The COVID-19 Pandemic – Changing Lives and Lessons Learned

Plastic and Reconstructive Surgery - Global Open

Rohrich, Rod J.; Hamilton, Kristy L.; Avashia, Yash; Savetsky, Ira

Introduction

The COVID-19 pandemic is evolving rapidly, and its course is altering the landscape for all citizens of the world, including plastic surgeons. Much remains unknown. However, an increasing body of evidence is guiding swift global action against the virus. The novel coronavirus, SARS-CoV-2, responsible for COVID-19, was identified in Wuhan, Hubei province, China in December 2019, notably close to a wet animal market that sells poultry, snakes and bats. The virus shares most of its genetic sequence with coronaviruses found in bats and is thought to arise from that animal, although an infected bat with SARS-CoV-2 has not yet been identified to confirm this theory.

Keywords

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

A Primer on Biodefense Data Science for Pandemic Preparedness

Patterns

Perakslis, Eric

Introduction

The coronavirus outbreak is sweeping the globe with outbreaks reported on every continent except Antarctica as of March 2020. Data scientists are uniquely and diversely skilled in ways that can be highly effective in minimizing, combatting, and recovering from the impacts of the COVID-19 outbreak. In this Opinion, the basics of biodefense as well as specific opportunities for the data science community to contribute are discussed.

Keywords

Epidemiology

Maternity Protection-Also During The Corona Crisis

Medizinische Clink, Intensivmedizin und Notfallmedizin

Michels, Guido; Ochmann, Uta; Cranen, Rita.

Abstract

Pregnant employees should be protected, particularly in crisis situations. The Maternity Protection Act states that employees are not allowed to have contact with infectious people, including people with SARS-CoV-2 infections; no new regulation is required here.

Keywords

Clinical aspects, diagnosis, treatment

COVID-19: Advice from the Canadian Association of Gastroenterology for Endoscopy Facilities, as of March 16, 2020

Journal of the Canadian Association of Gastroenterology

Tse, Frances; Borgaonkar, Mark; Leontiadis, Grigorios I.

Introduction

As the number of cases of novel coronavirus disease (COVID-19) rise in Canada and in the rest of the world, and with the designation of COVID-19 as a pandemic by the World Health Organization on March 11, 2020, the Canadian Association of Gastroenterology has issued the following guidance for endoscopy facilities to reduce and delay transmission of COVID-19. COVID-19 is a rapidly evolving global challenge. As endoscopists and physicians, we have the responsibility of protecting our patients, ourselves and other endoscopy personnel from this infection. To this end, we wish to emphasize the importance of following current guidance and advice from Public Health Agency of Canada on infection prevention and control for COVID-19. It is imperative that all endoscopy facilities, whether they are hospital endoscopy units, out-ofhospital premises or independent health facilities, develop institutional protocols and policies that are consistent with national, provincial and local municipal recommendations for infection control to reduce the spread of COVID-19 to both patients and personnel.

Keywords

Clinical aspects, diagnosis, treatment

Telehealth: Helping Your Patients and Practice Survive and Thrive During the COVID-19 Crisis with Rapid Quality Implementation

Journal of the American Academy of Dermatology

Lee, Ivy; Kovarik, Carrie; Tejasvi, Trilokraj; Pizarro, Michelle; Lipoff, Jules B.

To the Editor,

: Telehealth is an effective, efficient way to triage and deliver timely, quality medical care. In the setting of this public health emergency, telemedicine can maintain access and continuity of care for patients, support colleagues on the front line, optimize in-person services, and minimize infectious transmission of COVID-19 coronavirus. On March 17, 2020, the Centers for Medicare & Medicaid Services (CMS) issued a 1135 Waiver and expanded telehealth coverage for all Medicare patients during the COVID-19 pandemic.

Keywords

Ethics, social science, economics

Coronavirus shuts down trials of drugs for multiple other diseases

Nature

Ledford, H.

News

When 2020 began, Neena Nizar and her family were poised to harvest the fruit of a decade of hard work and sacrifice: a clinical trial of an experimental treatment for her two sons’ rare genetic disorder that was slated to start before the year’s end.

