Reply to “Does hand hygiene reduce SARS-CoV-2 transmission?”

Graefe's Archive for Clinical and Experimental Ophthalmology

Lai, Tracy H. T.; Tang, Emily W. H.; Fung, Kitty S. C.; Li, Kenneth K. W.

Dear Editor,

We would like to thank Dr. Chao Yang’s comments to our article. We would like to emphasize that both face masking and hand hygiene are important in preventing the transmission of coronavirus disease 2019 (COVID-19) and are not mutually exclusive. According to the report of the WHO-China joint mission on COVID-19, COVID-19 is transmitted via droplets and fomites during close unprotected contact between an infector and infectee. Airborne spread has not been reported for COVID-19, and it is not believed to be a major driver based on currently available evidence. A recent study by Ong et al. obtained air and surface environmental samples from isolation wards of COVID-19 patients and found the air samples to be negative of SARS-CoV-2, but positive samples were found on multiple environmental surfaces. These sites included the table, bed rail, locker, chair, light switches, door, window, and surfaces in the toilet including the toilet bowl, sink, and door handle. Stool samples were also positive for SARS-CoV-2. Otter and his colleagues found that SARS-CoV and other coronaviruses can survive on environmental surfaces up to 6 days. Furthermore, it is not uncommon that healthcare workers, including ophthalmologists, may overlook the importance of hand hygiene, as frequent face touching is notoriously common that even medical students touched their faces 23 times per hour and 44% of those touches involved contact with mucous membranes.

Keywords

Infection prevention and control

Prevalence And Impact Of Diabetes Among People Infected With SARS-Cov-2

Journal of Endocrinological Investigation

Fadini, G. P.; Morieri, M. L.; Longato, E.; Avogaro, A.

To the Editor,

In December 2019, a new coronavirus causing severe acute respiratory syndrome (SARS-CoV-2) emerged in Wuhan, China. The virus spread rapidly to more than 150 countries and, by the time we are writing (March 19th 2020), it affected > 230,000 individuals causing almost 10,000 deaths.
…

Keywords

Clinical aspects, diagnosis, treatment

Biological Treatment During COVID-19 Outbreak

Journal of Dermatological Treatment

Sriwijitalai, Won; Wiwanitkit, Viroj

Dear Editor,

We read the publication on ‘Should patients stop their biologic treatment during the COVID-19 pandemic’ and found that it is very interesting. Bashyam and Feldman raised an interesting issue for discussion regarding using biological treatment during COVID-19 outbreak. In fact, although there are infected patients worldwide, there has never any reports on biological treatment associated COVID-19. Whether, there is any problem relating to corticosteroid and TNF-α inhibitors in coronavirus infection is an interesting question. In a previous animal model study on coronavirus infection, TNF-α inhibitors did not deteriorate the disease course. Atanasova et al. found that blocking of TNF-α alone was not sufficient to ameliorate the disease. The immunopathology of the new disease is still largely unknown. It might be too early to conclude whether biological treatment should be ceased during COVID-19 outbreak.

Keywords

Clinical aspects, diagnosis, treatment; Epidemiology

COVID-19 Is A Disease Of Older People

The Journals of Gerontology: Series A

Le Couteur, David G.; Anderson, Rozalyn M.; Newman, Anne B.

Introduction

The case-fatality rate for COVID-19 increases dramatically with age from 3% to 5% between 65 and 74 years, 4% to 11% between 75 and 84 years, and 10% to 27% above 85 years and people aged 65 years and older account for 45% of hospitalizations, 53% of intensive care unit (ICU) admissions, and 80% of deaths (1). The first infections with the coronavirus, SARS-CoV-2, were recognized in December 2019 in Wuhan, China and since then, over 80,000 people in China contracted COVID-19, with more than 3,000 deaths (2). The United States has seen an exponential increase in the number of cases with the vast majority of deaths also occurring in people aged 65 years or older. Older people in residential aged care facilities and nursing homes have even greater risk of death given their age and comorbidities, confounded by the lack of capacity for social distancing from staff and other residents.

