Current Knowledge About The Antivirals Remdesivir (GS-5734) And GS-441524 As Therapeutic Options For Coronaviruses

One Health
Volume 9, June 2020, 100128

Amirian, E. Susan; Levy, Julie K.

Abstract

Recent international epidemics of coronavirus-associated illnesses underscore the urgent medical and public health need for vaccine development and regulatory body approved therapies. In particular, the current coronavirus disease 2019 (COVID-19) pandemic has quickly intensified interest in developing treatment options to mitigate impact on human life. Remdesivir (GS-5734™) is a broad-spectrum antiviral drug that is now being tested as a potential treatment for COVID-19 in international, multi-site clinical trials. Currently available evidence about the antiviral effects of remdesivir against coronaviruses is primarily based on in vitro and in vivo studies (including some on a chemically related compound, GS-441524™), which have demonstrated largely favorable findings. As the pandemic progresses, information from human compassionate use cases will continue to accumulate before the clinical trials are concluded. It is imperative for public health practitioners and the One Health community to stay up to date on the most promising potential therapeutic options that are under investigation. Thus, the purpose of this review is to synthesize the knowledge to date about remdesivir as a therapeutic option for coronaviruses, with a special focus on information relevant to the One Health community.

Keywords

Remdesivir, GS-5734, Coronavirus, COVID-19, SARS-CoV-2, Compassionate use

Covid-19: What Do Trainees Need To Know?

BMJ (Clinical Research ed.)
Volume 368, March 2020, m1276-m1276

Rimmer, Abi.

Introduction

Sarah Hallett, chair of the BMA junior doctors committee, answers questions on how the COVID-19 pandemic might affect trainees. This is an unprecedented situation for the NHS and it's likely that many staff, including junior doctors, will be asked to take on roles that may be unfamiliar or that they weren't expecting. We know that this is already happening in places where the pressure is being felt. Junior doctors shouldn't be asked to do anything outside of their own competence levels; if you have concerns about where you are being redeployed, you should raise this with your educational supervisor. When working in a different role, you should be supported and always know who you can escalate to. We would also expect any diversions for junior doctors to be for as short a time as possible. It's important, too, that once pressures ease, junior doctors can return to their training posts and trusts should do all they can to make sure this is the case.

Keywords

Clinical aspects, diagnosis, treatment; Epidemiology

Sicken Thy Neighbour: The Initial Trade Policy Response to COVID-19

The World Economy

Evenett, Simon J.

Introduction

In our interconnected world, whenever a global crisis occurs governments must decide whether discriminating against foreign suppliers is part of the solution? or whether foreign know-how and resources can be tapped for mutual advantage. Decisions to sacrifice open borders on the altar of some other goal are typically influenced by the steps? real or perceived? taken by other governments. At such times, written and unwritten international rules are tested, with consequences that can last well after the crisis dominated headlines. The COVID-19 pandemic is no exception.

Keywords

Ethics, social science, economics

Virology, Epidemiology, Pathogenesis, and Control of COVID-19

Viruses
Volume 12, Issue 4, Pages 372-372

Jin, Yuefei; Yang, Haiyan; Ji, Wangquan; Wu, Weidong; Chen, Shuaiyin; Zhang, Weiguo; Duan, Guangcai

Abstract

The outbreak of emerging severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19) in China has been brought to global attention and declared a pandemic by the World Health Organization (WHO) on March 11, 2020. Scientific advancements since the pandemic of severe acute respiratory syndrome (SARS) in 2002~2003 and Middle East respiratory syndrome (MERS) in 2012 have accelerated our understanding of the epidemiology and pathogenesis of SARS-CoV-2 and the development of therapeutics to treat viral infection. As no specific therapeutics and vaccines are available for disease control, the epidemic of COVID-19 is posing a great threat for global public health. To provide a comprehensive summary to public health authorities and potential readers worldwide, we detail the present understanding of COVID-19 and introduce the current state of development of measures in this review. 

Keywords

SARS-CoV-2; COVID-19; epidemiology; pathogenesis; therapeutics

Covid-19: Researchers Launch App To Track Spread Of Symptoms In The UK

BMJ (Clinical research ed.)
Volume 368, March 2020, m1263-m1263

Mayor, Susan.

