Videolaryngoscopy Increases 'Mouth-To-Mouth' Distance Compared With Direct Laryngoscopy

The European respiratory journal

Hall, D.; Steel, A.; Heij, R.; Eley, A.; Young, P.

Abstract

The COVID-19 outbreak has resulted in the consideration of videolaryngoscopy (VL) for tracheal intubation of patients during an outbreak. Benefits of VL compared with a standard curved Macintosh (MAC) blade include postural advantages, improved view for the laryngoscopist and assistants, enhanced supervision and easier management of unanticipated difficult airways.

Keywords

Infection prevention and control

Race to find COVID-19 treatments accelerates

Science (New York, N.Y.)
Volume 367, 2020, Issue 6485, P 1412-1413

Kupferschmidt, K.; Cohen, J.

Abstract

With cases of the new coronavirus disease 2019 (COVID-19) climbing steeply everywhere from Madrid to Manhattan , overwhelming one hospital after another and pushing the global death toll past 17,000, the sprint to find treatments has dramatically accelerated. Drugs that stop the novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), could save the lives of severely ill patients, protect health care workers and others at high risk of infection, and reduce the time patients spend in hospital beds.

Keywords

Clinical aspects, diagnosis, treatment

Does hand hygiene reduce SARS-CoV-2 transmission?

Graefe's Archive for Clinical and Experimental Ophthalmology

Yang, Chao.

Letter To The Editor

Tracy share their experience of stepping up infection control measures in ophthalmology to minimize COVID19 infection of both healthcare workers and patients, and emphasize universal masking, hand hygiene, and appropriate use of personal protective equipment (PPE). However, whether hand hygiene is “particularly important” for SARS-CoV-2 infection control needs further study, as there is no convincing evidence that this prevention tool is effective in the SARS-CoV-2 epidemic…

Keywords

Infection prevention and control

What Dermatologists Could Do To Cope With The Novel Coronavirus (SARS-Cov-2): A Dermatologist's Perspective From China

Journal of the European Academy of Dermatology and Venereology: JEADV

Zhang, Hanlin; Tang, Keyun; Fang, Rouyu; Sun, Qiuning

Abstract

Coronavirus disease, first emerged in Wuhan, China, rapidly spread all over the country since December 2019. Up to now, the epidemic situation in China remains stable, while the global march of the virus is seemingly unstoppable, especially in South Korea, Iran, and Italy. Here, we reported what dermatologists could do to cope with novel coronavirus from a Chinese dermatologist's perspective.

Keywords

Clinical aspects, diagnosis, treatment

Influenza Immunization Among Chinese Seniors: Urgent Calling For Improving Vaccination Coverage, Education, And Research

AGING MEDICINE
Volume 3, Issue 1

Li, Xin; Leng, Sean X.

Background

It is with great pleasure that we provide this commentary with a focus on influenza vaccination for an expert consensus entitled “Recommendations for influenza and Streptococcus pneumoniae vaccination in elderly people in China” to be published in this issue of Aging Medicine. Influenza is a major global public health burden with pandemic threat. Seasonal influenza infection is responsible for 3‐5 million severe illness cases and 290 000‐650 000 respiratory deaths annually worldwide.  According to the Centers for Disease Control and Prevention (CDC), influenza affects 5%‐20% of the population each year in the United States. It is estimated that influenza causes 226 000 excess hospitalizations, 25 000‐69 000 deaths, and US $87 billion excess health‐care cost with over 600 000 life‐years lost annually. Among all infectious diseases, influenza is foremost in its age‐related increase in serious complications, leading to hospitalization, catastrophic disability, and death in older adults. Moreover, influenza frequently causes exacerbation of many chronic conditions that are common in older adults, including cardiovascular diseases, further indirectly impacting senior health and mortality. In fact, over 90% of influenza‐related mortality occurs in persons aged over 65 years. In the United States, influenza and its secondary pneumonia are the fourth leading cause of death in this population. Therefore, prevention and treatment of influenza in older adults have become a major public health priority.

Keywords

COVID-19, SARS-CoV-2, Treatment

Economic and Monetary Union at twenty: a stocktaking of a tumultuous second decade: introduction

Journal of European Integration
Volume 42, 2020, Issue 3, Pages 287-293

Howarth, David; Verdun, Amy

Abstract

This contribution discusses the two main asymmetries of European Economic and Monetary Union (EMU) as they developed over the past two decades since the launch of the Single Currency. From the outset, EMU involved asymmetric degrees of integration in the area of ‘economic’ union (less centralised governance) versus ‘monetary’ union (more supranational governance). With the outbreak of the Sovereign Debt Crisis in 2010, the regime-shaping relevance of a second asymmetry emerged: one roughly between the member states of the Euro Area ‘core’ and those in the ‘periphery’. Each of the two asymmetries have created a range of challenges — institutional, policy and political — that undermine the stability and sustainability of the EMU project.