Keywords

Epidemiology

COVID-19 Outbreak And Inflammatory Bowel Disease Management: A Questionnaire Survey From Realistic Practice

Journal of Crohn's & Colitis

Bai, Xiaoyin; Yang, Hong; Qian, Jiaming

Introduction

Coronavirus disease 2019 [COVID-19] has swept Wuhan and other cities in China since January 2020.1 Despite the preliminary victory of containing the infection following 2 months of effort in China, the pandemic has posed a challenge regarding the routine clinical attention to patients with chronic disease. Inflammatory bowel disease [IBD] is a chronic disease which requires elaborate management. Due to the relative low incidence and prevalence of IBD,2 the limited number of specialists, and the individualised therapeutic approaches in our country, treatment recommendations still depend on the collaborative effort of experts in the high-volume hospitals. Nevertheless, given the severity of COVID-19, patients are adviseded to follow local primary physicians, which may result in unmet medical needs. In addition, most patients with IBD require glucocorticoids, immunomodulators, or biologic agents for a long time, which increases the likelihood of experiencing side effects and compromises the treatment outcome..

Keywords

Clinical aspects, diagnosis, treatment

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

COVID-19 in the Pediatric Population

Dermatologic Therapy

Abdelmaksoud, Ayman; Kroumpouzos, George; Jafferany, Mohammad; Lotti, Torello; Sadoughifar, Roxanna; Goldust, Mohamad

Dear Editor,

On 30 January 2020, the World Health Organization (WHO) declared Coronavirus (CoV) disease 2019 (COVID-19) epidemic as a public health emergency. All age groups are susceptible to COVID-19. Pregnant women are at high risk of acquiring the infection possibly due to the immunologic changes of gestation. However, there is no evidence so far for severe outcomes for mothers. Premature delivery was reported in pregnant patients with COVID1-9 but it was unclear whether it was related to the infection.

Keywords

Epidemiology

COVID-19 Global Pandemic: Options for Management of Gynecologic Cancers

International journal of gynecological cancer: official journal of the International Gynecological Cancer Society

Ramirez, Pedro T.; Chiva, Luis; Eriksson, Ane Gerda Z.; Frumovitz, Michael; Fagotti, Anna; Gonzalez Martin, Antonio; Jhingran, Anuja; Pareja, Rene

Abstract

Our world is facing a devastating crisis in the growing pandemic associated with the coronavirus (COVID-19) disease. As many nations take steps to implement strategies to contain the spread of this disease, we continue to see the tremendous impact this is having on the numerous healthcare workers who unite to overcome this tragic infection. We also recognize the concerns by both physicians and patients as it pertains to the management of patients diagnosed with cancer. We recognize that in this special situation we must continue to provide our gynecologic oncology patients with the highest quality of medical services and at the same time assure that we maximize the safety not only of our patients and their families but also of the medical staff and all associated teams that care for patients both in the inpatient and outpatient settings. To that end, the Editorial Team of the International Journal of Gynecological Cancer have compiled evidence-based data using established guidelines to propose strategies to optimize care of our patients while at the same time offering potential options to alleviate the burden to the healthcare system when resources may need to be diverted to the direct care of patients affected by the coronavirus (COVID-19) disease. Our proposal is intended as a tool for consideration and certainly not as a strategy for permanent change in patterns of practice. The goal is to share options, as gathered collectively by our team, in both the management and surveillance of patients diagnosed with gynecologic cancers during this time of global crisis.

Keywords

Epidemiology

How Sick Will The Coronavirus Make You? The Answer May Be In Your Genes

Science

Kaiser, Jocelyn

Introduction

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.

Keywords

Clinical Aspects, Diagnosis, Treatment

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

Policing the Coronavirus Outbreak: Processes and Prospects for Collective Disorder

Policing: A Journal of Policy and Practice

Reicher, Stephen; Stott, Clifford

Introduction

This briefing is divided into three parts. First, we outline the factors which lead to incidents of collective disorder (or riots). Second, we consider how the overall response to the coronavirus outbreak, and the role of the police within this response, will impact the probability of such disorder. Third, we apply these understandings to three specific scenarios of potential disorder.

