Therapeutic opportunities to manage COVID-19/SARS-CoV-2 infection: Present and future

Indian Journal Of Ophthalmology

Shetty, Rohit; Ghosh, Arkasubhra; Honavar, Santosh G.; Khamar, Pooja; Sethu, Swaminathan.

Abstract

A severe form of respiratory disease - COVID-19, caused by SARS-CoV-2 infection, has evolved into a pandemic resulting in significant morbidity and mortality. The unabated spread of the disease is due to lack of vaccine and effective therapeutic agents against this novel virus. Hence, the situation demands an immediate need to explore all the plausible therapeutic and prophylactic strategies that can be made available to stem the spread of the disease. Towards this effort, the current review outlines the key aspects of the pathobiology associated with the morbidity and mortality in COVID-19 patients, which includes a viral response phase and an exaggerated host response phase. The review also summarizes therapeutic agents that are currently being explored along with those with potential for consideration. The broad groups of therapeutic agents discussed include those that: (i) block viral entry to host cells, (ii) block viral replication and survival in host cells, and (iii) dampen exaggerated host immune response. The various kinds of pharmaceutical prophylactic options that may be followed to prevent COVID-19 have also been discussed.

Keywords

COVID‑19, prophylaxis, SARS‑CoV‑2, therapy

A Strange New World

New Scientist
Volume 245, Issue 3275, 28 March 2020, Page 5

Introduction

The new coronavirus may be upending our lives, but we aren't helpless against it.

HARD times lie ahead. Not only do we all have to contend with the threat of covid-19 itself, and its economic fallout, but as nations lock down movement outside our homes, there are extra mental pressures to cope with too. Fortunately, there are constructive things we can do.

Keywords

Epidemiology

Possible Method for the Production of a Covid-19 Vaccine

The Veterinary Record
Volume 186, Issue 12, Pages 388-388

Myint, Aung; Jones, Trevor

Introduction

OVER a number of years we worked on genetically transformed Pasteurella multocida vaccines, experimenting on whether they could provide protection against a variety of animal and avian virus diseases. We think the methodology has potential for a Covid19 vaccine.

Keywords

Clinical aspects, diagnosis, treatment

Sourcing Personal Protective Equipment During the COVID-19 Pandemic

JAMA

Livingston, Edward; Desai, Angel; Berkwits, Michael

Introduction

As the coronavirus disease 2019 (COVID-19) pandemic accelerates, global health care systems have become overwhelmed with potentially infectious patients seeking testing and care. Preventing spread of infection to and from health care workers (HCWs) and patients relies on effective use of personal protective equipment (PPE)—gloves, face masks, air-purifying respirators, goggles, face shields, respirators, and gowns. A critical shortage of all of these is projected to develop or has already developed in areas of high demand. PPE, formerly ubiquitous and disposable in the hospital environment, is now a scarce and precious commodity in many locations when it is needed most to care for highly infectious patients. An increase in PPE supply in response to this new demand will require a large increase in PPE manufacturing, a process that will take time many health care systems do not have, given the rapid increase in ill COVID-19 patients.

Keywords

Clinical aspects, diagnosis, treatment

Reply to “Does hand hygiene reduce SARS-CoV-2 transmission?”

Graefe's Archive for Clinical and Experimental Ophthalmology

Lai, Tracy H. T.; Tang, Emily W. H.; Fung, Kitty S. C.; Li, Kenneth K. W.

Dear Editor,

We would like to thank Dr. Chao Yang’s comments to our article. We would like to emphasize that both face masking and hand hygiene are important in preventing the transmission of coronavirus disease 2019 (COVID-19) and are not mutually exclusive. According to the report of the WHO-China joint mission on COVID-19, COVID-19 is transmitted via droplets and fomites during close unprotected contact between an infector and infectee. Airborne spread has not been reported for COVID-19, and it is not believed to be a major driver based on currently available evidence. A recent study by Ong et al. obtained air and surface environmental samples from isolation wards of COVID-19 patients and found the air samples to be negative of SARS-CoV-2, but positive samples were found on multiple environmental surfaces. These sites included the table, bed rail, locker, chair, light switches, door, window, and surfaces in the toilet including the toilet bowl, sink, and door handle. Stool samples were also positive for SARS-CoV-2. Otter and his colleagues found that SARS-CoV and other coronaviruses can survive on environmental surfaces up to 6 days. Furthermore, it is not uncommon that healthcare workers, including ophthalmologists, may overlook the importance of hand hygiene, as frequent face touching is notoriously common that even medical students touched their faces 23 times per hour and 44% of those touches involved contact with mucous membranes.

Keywords

Infection prevention and control

The Role of Emergency Radiology in COVID-19: From Preparedness to Diagnosis

Canadian Association of Radiologists Journal

Nasir, Muhammad Umer; Roberts, James; Muller, Nestor L.; Macri, Francesco; Mohammed, Mohammed F.; Akhlaghpoor, Shahram; Parker, William; Eftekhari, Arash; Rezaei, Susan; Mayo, John; Nicolaou, Savvas.

Abstract

Emergency trauma radiology, although a relatively new subspecialty of radiology, plays a critical role in both the diagnosis/triage of acutely ill patients, but even more important in providing leadership and taking the lead in the preparedness of imaging departments in dealing with novel highly infectious communicable diseases and mass casualties. This has become even more apparent in dealing with COVID-19, the disease caused by the novel coronavirus SARS-CoV-2, first emerged in late 2019. We review the symptoms, epidemiology, and testing for this disease. We discuss characteristic imaging findings of COVID-19 in relation to other modern coronavirus diseases including SARS and MERS. We discuss roles that community radiology clinics, outpatient radiology departments, and emergency radiology departments can play in the diagnosis of this disease. We review practical methods to reduce spread of infections within radiology departments.

Keywords

COVID-19, emergency and trauma radiology, MERS, SARS, CT, preparedness

Prevalence And Impact Of Diabetes Among People Infected With SARS-Cov-2

Journal of Endocrinological Investigation

Fadini, G. P.; Morieri, M. L.; Longato, E.; Avogaro, A.

To the Editor,

In December 2019, a new coronavirus causing severe acute respiratory syndrome (SARS-CoV-2) emerged in Wuhan, China. The virus spread rapidly to more than 150 countries and, by the time we are writing (March 19th 2020), it affected > 230,000 individuals causing almost 10,000 deaths.
…

Keywords

Clinical aspects, diagnosis, treatment

Biological Treatment During COVID-19 Outbreak

Journal of Dermatological Treatment

Sriwijitalai, Won; Wiwanitkit, Viroj

Dear Editor,

We read the publication on ‘Should patients stop their biologic treatment during the COVID-19 pandemic’ and found that it is very interesting. Bashyam and Feldman raised an interesting issue for discussion regarding using biological treatment during COVID-19 outbreak. In fact, although there are infected patients worldwide, there has never any reports on biological treatment associated COVID-19. Whether, there is any problem relating to corticosteroid and TNF-α inhibitors in coronavirus infection is an interesting question. In a previous animal model study on coronavirus infection, TNF-α inhibitors did not deteriorate the disease course. Atanasova et al. found that blocking of TNF-α alone was not sufficient to ameliorate the disease. The immunopathology of the new disease is still largely unknown. It might be too early to conclude whether biological treatment should be ceased during COVID-19 outbreak.

Keywords

Clinical aspects, diagnosis, treatment; Epidemiology

COVID-19 Is A Disease Of Older People

The Journals of Gerontology: Series A

Le Couteur, David G.; Anderson, Rozalyn M.; Newman, Anne B.

Introduction

The case-fatality rate for COVID-19 increases dramatically with age from 3% to 5% between 65 and 74 years, 4% to 11% between 75 and 84 years, and 10% to 27% above 85 years and people aged 65 years and older account for 45% of hospitalizations, 53% of intensive care unit (ICU) admissions, and 80% of deaths (1). The first infections with the coronavirus, SARS-CoV-2, were recognized in December 2019 in Wuhan, China and since then, over 80,000 people in China contracted COVID-19, with more than 3,000 deaths (2). The United States has seen an exponential increase in the number of cases with the vast majority of deaths also occurring in people aged 65 years or older. Older people in residential aged care facilities and nursing homes have even greater risk of death given their age and comorbidities, confounded by the lack of capacity for social distancing from staff and other residents.

Keywords

Epidemiology

COVID-19 Outbreak And Inflammatory Bowel Disease Management: A Questionnaire Survey From Realistic Practice

Journal of Crohn's & Colitis

Bai, Xiaoyin; