Covid-19: diabetes clinicians set up social media account to help alleviate patients’ fears

BMJ
Volume 368, March 2020, m1262-m1262

Iacobucci, Gareth.

Abstract

A group of diabetes doctors and other clinicians has set up a social media account to help alleviate patients’ fears around covid-19 and provide them with “a secure base” of information. Around one in 13 people in the UK has diabetes, roughly 90% type 2 diabetes and 10% type 1. The UK government has advised that all people with diabetes—along with other at-risk groups—should be “particularly stringent” in following social distancing measures that ministers have set out for the whole country to follow

Keywords

Epidemiology

A War on Two Fronts: Cancer Care in the Time of COVID-19

Annals of Internal Medicine

Kutikov, Alexander; Weinberg, David S.; Edelman, Martin J.; Horwitz, Eric M.; Uzzo, Robert G.; Fisher, Richard I.

Introduction

The rapidly expanding coronavirus disease 2019 (COVID-19) (SARS–CoV-2) acute respiratory pandemic has assaulted all aspects of daily life. As of 25 March 2020, there were more than 450 000 cases worldwide. In the absence of a vaccine or a therapeutic agent, a “social distancing” strategy is the primary intervention to hamper the spread of infection. A major fear of most governments and individuals is the heavy impact on the health care delivery system. Cumbersome diagnostic testing, inadequate protective supplies for frontline providers and first responders, and limited hospital capacity—including intensive care—have all conspired to create an environment compared to warfare.

Keywords

Epidemiology; Ethics, social science, economics

Heart Failure Collaboratory Statement on Clinical Trials in the Landscape of COVID-19

JACC: Heart Failure

Abraham, William T.; Fiuzat, Mona; Psotka, Mitchell A.; O’Connor, Christopher M.

Introduction

Heart Failure Collaboratory Statement on Clinical Trials in the Landscape of COVID-19 The COVID-19 pandemic has disrupted health care delivery systems around the world, with a significant impact on clinical trials for current and future study participants, sponsors, investigators, coordinators, and regulators. Thoughtful consideration on how to manage clinical trials during the COVID-19 pandemic is of particular relevance to the heart failure (HF) ecosystem, as HF patients represent a vulnerable population at high risk for COVID-19 related morbidity and mortality. This ecosystem includes patients with HF, clinical trialists, investigators, research coordinators, regulatory authorities, payers, and both public and private sponsors of HF clinical trials.

Keywords

Clinical aspects, diagnosis, treatment

Medical Education And Care In Dermatology During The SARS-Cov2 Pandemia: Challenges And Chances

Journal of the European Academy of Dermatology and Venereology

Reinholz, M.; French, L. E.i

Abstract

The first novel coronavirus (SARS‐CoV‐2) cases occurred in Germany after contact with a Chinese business delegate between January 19 and 22, 2020 near the city of Munich, Bavaria. Since then numerous additional cases have been reported and the dissemination of the infection does not only pose a major health challenge for the entire population, medical care facilities and the economy, but also for the medical training of future doctors and outpatient care of patients with skin disease.

Keywords

Dermatology, viral infections, medical education, patient care, teaching, SARS-CoV2

virus

Tracking COVID-19 Responsibly

The Lancet

Muhareb, Rania; Giacaman, Rita.

Introduction

As of March 25, 2020, WHO's online coronavirus disease 2019 (COVID-19) situation dashboard reveals that the pandemic spans 195 countries and territories with 375 498 cases. With this rapid expansion of the pandemic comes a growing need to ensure that accurate and credible information is accessible to public health authorities, researchers, and the wider public. This has prompted WHO, institutions, and individuals to develop online tools to track the spread of the pandemic. Although WHO's emergency preparedness is informed by established principles of international law,

1 the multiplicity of actors has the potential to create confusion and barriers to accessing reliable and consistent data. These actors’ categorisation of countries and territories, which could be subject to geopolitical considerations, remains unaccountable to affected populations.

Keywords

Epidemiology

The Role of the Global Health Development/Eastern Mediterranean Public Health Network and the Eastern Mediterranean Field Epidemiology Training Programs in Preparedness for COVID-19

JMIR public health and surveillance
Volume 6, Issue 1, e18503

Al Nsour, M.; Bashier, H.; Al Serouri, A.; Malik, E.; Khader, Y.; Saeed, K.; Ikram, A.; Abdalla, A. M.; Belalia, A.; Assarag, B.; Baig, M. A.; Almudarra, S.; Arqoub, K.; Osman, S.; Abu-Khader, I.; Shalabi, D.; Majeed, Y.

Abstract

The World Health Organization (WHO) declared the current COVID-19 a public health emergency of international concern on January 30, 2020. Countries in the Eastern Mediterranean Region (EMR) have a high vulnerability and variable capacity to respond to outbreaks. Many of these countries addressed the need for increasing capacity in the areas of surveillance and rapid response to public health threats. Moreover, countries addressed the need for communication strategies that direct the public to actions for self- and community protection. This viewpoint article aims to highlight the contribution of the Global Health Development (GHD)/Eastern Mediterranean Public Health Network (EMPHNET) and the EMR's Field Epidemiology Training Program (FETPs) to prepare for and respond to the current COVID-19 threat. GHD/EMPHNET has the scientific expertise to contribute to elevating the level of country alert and preparedness in the EMR and to provide technical support through health promotion, training and training materials, guidelines, coordination, and communication. The FETPs are currently actively participating in surveillance and screening at the ports of entry, development of communication materials and guidelines, and sharing information to health professionals and the public. However, some countries remain ill-equipped, have poor diagnostic capacity, and are in need of further capacity development in response to public health threats. It is essential that GHD/EMPHNET and FETPs continue building the capacity to respond to COVID-19 and intensify support for preparedness and response to public health emergencies.

Keywords

COVID-19, Outbreak, Preparedness, Response, Public health 

Reacquainting Cardiology with Mechanical Ventilation in Response to the COVID-19 Pandemic

JACC: Case Reports

Gage, Ann; Higgins, Andrew; Lee, Ran; Panhwar, Muhammad Siyab; Kalra, Ankur

Introduction

Reports from countries struck by the coronavirus disease 2019 (COVID-19) pandemic have consistently highlighted physician shortages and the utilization of physicians not specifically trained in critical care to care for COVID-19 patients. Given the significant overlap between cardiology and critical care, cardiologists may be among the first physicians asked to step in to fill this shortage. If and when this occurs, a basic framework for recognition of acute respiratory failure, acute respiratory distress syndrome (ARDS), and initial ventilator management is imperative. The following is a brief review of ARDS and an overview of ventilator management designed to help ensure physician comfort and patient safety.

Keywords

Clinical aspects, diagnosis, treatment

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