Keywords

Epidemiology

Molecular characterization of SARS-CoV-2 from the first case of COVID-19 in Italy

Clinical Microbiology and Infection

Capobianchi, Maria Rosaria; Rueca, Martina; Messina, Francesco; Giombini, Emanuela; Carletti, Fabrizio; Colavita, Francesca; Castilletti, Concetta; Lalle, Eleonora; Bordi, Licia; Vairo, Francesco; Nicastri, Emanuele; Ippolito, Giuseppe; Maria Gruber, Cesare Ernesto; Bartolini, Barbara

 

To the Editor,

On January 29, 2020, two Chinese spouses (patient 1, female; patient 2, male), coming to Italy as tourists from Hubei province, were hospitalized at the National Institute for Infectious Diseases “L. Spallanzani”, Rome, with fever and respiratory symptoms. SARSCoV-2 diagnosis was accomplished using real-time RT-PCR on a nasopharyngeal swab and sputum for patient 1 and on a nasopharyngeal swab for patient 2, collected 1 day after symptom onset. Partial sequencing confirmed both patients to be infected with SARS-CoV-2

Keywords

Clinical aspects, diagnosis, treatment

How should we implement radiotherapy for cancer patients in China during the endemic period of COVID-19?

Radiotherapy and Oncology
Volume 147, 2020, Pages 100-102

Wei, Wei; Jiang, Hao; Chen, Weipeng; Zhou, Yuling; Guo, Shuanshuan; Zhong, Guihua; Zhou, Huaili; Wang, Siyang; Zhang, Hongyu; Jiang, Wen; Liu, Zhi-gang.

Letter to the Editor

Since December 2019, an increasing number of cases of the2019 novel coronavirus disease (COVID-19) infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been identified in Wuhan, a large city of 11 million people in centralChina[1,2]. By February 19, 2020, the rapid spread of the virus had caused 74,280 cases and 2,009 deaths in China. Most cases were identified in Hubei Province, followed by bordering provinces, such as Guangdong Province, Henan Province, Hunan Province, and Anhui Province.

Keywords

COVID-19, SARS-CoV-2, Treatment

Ensuring Animal Welfare During Covid-19 Pandemic

Veterinary Record
Volume 186, Issue 12, Pages 389-389

Aitken, Maureen M.

Introduction

THE RCVS is providing useful advice for veterinary practitioners in the current coronavirus pandemic. However, I feel strongly that we, as veterinary professionals, must recognise the threats to animal welfare that would arise from animal owners being required to self isolate or be in quarantine. It is reassuring that at present ‘social distancing’ allows dog walking and horse riding. It is essential that ‘tending to animals’ should be recognised and clearly stated to be a valid reason for leaving one’s home.

Keywords

Ethics, social science, economics

Molecular characterization of SARS-CoV-2 in the first COVID-19 cluster in France reveals an amino-acid deletion in nsp2 (Asp268Del)

Clinical Microbiology and Infection

Bal, Antonin; Destras, G.; Gaymard, Alexandre; Bouscambert-Duchamp, Maude; Valette, Martine; Escuret, Vanessa; Frobert, Emilie; Billaud, G.; Trouillet-Assant, Sophie; Cheynet, V.; Brengel-Pesce, Karen; Morfin, Florence; Lina, Bruno; Josset, Laurence 

To the Editor

In December 2019, a novel coronavirus emerged in China, causing outbreaks of pneumonia [1]. The virus was subsequently identified as a betacoronavirus and named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). SARS-CoV-2 is responsible for the coronavirus disease 2019 (COVID-19) pandemic which includes asymptomatic upper and lower respiratory tract infections. Among the first European cases of COVID-19, six were associated with a cluster of transmissions in the French Alps in late January 2020 [2]. The index case of this cluster travelled from Singapore to France and went back to the United Kingdom (UK) where he tested positive for SARS-CoV-2 on February 6th. Here, we aimed to investigate the French cases related to this cluster using metagenomic next-generation sequencing (mNGS) analysis.

Keywords

Virology, immunology

SARS-CoV-2: What Do We Know So Far?

Acta physiologica (Oxford, England)

Khedkar, Pratik Hemant; Patzak, Andreas.

