Clinical journal of the American Society of Nephrology: CJASN
The excellent update on the COVID-19 pandemic by Darlenski and Tsankov1 notes that the conjunctiva is a potential entry point for the infection. With respect to the eye, the American Academy of Ophthalmology has just released an advisory on SARS-CoV-2 stating that there have been several reports to suggest that the virus can cause a mild follicular conjunctivitis.
Epidemiology
The European respiratory journal
On 30 January 2020, the World Health Organization declared that the outbreak of a coronavirus disease-2019 (COVID-19) was a Public Health Emergency of International Concern. The WHO guidance states that patients with COVID-19 should be managed by staff wearing appropriate personal protective equipment; however, working whilst wearing personal protective equipment is unfamiliar to many healthcare professionals. We ran high-fidelity, in situ simulation of high-risk procedures on patients with COVID-19 in a negative-pressure side room on our intensive care unit. Our aim was to identify potential problems, to test the robustness of our systems and to inform modification of our standard operating procedures for any patients with COVID-19 admitted to our intensive care unit. The simulations revealed several important latent risks and allowed us to put corrective measures in place prior to the admission of patients with COVID-19. We recommend that staff working in clinical areas expected to receive patients with COVID-19 conduct in situ simulation in order to detect their own unique risks and aid in the creation of local guidelines of management of patients with COVID-19.
COVID-19; coronavirus; intensive care medicine; simulation
One Health
During the first few months of 2020, the COVID-19 pandemic reached Europe and spread around the world. Health systems all over the world are trying to control the outbreak in the shortest possible time. Exotic disease outbreaks are not uncommon in animal health and randomised surveillance is frequently used as support for decision-making. This editorial discusses the possibilities of practicing One Health, by using methods from animal health to enhance surveillance for COVID-19 to provide an evidence base fort decision-making in communities and countries.
Coronavirus, COVID-19, Disease surveillance, Pandemic, Decision-making
Science (New York, N.Y.)
Volume 367, 2020, Issue 6485, p 1414-1415
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.
Epidemiology
JCO Global Oncology
Volume 6, Page 518-524
Outbreaks of infectious etiology, particularly those caused by a novel virus that has no known treatment or vaccine, may result in the interruption of medical care provided to patients with cancer and put them at risk for undertreatment in addition to the risk of being exposed to infection, a life-threatening event among patients with cancer. This article describes the approach used to manage patients with cancer during a large-scale Middle East respiratory syndrome-coronavirus hospital outbreak in Saudi Arabia to ensure continuity of care and minimize harm from treatment interruption or acquiring infection. The approach taken toward managing this high-risk situation (COVID-19) could be easily adopted by health care organizations and would be helpful to ensure readiness for the occurrence of future outbreaks of different infectious etiologies like those recent episodes of new coronavirus.
Opinion piece; Clinical aspects, diagnosis, treatment
Advances in Radiation Oncology
Dinh, Tru-Khang T.; Halasz, Lia M.; Ford, Eric; Rengan, Ramesh.
On December 31, 2019, a cluster of cases of severe respiratory syndrome was reported in patients with connection to a seafood market in Wuhan, Hubei Province, China1. Within one week, Chinese health authorities were able to link these cases to a novel, enveloped RNA coronavirus, SARS-CoV-2, now commonly known to cause COVID-192. By February 14, 2020, over 66,000 cases of COVID-19 were reported in China3. On January 19, a 35-year-old man returning from Wuhan to his home in Snohomish County, Washington, presented to urgent care with several days of cough and fever and ultimately tested positive for COVID-19, becoming the first case in the United States. The first COVID-related death occurred 4 weeks later, associated with a separate site, along-term care facility in Kirkland, WA, which rapidly became a cluster of 30 fatal cases as of March 16th. At the writing of this article, March 17th, there are 1,012 confirmed cases in the state of Washington, with 52 deaths, primarily in King County. Evergreen Health, the major medical center in Kirkland has recently declared that they have no remaining critical care capacity.