Keywords

Ethics, social science, economics

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

Using Psychoneuroimmunity Against COVID-19

Brain, Behavior, and Immunity

Kim, Sung-Wan; Su, Kuan-Pin 

Abstract

The worldwide outbreak of coronavirus disease 2019 (COVID-19) raises concerns of widespread panic and anxiety in individuals subjected to the real or perceived threat of the virus. Compared to general populations, patients who are institutionalized in a closed unit are also very vulnerable to COVID-19 infection and complications. This crisis touched on difficult issues of not only psychiatric care and ethics, but also psychological impacts to psychiatric care givers. In this Viewpoint, we address both physical and biopsychosocial aspects of this infection, as well as the psychoneuroimmunity of preventive strategies of healthy lifestyle, regular exercise, balanced nutrition, quality sleep and a strong connection with people. Social distancing and wearing masks might help us from pathogen exposure, yet such these measures also prevent us from expressing compassion and friendliness. Therefore, all forms of psychological support should be routinely implemented not only to consider psychological resilience but also to enhance psychoneuroimmunity against COVID-19.

Keywords

Epidemiology

Covid-19 and the Digestive System

Journal of gastroenterology and hepatology

Wong, S. H.; Lui, R. N.; Sung, J. J.

Abstract

The novel coronavirus disease (COVID-19) is currently causing a major pandemic. It is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a member of the Betacoronavirus genus that also includes the SARS-CoV and Middle East Respiratory Syndrome Coronavirus (MERS-CoV). While patients typically present with fever and a respiratory illness, some patients also report gastrointestinal symptoms such as diarrhoea, vomiting and abdominal pain. Studies have identified the SARS-CoV-2 RNA in stool specimens of infected patients, and its viral receptor angiotensin converting enzyme 2 (ACE2) was found to be highly expressed in gastrointestinal epithelial cells. These suggest that SARS-CoV-2 can actively infect and replicate in the gastrointestinal tract. This has important implications to the disease management, transmission, and infection control. In this article, we review the important gastrointestinal aspects of the disease.

Keywords

COVID-19, coronavirus, pneumonia, gastrointestinal infection, diarrhoea

Mental Health and Psychological Intervention Amid COVID-19 Outbreak: Perspectives from South Korea

Yonsei Med J

Volume 61, Issue 4, April 2020, Pages 271-272

Jung, Sun Jae; Jun, Jin Yong

Introduction

The 2019 novel coronavirus (2019-nCoV, COVID-19) has been identified as the pathogen behind the pneumonia outbreak in Wuhan, Hubei Province, China, on December 8, 2019. In South Korea, the country’s first patient (who flew in from Wuhan) was identified on January 20, 2020.1 Until February 17, the number of confirmed cases remained relatively stable, with 30 diagnosed patients; however, the situation changed drastically after identification of the 31st patient, and the number of confirmed cases jumped to 2,022 by February 28.

Keywords

Mental health, COVID-19

The effect of human mobility and control measures on the COVID-19 epidemic in China

Science (New York, N.Y.)

Kraemer, M. U. G.; Yang, C. H.; Gutierrez, B.; Wu, C. H.; Klein, B.; Pigott, D. M.; du Plessis, L.; Faria, N. R.; Li, R.; Hanage, W. P.; Brownstein, J. S.; Layan, M.; Vespignani, A.; Tian, H.; Dye, C.; Pybus, O. G.; Scarpino, S. V.

Abstract

The ongoing COVID-19 outbreak expanded rapidly throughout China. Major behavioral, clinical, and state interventions have been undertaken to mitigate the epidemic and prevent the persistence of the virus in human populations in China and worldwide. It remains unclear how these unprecedented interventions, including travel restrictions, affected COVID-19 spread in China. We use real-time mobility data from Wuhan and detailed case data including travel history to elucidate the role of case importation on transmission in cities across China and ascertain the impact of control measures. Early on, the spatial distribution of COVID-19 cases in China was explained well by human mobility data. Following the implementation of control measures, this correlation dropped and growth rates became negative in most locations, although shifts in the demographics of reported cases were still indicative of local chains of transmission outside Wuhan. This study shows that the drastic control measures implemented in China substantially mitigated the spread of COVID-19.