Keywords

Clinical aspects, diagnosis, treatment; Epidemiology

A Systems Approach To Preventing And Responding To COVID-19

EClinicalMedicine

Bradley, Declan Terence; Mansouri, Mariam Abdulmonem; Kee, Frank; Garcia, Leandro Martin Totaro

Introduction

A novel zoonotic coronavirus, SARS-CoV-2 has resulted in a pandemic of respiratory infection. COVID-19 has provoked restrictive infection control measures, social and economic disruption, and expressions of racism. Systems thinking can help policymakers understand and influence the spread of infection and its multifaceted consequences across the community since society is itself a complex adaptive system. It can provide a framework to look beyond the chain of infection and better understand the multiple implications of decisions and (in)actions in face of such a complex situation involving many interconnected factors. Causal loop diagrams (CLDs) are tools to depict the causal connections between components of a system, and illustrate how changes in one component cascade in changes in others and back to itself, via feedback loops, potentially affecting the status of the entire system.

Keywords

Epidemiology

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

Clinical And Immunologic Features In Severe And Moderate Coronavirus Disease 2019

The Journal of Clinical Investigation

Chen, Guang; Wu, Di; Guo, Wei; Cao, Yong; Huang, Da; Wang, Hongwu; Wang, Tao; Zhang, Xiaoyun; Chen, Huilong; Yu, Haijing; Zhang, Xiaoping; Zhang, Minxia; Wu, Shiji; Song, Jianxin; Chen, Tao; Han, Meifang; Li, Shusheng; Luo, Xiaoping; Zhao, Jianping; Ning, Qin

Abstract

BACKGROUND: Since December 2019, an outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, and is now becoming a global threat. We aimed to delineate and compare the immunological features of severe and moderate COVID-19.
METHODS: In this retrospective study, the clinical and immunological characteristics of 21 patients (17 male and 4 female) with COVID-19 were analyzed. These patients were classified as severe (11 cases) and moderate (10 cases) according to the guidelines released by the National Health Commission of China.
RESULTS: The median age of severe and moderate cases was 61.0 and 52.0 years, respectively. Common clinical manifestations included fever, cough, and fatigue. Compared with moderate cases, severe cases more frequently had dyspnea, lymphopenia, and hypoalbuminemia, with higher levels of alanine aminotransferase, lactate dehydrogenase, C-reactive protein, ferritin, and D-dimer as well as markedly higher levels of IL-2R, IL-6, IL-10, and TNF-α. Absolute numbers of T lymphocytes, CD4+ T cells, and CD8+ T cells decreased in nearly all the patients, and were markedly lower in severe cases (294.0, 177.5, and 89.0 × 106 /L, respectively) than moderate cases (640.5, 381.5, and 254.0 × 106 /L, respectively). The expression of IFN-γ by CD4+ T cells tended to be lower in severe cases (14.1%) than in moderate cases (22.8%).
CONCLUSION: The SARS-CoV-2 infection may affect primarily T lymphocytes, particularly CD4+ and CD8+ T cells, resulting in a decrease in numbers as well as IFN-γ production by CD4+ T cells. These potential immunological markers may be of importance because of their correlation with disease severity in COVID-19.

Keywords

Clinical aspects, diagnosis, treatment; Epidemiology

SARS-CoV-2: A Storm is Raging

The Journal of Clinical Investigation

Pedersen, Savannah F.; Ho, Ya-Chi

Abstract

The pandemic coronavirus infectious disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is rapidly spreading across the globe. In this issue of the JCI, Chen and colleagues compared the clinical and immunologic characteristics between moderate versus severe COVID-19. The authors found that respiratory distress on admission is associated with unfavorable outcomes. Increased cytokine levels (IL-6, IL-10 and TNFα), lymphopenia (in CD4+ and CD8+ T cells), and decreased IFNγ expression in CD4+ T cells are associated with severe COVID-19. Overall, this study characterized the cytokine storm in severe COVID-19 and provides insights into immune therapeutics and vaccine design.

Keywords

COVID-19, infection, anesthesia, safety

A Survey Of 434 Clinical Trials About Coronavirus Disease 2019 In China

Journal of Medical Virology

Leng, Zikuan; Yin, Dongfei; Zhao, Zhe; Yan, Miaoheng; Yang, Yanlei; He, Xijing; Zhao, Robert Chunhua; Liu, Hongjian

To the Editor,

As of 15 March 2020, 81 059 cases were diagnosed totally in China, including 10 817 patients receiving treatments and 3226 severe cases. Currently, there are no effective antiviral medications or vaccines available. However, many clinical trials about coronavirus disease 2019 (COVID‐19) are undergoing to find effective treatment in China, which has not been reported.

Keywords

Clinical aspects, diagnosis, treatment

COVID-19 and the Renin-Angiotensin System

Kidney International Reports

Malha, Line; Mueller, Franco B.; Pecker, Mark S.; Mann, Samuel J.; August, Phyllis; Feig, Peter U.

Introduction

In late 2019, a coronavirus disease (COVID-19) leading to severe acute respiratory syndrome (SARS) started in China and has become a pandemic. The responsible virus has been designated SARS-CoV-2. The cellular receptor for SARS-CoV-2 is angiotensin-converting enzyme 2 (ACE2), a mostly membrane-bound homologue of angiotensin-converting enzyme(ACE) that has generated great interest in the interaction between COVID-19 and the renin-angiotensin system (RAS),1 as well as in the medicines commonly used to block the RAS. These agents, ACE inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) are widely used in the treatment of hypertension, heart failure, chronic kidney disease, and diabetes.

Keywords

Epidemiology

Anticoagulant Treatment Is Associated With Decreased Mortality In Severe Coronavirus Disease 2019 Patients With Coagulopathy

Journal of thrombosis and haemostasis : JTH

Tang, Ning; Bai, Huan; Chen, Xing; Gong, Jiale; Li, Dengju; Sun, Ziyong

Abstract

Background

A relatively high mortality of severe coronavirus disease 2019 (COVID‐19) is worrying, and the application of heparin in COVID‐19 has been recommended by some expert consensus because of the risk of disseminated intravascular coagulation and venous thromboembolism. However, its efficacy remains to be validated.

Methods

Coagulation results, medications, and outcomes of consecutive patients being classified as having severe COVID‐19 in Tongji hospital were retrospectively analyzed. The 28‐day mortality between heparin users and nonusers were compared, as was a different risk of coagulopathy, which was stratified by the sepsis‐induced coagulopathy (SIC) score or D‐dimer result.

Results

There were 449 patients with severe COVID‐19 enrolled into the study, 99 of them received heparin (mainly with low molecular weight heparin) for 7 days or longer. D‐dimer, prothrombin time, and age were positively, and platelet count was negatively, correlated with 28‐day mortality in multivariate analysis. No difference in 28‐day mortality was found between heparin users and nonusers (30.3% vs 29.7%, P = .910). But the 28‐day mortality of heparin users was lower than nonusers in patients with SIC score ≥4 (40.0% vs 64.2%, P = .029), or D‐dimer >6‐fold of upper limit of normal (32.8% vs 52.4%, P = .017).

Conclusions

Anticoagulant therapy mainly with low molecular weight heparin appears to be associated with better prognosis in severe COVID‐19 patients meeting SIC criteria or with markedly elevated D‐dimer.

Keywords

RCT; Clinical aspects, diagnosis, treatment

Use Of In Situ Simulation To Evaluate The Operational Readiness Of A High Consequence Infectious Disease Intensive Care Unit

The European respiratory journal

Fregene, T. E.; Nadarajah, P.; Buckley, J. F.; Bigham, S.; Nangalia, V.

Abstract

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.

Keywords

COVID-19; coronavirus; intensive care medicine; simulation

Surveillance To Improve Evidence For Community Control Decisions During The COVID-19 Pandemic – Opening The Animal Epidemic Toolbox For Public Health

One Health

Foddai, Alessandro; Lindberg, Ann; Lubroth, Juan; Ellis-Iversen, Johanne

Abstract

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.

Keywords

Coronavirus, COVID-19, Disease surveillance, Pandemic, Decision-making

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

Radiation Therapy in King County, Washington During The COVID-19 Pandemic: Balancing Patient Care, Transmission Mitigation and Resident Training

Advances in Radiation Oncology

Dinh, Tru-Khang T.; Halasz, Lia M.; Ford, Eric; Rengan, Ramesh.

Introduction

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.

Keywords

Clinical aspects, diagnosis, treatment

The Looming Pandemic Of COVID-19: What Therapeutic Options Do We Have Now?

Journal of the Chinese Medical Association: JCMA

Afsar, Nasir Ali

Dear Editor,

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

Keywords

Clinical aspects, diagnosis, treatment

Spiritual Lessons From the Coronavirus Pandemic

Journal of Religion and Health

Hart, Curtis W.

Editor,

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.

Keywords

Clinical aspects, diagnosis, treatment

COVID-19 and Economy

Dermatologic Therapy

Gupta, Mrinal; Abdelmaksoud, Ayman; Jafferany, Mohammad; Lotti, Torello; Sadoughifar, Roxanna; Goldust, Mohamad

Dear Editor,

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.

Keywords

Ethics, social science, economics