Clinical aspects, diagnosis, treatment
Journal of the Chinese Medical Association: JCMA
The world came to know about a new corona virus infection spreading from Wuhan, China in December 2019. Over the following three months, this respiratory pathogen, named as nCoV2019, SARS CoV-2 or Covid-19 has affected many in the most populous regions of the world and there are growing concerns about it being a pandemic. WHO has reported infection in all continents in its Situation Report-42 published on 2-March-2020 and >3000 deaths
Clinical aspects, diagnosis, treatment
Journal of Religion and Health
This Editorial is being written from my study here in the Hudson Valley in Westchester County just north of New York City. Here I am, as I imagine many of you are, getting used to the “new normal” imposed by the pandemic of the coronavirus. It is a jarring process to get used to the restraint this puts upon us: no movies, no shopping trips, and no evenings out with friends. When we look at our current situation with the perspective now of about a week we realize that these inhibitions are at least for now not insurmountable.
Clinical aspects, diagnosis, treatment
Hastings Center Report
Few novel or emerging infectious diseases have posed such vital ethical challenges so quickly and dramatically as the novel coronavirus SARS-CoV-2. The World Health Organization declared a public health emergency of international concern and recently classified COVID-19 as a worldwide pandemic. As of this writing, the epidemic has not yet peaked in the United States, but community transmission is widespread. President Trump declared a national emergency as fifty governors declared state emergencies. In the coming weeks, hospitals ll become overrun, stretched to their capacities. When the health system becomes stretched beyond capacity, how can we ethically allocate scarce health goods and services? How can we ensure that marginalized populations can access the care they need? What ethical duties do we owe to vulnerable people separated from their families and communities? And how do we ethically and legally balance public health with civil liberties?
COVID-19; allocation of scarce resources; civil liberties; crisis standards of care; novel coronavirus SARS-CoV-2; public health emergency; public health ethics
Dermatologic Therapy
Novel coronavirus (COVID-19), which originated from Wuhan, China, has spread to more than 125 countries s of the world infecting more than 100 000 population.1Apart from being a global health concern, COVID-19 is having major consequences on the world economy, and experts have predicted that COVID-19 will lower global gross domestic product growth by one-half a percentage point for 2020 (from 2.9% to 2.4%). The whole world is now a single global community, where any major happening in one part is bound to have repercussions in rest of the world.
Ethics, social science, economics
RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin
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.
Clinical aspects, diagnosis, treatment
mBio
Volume 11, 2020, Issue 2
As we enter the second quarter of the COVID-19 pandemic, with testing for severe acute respiratory syndrome coronavirus 2 (SARS–CoV-2) increasingly available (though still limited and/or slow in some areas), we are faced with new questions and challenges regarding this novel virus. When to test? Whom to test? What to test? How often to test? And, what to do with test results? Since SARS–CoV-2 is a new virus, there is little evidence to fall back on for test utilization and diagnostic stewardship.
Clinical aspects, diagnosis, treatment; Epidemiology
European Journal of Emergency Medicine
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.
COVID-19, SARS-CoV-2, Treatment
Current Medical Science
During the outbreak of novel coronavirus pneumonia (NCP) in Wuhan, public hospitals have played an important role in intensive care, case guidance and scheme optimization. At the same time, it also faces unprecedented challenges and tests. Based on the treatment of severe patients in Wuhan, combined with the treatment practice in Tongji Hospital affiliated to Tongji Medical College, Huazhong University of Science and Technology, this paper puts forward the urgency of further strengthening the construction of public hospitals, discusses the feasible path for promoting the development of public hospitals, so as to meet the growing medical needs of the people, improve the ability to respond to major public health emergencies, and effectively guarantee the safety of people's lives and the promotion of a healthy China construction.
