.9%), followed by diabetes (8.2%). 130 (8.2%) patients reported having two or more comorbidities. After adjusting for age and smoking status, COPD [hazards ratio (HR) 2.681, 95% confidence interval (95%CI) 1.424-5.048], diabetes (HR 1.59, 95%CI 1.03-2.45), hypertension (HR 1.58, 95%CI 1.07-2.32) and malignancy (HR 3.50, 95%CI 1.60-7.64) were risk factors of reaching to the composite endpoints. The HR was 1.79 (95%CI 1.16-2.77) among patients with at least one comorbidity and 2.59 (95%CI 1.61-4.17) among patients with two or more comorbidities. CONCLUSION: Among laboratory-confirmed cases of Covid-19, patients with any comorbidity yielded poorer clinical outcomes than those without. A greater number of comorbidities also correlated with poorer clinical outcomes.

Keywords

Clinical aspects, diagnosis, treatment

Clinical and CT features of early-stage patients with COVID-19: a retrospective analysis of imported cases in Shanghai, China

The European respiratory journal

Yang, Shuyi; Shi, Yuxin; Lu, Hongzhou; Xu, Jianqing; Li, Feng; Qian, Zhiping; Hua, Xinyan; Ding, Xueting; Song, Fengxiang; Shen, Jie; Lu, Yang; Shan, Fei; Zhang, Zhiyong.

To the Editor,

Since December 2019, some patients with novel corona virus infectious disease (COVID-19) emerged in Wuhan, Hubei, China. The pathogen analysis discovered a new type of coronavirus from infected airway epithelial cells and named as sever acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2). At the time of Chinese people were heading home for celebrating the Spring Festival, many latent cases left Wuhan, which led to the emergence of imported COVID-19 cases across the mainland of China and some other countries. Shanghai is one of the major cities with imported cases.

Keywords

COVID-19, SARS-CoV-2, Treatment

National Institute for the Infectious Diseases "L. Spallanzani", IRCCS. Recommendations for COVID-19 clinical management

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

Nicastri, E.; Petrosillo, N.; Bartoli, T. A.; Lepore, L.; Mondi, A.; Palmieri, F.; D'Offizi, G.; Marchioni, L.; Murachelli, S.; Ippolito, G.; Antinori, A.

Abstract

On January 9 2020, the World Health Organization (WHO) declared the identification, by Chinese Health authorities, of a novel coronavirus, further classified as SARS-CoV-2 responsible of a disease (COVID-19) ranging from asymptomatic cases to severe respiratory involvement. On March 9 2020, WHO declared COVID-19 a global pandemic. Italy is the second most affected country by COVID-19 infection after China. The "L. Spallanzani" National Institute for the Infectious Diseases, IRCCS, Rome, Italy, has been the first Italian hospital to admit and manage patients affected by COVID-19. Hereby, we show our recommendations for the management of COVID-19 patients, based on very limited clinical evidences; they should be considered as expert opinions, which may be modified according to newly produced literature data.

Keywords

COVID-19, SARS-CoV-2, Treatment

Audio interview: Making decisions about testing and treatment for your patients

New England Journal of Medicine
Volume 382, Issue 11, March 2020, Page 1

Rubin, E. J.; Baden, L. R.; Morrissey, S.

Introduction

The rapid spread of SARS-CoV-2, a novel corona- virus that emerged in late 2019, and the resulting Covid-19 disease has been labeled a Public Health Emergency of International Concern by the World Health Organization.

Keywords

Epidemiology

AJN On The Web Clinical And High-Resolution CT Features Of The COVID-19 Infection: Comparison Of The Initial And Follow-Up Changes

AJN The American Journal of Nursing
Volume 120, Issue 3, March 2020, Page 13

Xiong, Ying; Sun, Dong; Liu, Yao; Fan, Yanqing; Zhao, Lingyun; Li, Xiaoming; Zhu, Wenzhen.

Abstract

Objectives: In late December, 2019, an outbreak of coronavirus disease (COVID-19) in Wuhan, China was caused by a novel coronavirus, newly named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We aimed to quantify severity of COVID-19 infection on High-Resolution CT and to determine its relationship with clinical parameters.

Materials and methods: From Jan 11, 2020, to Feb 5, 2020, the clinical, laboratory and HRCT features of 42 patients (26-75 years, 25 males) with COVID-19 were analyzed. The initial and follow-up CT obtained a mean of 4.5 days and 11.6 days from the illness onset were retrospectively assessed for the severity and progression of pneumonia. Correlations among clinical parameters, initial CT features and progression of opacifications were evaluated with Spearman correlation and linear regression analysis.

Results: Thirty-five (83%) patients exhibited a progressive process according to CT features during the early stage from onset. Follow-up CT findings showed progressive opacifications, consolidation, interstitial thickening, fibrous strips and air bronchograms, compared to initial CT (all p<0.05). Before regular treatments, there was a moderate correlation between the days from onset and sum score of opacifications (R=0.68, p<0.01). The C-reactive protein, erythrocyte sedimentation rate and lactate dehydrogenase showed significantly positive correlation with the severity of pneumonia assessed on initial CT (R range 0.36-0.75, p<0.05). The highest temperature and the severity of opacifications assessed on initial CT were significantly related to the progression of opacifications on follow-up CT (p=0.001-0.04).

Conclusions: Patients with the COVID-19 infection usually presented with typical ground-grass opacities and other CT features, which showed significant correlations with some clinical and laboratory measurements. Follow-up CT images often demonstrated progressions during the early stage from illness onset.

.

Keywords

COVID-19, SARS-CoV-2, viral pneumonia, clinical features, Computed Tomography, follow-up