Introduction

We are living in times where a viral disease has brought normal life in much of the world to a halt. Named after its causative agent, coronavirus disease 2019 (COVID-19) is caused by a novel coronavirus recently renamed as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 manifests as dry cough, frequent fevers and in severe cases pneumonia. Older patients and patients with underlying comorbidities are at a higher risk of death. We are living in times where a viral disease has brought normal life in much of the world to a halt. Named after its causative agent, coronavirus disease 2019 (COVID-19) is caused by a novel coronavirus recently renamed as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 manifests as dry cough, frequent fevers and in severe cases pneumonia.

Keywords

COVID-19, SARS-CoV-2, Treatment

COVID-19 positive test result from private hospital laboratory, neglecting on reporting and problem on national infection control

Gastrointestinal Endoscopy

Thompson, Christopher C.; Shen, Lin; Lee, Linda S.

To the Editor,

The new coronavirus disease (COVID-19) is a new global public health problem. It already affects more than 140 countries around the world. Thailand is the second country in the timeline of disease pandemic [1]. The infection occurs since early January 2020 and COVID-19 is still uncontrollable problem. The Thai Ministry of Public Health tried several methods for counteracting the disease outbreak. As a legal control, COVID-19 is included into the national list of infectious disease under surveillance. The laws note that when a medical center detects this disease, an official report to governmental Center of Disease Control has to done within 3 hours. If one violates this legal control, there will be punishment.

Keywords

Infection prevention and control

Early Antiviral Treatment Contributes to Alleviate the Severity and Improve the Prognosis of Patients With Novel Coronavirus Disease (COVID-19)

Journal of Internal Medicine

Wu, Jian; Li, Wei; Shi, Xiaowei; Chen, Zhongming; Jiang, Bin; Liu, Jun; Wang, Dawei; Liu, Chengyuan; Meng, Yiling; Cui, Leilei; Yu, Jiong; Cao, Hongcui; Li, Lanjuan

Abstract

Background

At present, the severity of patients infected with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has been a focal point.

Methods

To assess the factors associated with severity and prognosis of patients infected with SARS‐CoV‐2, we retrospectively investigated the clinical, imaging and laboratory characteristics of confirmed 280 cases of novel coronavirus disease (COVID‐19) from 20 January to 20 February 2020.

Results

The median age of patients in the mild group was 37.55 years, whilst that in the severe group was 63.04 years. The proportion of patients aged over 65 years in the severe group was significantly higher than that of the mild group (59.04% vs. 10.15%, P < 0.05). 85.54% of severe patients had diabetes or cardiovascular diseases, which was significantly higher than that of the mild group (51.81% vs. 7.11%, P = 0.025; 33.73% vs. 3.05%, P = 0.042). Patients in the mild group experienced earlier initiation of antiviral treatment (1.19 ± 0.45 vs. 2.65 ± 1.06 days in the severe group, P < 0.001). Our study showed that comorbidity, time from illness onset to antiviral treatment and age >=65 were three major risk factors for COVID‐19 progression, whilst comorbidity and time from illness onset to antiviral treatment were two major risk factors for COVID‐19 recovery.

Conclusions

The elderly and patients with underlying diseases are more likely to experience a severe progression of COVID‐19. It is recommended that timely antiviral treatment should be initiated to slow the disease progression and improve the prognosis.

Keywords

Clinical aspects, diagnosis, treatment; Epidemiology

Potential Effects of Coronaviruses on the Cardiovascular System: A Review

JAMA Cardiology

Madjid, Mohammad; Safavi-Naeini, Payam; Solomon, Scott D.; Vardeny, Orly

Abstract

Importance:  Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19) has reached a pandemic level. Coronaviruses are known to affect the cardiovascular system. We review the basics of coronaviruses, with a focus on COVID-19, along with their effects on the cardiovascular system.

Observations:  Coronavirus disease 2019 can cause a viral pneumonia with additional extrapulmonary manifestations and complications. A large proportion of patients have underlying cardiovascular disease and/or cardiac risk factors. Factors associated with mortality include male sex, advanced age, and presence of comorbidities including hypertension, diabetes mellitus, cardiovascular diseases, and cerebrovascular diseases. Acute cardiac injury determined by elevated high-sensitivity troponin levels is commonly observed in severe cases and is strongly associated with mortality. Acute respiratory distress syndrome is also strongly associated with mortality.