Introduction

Nearly 700 000 people signed up in the first 24 hours of the launch of an app to help track the spread of coronavirus across the UK in real time and collect information on the range of self-reported symptoms and the characteristics of those most at risk.

The Covid Symptom Tracker app (covid.joinzoe.com) enables users to make a daily report of any symptoms. It is available free of charge to members of the public in the UK. The app has also been given to 5000 twins and their families recruited from the ongoing TwinsUK cohort study.

Keywords

Clinical aspects, diagnosis, treatment; Epidemiology

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

Clinical Characteristics of Covid-19 in China

The New England Journal of Medicine

Chen, Andre T. C.; Coura-Filho, George B.; Rehder, Marília H. H.

To the Editor,

According to the World Health Organization (WHO), the case definition for surveillance of returning travelers requires that they need to present with fever and at least one respiratory symptom to be considered as having suspected cases of coronavirus disease 2019 (Covid-19).1 In their article regarding 1099 patients with laboratory-confirmed Covid-19 at hospitals across China during the first 2 months of the pandemic, Guan et al. (Feb. 28 online publication, available at NEJM.org)2 present compelling data supporting the need for a reassessment of these criteria. The authors found that only 43.8% of the patients presented with fever on admission, although fever developed in 88.7% during hospitalization. That means that if those travelers were returning from affected areas, more than half would not be suspected of having Covid-19, which would result in undetected patients who can spread the virus. This issue may be particularly relevant in low-income countries with less structured health care systems, which could not provide adequate follow-up of these travelers.

Keywords

Clinical aspects, diagnosis, treatment

Epidemiology of Covid-19 in a Long-Term Care Facility in King County, Washington

New England Journal of Medicine

McMichael, Temet M.; Currie, Dustin W.; Clark, Shauna; Pogosjans, Sargis; Kay, Meagan; Schwartz, Noah G.; Lewis, James; Baer, Atar; Kawakami, Vance; Lukoff, Margaret D.; Ferro, Jessica; Brostrom-Smith, Claire; Rea, Thomas D.; Sayre, Michael R.; Riedo, Francis X.; Russell, Denny; Hiatt, Brian; Montgomery, Patricia; Rao, Agam K.; Chow, Eric J.; Tobolowsky, Farrell; Hughes, Michael J.; Bardossy, Ana C.; Oakley, Lisa P.; Jacobs, Jesica R.; Stone, Nimalie D.; Reddy, Sujan C.; Jernigan, John A.; Honein, Margaret A.; Clark, Thomas A.; Duchin, Jeffrey S.

Abstract

BACKGROUND

Long-term care facilities are high-risk settings for severe outcomes from outbreaks of Covid-19, owing to both the advanced age and frequent chronic underlying health conditions of the residents and the movement of health care personnel among facilities in a region.

METHODS

After identification on February 28, 2020, of a confirmed case of Covid-19 in a skilled nursing facility in King County, Washington, Public Health–Seattle and King County, aided by the Centers for Disease Control and Prevention, launched a case investigation, contact tracing, quarantine of exposed persons, isolation of confirmed and suspected cases, and on-site enhancement of infection prevention and control.

RESULTS

As of March 18, a total of 167 confirmed cases of Covid-19 affecting 101 residents, 50 health care personnel, and 16 visitors were found to be epidemiologically linked to the facility. Most cases among residents included respiratory illness consistent with Covid-19; however, in 7 residents no symptoms were documented. Hospitalization rates for facility residents, visitors, and staff were 54.5%, 50.0%, and 6.0%, respectively. The case fatality rate for residents was 33.7% (34 of 101). As of March 18, a total of 30 long-term care facilities with at least one confirmed case of Covid-19 had been identified in King County.

CONCLUSIONS

In the context of rapidly escalating Covid-19 outbreaks, proactive steps by long-term care facilities to identify and exclude potentially infected staff and visitors, actively monitor for potentially infected patients, and implement appropriate infection prevention and control measures are needed to prevent the introduction of Covid-19.