Keywords

COVID-19, Epidemic

Management of IBD during the COVID-19 outbreak: resetting clinical priorities

Nature reviews. Gastroenterology & hepatology

Danese, S.; Cecconi, M.; Spinelli, A.

Comment

Since December 2019 when the 2019 novel coronavirus (2019-nCoV as it was then termed, now named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by the WHO) outbreak had been described in Wuhan, Hubei, China, the situation has dramatically evolved. The pandemic, as declared by the WHO, has led to >300,000 cases worldwide reported as of March 2020, in all continents, excluding Antarctica, spreading on a logarithmic scale in Europe. Italy is currently the second most affected country after China and, as of 13 March 2020, Europe was declared the centre of the pandemic. Because of the very high transmission capacity, the WHO declared the outbreak of coronavirus disease (COVID-19) caused by SARS-CoV-2 infection a public health emergency of international concern.

Keywords

Clinical aspects, diagnosis, 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

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

Identification of Viral Etiology of Acute Respiratory Tract Infections in Children and Adults in Tabanan, Bali, Indonesia

Access Microbiology

Widhidewi, Ni Wayan; Wiyatno, Ageng; Dewantari, Aghnianditya Kresno; Paramasatiari, Lila; Aryastuti, Sri Agung; Artika, I. Nengah; Setiawan, Wayan Doddy; Soebandrio, Amin; Aye Myint, Khin Saw; safari, Dodi

Dear Editor,

Acute respiratory tract infection (ARTI) is the most common infectious disease in humans worldwide. The morbidity and mortality rates are high, especially in developing countries from Southeast Asia and Africa. While ARTI is commonly associated with viruses, there is limited data on the spectrum of viruses causing ARTI in developing countries, including Indonesia. This study was based on utilizing molecular techniques targeting a panel of 11 endemic and emerging respiratory viral pathogens including zoonotic viruses in a cohort of children and adults presenting at Tabanan General Hospital, Bali, with acute respiratory illness, from January to November 2017. In total, 98 out of 200 samples (49.0 %) tested positive for viruses. Our study confirmed 64.3 % viral etiology in children and 12.2 % in adults. Viruses that were detected were Herpesviridae (15.0 %) followed by enteroviruses (12.0 %), influenza A virus (11.5 %), respiratory syncytial virus (8.0 %), Adenoviridae (6.5 %), human metapneumovirus (3.5 %), Paramyxoviridae (2.0 %), bocavirus (1.0 %) and Coronaviridae (0.5 %). The study sheds light on the viral spectrum of ARTI in children and adults in Tabanan, Bali, Indonesia

Keywords

Acute respiratory tract infection, etiology, virus, Bali

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

Pharmacologic Treatments and Supportive Care for Middle East Respiratory Syndrome

Emerging infectious diseases
Volume 26, Issue 6

Kain, Taylor; Lindsay, Patrick J.; Adhikari, Neill K. J.; Arabi, Yaseen M.; Van Kerkhove, Maria D.; Fowler, Robert A.

Abstract

Available animal and cell line models have suggested that specific therapeutics might be effective in treating Middle East respiratory syndrome (MERS). We conducted a systematic review of evidence for treatment with pharmacologic and supportive therapies. We developed a protocol and searched 5 databases for studies describing treatment of MERS and deaths in MERS patients. Risk of bias (RoB) was assessed by using ROBINS-I tool. We retrieved 3,660 unique citations; 20 observational studies met eligibility, and we studied 13 therapies. Most studies were at serious or critical RoB; no studies were at low RoB. One study, at moderate RoB, showed reduced mortality rates in severe MERS patients with extracorporeal membrane oxygenation; no other studies showed a significant lifesaving benefit to any treatment. The existing literature on treatments for MERS is observational and at moderate to critical RoB. Clinical trials are needed to guide treatment decisions.

Keywords

RCT; Clinical aspects, diagnosis, treatment; 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