Conclusions and Relevance:  Coronavirus disease 2019 is associated with a high inflammatory burden that can induce vascular inflammation, myocarditis, and cardiac arrhythmias. Extensive efforts are underway to find specific vaccines and antivirals against SARS-CoV-2. Meanwhile, cardiovascular risk factors and conditions should be judiciously controlled per evidence-based guidelines.

Keywords

Clinical aspects, diagnosis, treatment

Cardiovascular Implications of Fatal Outcomes of Patients With Coronavirus Disease 2019 (COVID-19)

JAMA Cardiology

Guo, Tao; Fan, Yongzhen; Chen, Ming; Wu, Xiaoyan; Zhang, Lin; He, Tao; Wang, Hairong; Wan, Jing; Wang, Xinghuan; Lu, Zhibing

Abstract

Importance  Increasing numbers of confirmed cases and mortality rates of coronavirus disease 2019 (COVID-19) are occurring in several countries and continents. Information regarding the impact of cardiovascular complication on fatal outcome is scarce.

Objective  To evaluate the association of underlying cardiovascular disease (CVD) and myocardial injury with fatal outcomes in patients with COVID-19.

Design, Setting, and Participants  This retrospective single-center case series analyzed patients with COVID-19 at the Seventh Hospital of Wuhan City, China, from January 23, 2020, to February 23, 2020. Analysis began February 25, 2020.

Main Outcomes and Measures  Demographic data, laboratory findings, comorbidities, and treatments were collected and analyzed in patients with and without elevation of troponin T (TnT) levels.

Result  Among 187 patients with confirmed COVID-19, 144 patients (77%) were discharged and 43 patients (23%) died. The mean (SD) age was 58.50 (14.66) years. Overall, 66 (35.3%) had underlying CVD including hypertension, coronary heart disease, and cardiomyopathy, and 52 (27.8%) exhibited myocardial injury as indicated by elevated TnT levels. The mortality during hospitalization was 7.62% (8 of 105) for patients without underlying CVD and normal TnT levels, 13.33% (4 of 30) for those with underlying CVD and normal TnT levels, 37.50% (6 of 16) for those without underlying CVD but elevated TnT levels, and 69.44% (25 of 36) for those with underlying CVD and elevated TnTs. Patients with underlying CVD were more likely to exhibit elevation of TnT levels compared with the patients without CVD (36 [54.5%] vs 16 [13.2%]). Plasma TnT levels demonstrated a high and significantly positive linear correlation with plasma high-sensitivity C-reactive protein levels (β = 0.530, P < .001) and N-terminal pro–brain natriuretic peptide (NT-proBNP) levels (β = 0.613, P < .001). Plasma TnT and NT-proBNP levels during hospitalization (median [interquartile range (IQR)], 0.307 [0.094-0.600]; 1902.00 [728.35-8100.00]) and impending death (median [IQR], 0.141 [0.058-0.860]; 5375 [1179.50-25695.25]) increased significantly compared with admission values (median [IQR], 0.0355 [0.015-0.102]; 796.90 [401.93-1742.25]) in patients who died (P = .001; P < .001), while no significant dynamic changes of TnT (median [IQR], 0.010 [0.007-0.019]; 0.013 [0.007-0.022]; 0.011 [0.007-0.016]) and NT-proBNP (median [IQR], 352.20 [174.70-636.70]; 433.80 [155.80-1272.60]; 145.40 [63.4-526.50]) was observed in survivors (P = .96; P = .16). During hospitalization, patients with elevated TnT levels had more frequent malignant arrhythmias, and the use of glucocorticoid therapy (37 [71.2%] vs 69 [51.1%]) and mechanical ventilation (41 [59.6%] vs 14 [10.4%]) were higher compared with patients with normal TnT levels. The mortality rates of patients with and without use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers was 36.8% (7 of 19) and 25.6% (43 of 168).

Conclusions and Relevance  Myocardial injury is significantly associated with fatal outcome of COVID-19, while the prognosis of patients with underlying CVD but without myocardial injury is relatively favorable. Myocardial injury is associated with cardiac dysfunction and arrhythmias. Inflammation may be a potential mechanism for myocardial injury. Aggressive treatment may be considered for patients at high risk of myocardial injury.

Keywords

Clinical aspects, diagnosis, treatment; Epidemiology