novel coronavirus pneumonia, public hospital, epidemic prevention and control, public health emergency, construction
Journal of Medical Virology
Abstract In this study, we collected a total of 610 hospitalized patients from Wuhan between Feb 2, 2020, and Feb 17, 2020. We reported a potentially high false negtive rate of RT-PCR testing for SARS-CoV-2 in the 610 hospitalized patients clinically diagnosed with COVID-19 during the 2019 outbreak. We also found that the RT-PCR results from several tests at different points were variable from the same patients during the course of diagnosis and treatment of these patients. Our results indicate that in addition to the emphasis on RT-PCR testing, clinical indicators such as CT images should also be used not only for diagnosis and treatment but also for isolation, recovery/discharge and transferring for hospitalized patients clinically diagnosed with COVID-19 during the current epidemic. These results suggested the urgent needs for standard of procedures(SOP) of sampling from different anatomic sites, sample transportation, optimization of RT-PCR, serology diagnosis/screening for SARS-CoV-2 infection, and distinct diagnosis from other respiratory diseases such as fluenza infections as well. This article is protected by copyright. All rights reserved.
Clinical aspects, diagnosis, treatment
Salud publica de Mexico
The SARS-CoV-2 pandemic is of hich risk for patients on chronic hemodialysis due to their immunosuppressed state, advanced age, and the coexistence of significant comorbidities, in particular cardiovascular disease, diabetes mellitus, and others. Additionally, they constitute a closed conglomerate since they come to treatment regularly, spending hours in the treatment places, exposed to a possible acquisition of the infection. Finally, going to their treatment regularly prevents them from remaining in home isolation and with potential exposure. These recommendations summarize the interventions proposed by three international organizations and add some suggested by national experts, with the aim to early identify the patients and health personnel at risk and reducing the risk of infection.
coronavirus infection; hemodialysis; pandemic; primary prevention; recommendations
MMWR. Morbidity and Mortality Weekly Report
Volume 69, March 2020, Issue 12, p 339-342
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.
Clinical aspects, diagnosis, treatment
Nature
The ongoing outbreak of viral pneumonia in China and beyond is associated with a novel coronavirus, SARS-CoV-2(1). This outbreak has been tentatively associated with a seafood market in Wuhan, China, where the sale of wild animals may be the source of zoonotic infection(2). Although bats are likely reservoir hosts for SARS-CoV-2, the identity of any intermediate host that might have facilitated transfer to humans is unknown. Here, we report the identification of SARS-CoV-2-related coronaviruses in Malayan pangolins (Manis javanica) seized in anti-smuggling operations in southern China. Metagenomic sequencing identified pangolin-associated coronaviruses that belong to two sub-lineages of SARS-CoV-2-related coronaviruses, including one that exhibits strong similarity to SARS-CoV-2 in the receptor-binding domain. The discovery of multiple lineages of pangolin coronavirus and their similarity to SARS-CoV-2 suggests that pangolins should be considered as possible hosts in the emergence of novel coronaviruses and should be removed from wet markets to prevent zoonotic transmission.
Epidemiology
Respiratory Research
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 .
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.
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.
Multiple factors were related to severe 2019 novel coronavirus pneumonia and composite endpoint, and more related studies are needed in the future.
Epidemiological study; Clinical aspects, diagnosis, treatment; Epidemiology
Clinical Infectious Diseases
Mortality from coronavirus disease 2019 (COVID-19) is strongly associated with cardiovascular disease, diabetes, and hypertension. These disorders share underlying pathophysiology related to the renin-angiotensin system (RAS) that may be clinically insightful. In particular, activity of the angiotensin-converting enzyme 2 (ACE2) is dysregulated in cardiovascular disease, and this enzyme is used by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to initiate the infection. Cardiovascular disease and pharmacologic RAS inhibition both increase ACE2 levels, which may increase the virulence of SARS-CoV-2 within the lung and heart. Conversely, mechanistic evidence from related coronaviruses suggests that SARS-CoV-2 infection may downregulate ACE2, leading to toxic overaccumulation of Angiotensin II that induces acute respiratory distress syndrome and fulminant myocarditis. RAS inhibition could mitigate this effect. With conflicting mechanistic evidence, we propose key clinical research priorities necessary to clarify the role of RAS inhibition in COVID-19 mortality that could be rapidly addressed by the international research community.
COVID-19, SARS-CoV-2, Angiotensin-Converting Enzyme 2, Renin-Angiotensin System, Cardiovascular Disease