Keywords

GERIATRICS/​AGING, INFECTIOUS DISEASE, VIRAL INFECTIONS, GLOBAL HEALTH, INFLUENZA

Covid-19: "Illogical" Lack Of Testing Is Causing Healthy Staff To Self-Isolate, BMA Chief Warns (Copy)

BMJ (Clinical research ed.)
Volume 369, March 2020, m1277-m1277

Iacobucci, Gareth.

Introduction

The absence of COVID-19 testing for NHS staff is causing huge workforce shortages by forcing doctors to self-isolate even if they do not have the virus, the head of the BMA has warned.

The government’s advice is for people with COVID-19 symptoms to stay at home for seven days, but for all other household members who remain well to isolate for 14 days. The BMA council chairman, Chaand Nagpaul, said that the lack of testing for staff was “counter-intuitive” as it was likely to be forcing more staff than necessary to stay away from hospitals and GP surgeries because they do not know if they are infected.

Keywords

Epidemiology

Experts' Request to the Spanish Government: Move Spain Towards Complete Lockdown

The Lancet

 Oriol Mitjà, Àlex Arenas, Xavier Rodó, Aurelio Tobias, Joe Brew, José M Benlloch

Introduction

We would like to express our concern about the limited capacity of actions taken by the Spanish Government to successfully control the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak and end the exponential growth phase of new cases. The measures taken so far, consisting primarily of partial restriction mobility, are in the right direction, although some researchers have warned about the pressure placed on the building blocks of the health system.

Keywords

Epidemiology

Are certain drugs associated with enhanced mortality in COVID-19?

QJM: An International Journal of Medicine

Goldstein, Mark R.; Poland, Gregory A.; Graeber, Charles W.

Introduction

Prevalent comorbidities for the development of severe pneumonia requiring intensive care unit treatment, acute respiratory distress syndrome (ARDS), and death from Coronavirus disease 2019 (COVID-19) include hypertension, diabetes and cardiovascular disease [1,2]. We posit that drugs commonly used in the treatment of those comorbidities may actually increase the risk of severe pneumonia, ARDS and mortality in the setting of COVID-19; the drugs of primary concern include angiotensin receptor blockers (ARBs) used for blood pressure lowering and statins used for cholesterol lowering.

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

Telemedicine Services Thrive During Covid-19

The Veterinary record
Volume 186, Issue 12, Pages 365-365

By Adele Waters

Abstract

Not all veterinary businesses are suffering a downturn in demand – or their fortunes – during the Covid-19 pandemic.

Quite the reverse for those offering the public access to telemedicine or remote first-line advice services – they appear to be positively thriving and competing for customers.

Last week, FirstVet, which provides on-demand video consultations with local, qualified vets throughout the UK, reported it has seen a 20 per cent week-on-week increase in pet owners using its video vet service between February and March due to self isolation and mandatory quarantine.

Meanwhile, Joii, a pet care app that offers video consultations with vets, said it had experienced ‘a substantial increase’ in users, with almost 30,000 people downloading or using the app in the past two months. The app has been trending at number 1 within the medical category in both Google Play and the Apple store…

Keywords

Clinical aspects, diagnosis, treatment; Epidemiology

COVID 19 and Intra Cerebral Hemorrhage: Causative or Coincidental

New Microbes and New Infections

Sharifi-Razavi, A.; Karimi, N.; Rouhani, N.

Introduction

Pneumonia appears to be the most manifestation of COVID 19, but some extra-pulmonary involvement such as gastrointestinal, cardiac and renal has been reported. According to limited clinical data about the virus behavior up to now, specially extra-pulmonary symptoms, we should be aware on possibility of initial cerebrovascular manifestations of COVID19.

Keywords

Epidemiology

Consensus Guidelines For Managing The Airway In Patients With COVID-19

Anaesthesia

Cook, T. M.; El-Boghdadly, K.; McGuire, B.; McNarry, A. F.; Patel, A.; Higgs, A..

Abstract

Severe acute respiratory syndrome-corona virus-2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), is highly contagious. Airway management of patients with COVID-19 is high risk to staff and patients. We aimed to develop principles for airway management of patients with COVID-19 to encourage safe, accurate and swift performance. This consensus statement has been brought together at short notice to advise on airway management for patients with COVID-19, drawing on published literature and immediately available information from clinicians and experts. Recommendations on the prevention of contamination of healthcare workers, the choice of staff involved in airway management, the training required and the selection of equipment are discussed. The fundamental principles of airway management in these settings are described for: emergency tracheal intubation; predicted or unexpected difficult tracheal intubation; cardiac arrest; anaesthetic care; and tracheal extubation. We provide figures to support clinicians in safe airway management of patients with COVID-19. The advice in this document is designed to be adapted in line with local workplace policies.

Keywords

airway; anaesthesia; coronavirus; COVID-19; critical care; difficult airway; intubation

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

Not wearing masks to protect against coronavirus is a ‘big mistake,’ top Chinese scientist says

The European respiratory journal

Cohen, Jon.

To the Editor,

Chinese scientists at the front of that country’s outbreak of coronavirus disease 2019 (COVID-19) have not been particularly accessible to foreign media. Many have been overwhelmed trying to understand their epidemic and combat it, and responding to media requests, especially from journalists outside of China, has not been a top priority.

Science has tried to interview George Gao, director-general of the Chinese Center for Disease Control and Prevention (CDC), for 2 months. Last week he responded.

Keywords

COVID-19, SARS-CoV-2, Treatment

A Role For CT In COVID-19? What Data Really Tell Us So Far

The Lancet

Hope, Michael D.; Raptis, Constantine A.; Shah, Amar; Hammer, Mark M.; Henry, Travis S.

Introduction

Radiologists have watched the coronavirus disease 2019 (COVID-19) pandemic unfold, wondering if and how imaging could be useful for diagnosis. Perhaps imaging could aid in screening or accelerate the speed of diagnosis, especially with shortages of RT-PCR.

Some radiology literature suggests a pivotal role for CT. Ai and colleagues report on 1014 patients who received both RT-PCR and CT in Wuhan, China, during their epidemic. They found that 97% of cases with RT-PCR-confirmed diagnoses had CT findings of pneumonia, and conclude, “CT imaging has high sensitivity for diagnosis of COVID-19”. Other investigators are less optimistic. Inui and colleagues reviewed CT scans of 112 cases of RT-PCR-confirmed COVID-19 from the Diamond Princess cruise ship. Less than two-thirds (61%) of cases had lung opacities on CT; 20% of symptomatic patients had negative CTs.

Keywords

Clinical aspects, diagnosis, treatment

Dynamic Change Process Of Target Genes By RT-PCR Testing Of SARS-Cov-2 During The Course Of A Coronavirus Disease 2019 Patient

Clinica Chimica Acta
Volume 506, July 2020, Pages 172-175

Lv, Ding-feng; Ying, Qi-ming; Weng, Yue-song; Shen, Chi-bin; Chu, Jin-guo; Kong, Jing-ping; Sun, Ding-he; Gao, Xiang; Weng, Xing-bei; Chen, Xue-qin.

Abstract

We report the dynamic change process of target genes by RT-PCR testing of SARS-Cov-2 during the course of a COVID-19 patient: from successive negative results to successive single positive nucleocapsid gene, to two positive target genes (orf1ab and nucleocapsid) by RT-PCR testing of SARS-Cov-2, and describe the diagnosis, clinical course, and management of the case. In this case, negative results of RT-PCR testing was not excluded to diagnose a suspected COVID-19 patient, clinical signs and symptoms, other laboratory findings, and chest CT images should be taken into account for the absence of enough positive evidence. This case highlights the importance of successive sampling and testing SARS-Cov-2 by RT-PCR as well as the increased value of single positive target gene from pending to positive in two specimens to diagnose laboratory-confirmed COVID-19.

Keywords

Coronavirus, SARS-Cov-2, COVID-19, RT-PCR testing, Nucleocapsid

Undocumented U.S. Immigrants and Covid-19

New England Journal of Medicine

Page, Kathleen R.; Venkataramani, Maya; Beyrer, Chris; Polk, Sarah.

Introduction

In 2019, as the “public charge” rule made its tions, and separation of families case managers to disenroll their children from the Supplemental Nutrition Assistance Program (SNAP), fearing it would affect their chances of obtaining legal status in the future or lead to deportation. The new public charge rule, which went into effect on February 24, 2020, states that “aliens are inadmissible to the United States if they are unable to care for themselves without becoming public charges”

Keywords

Epidemiology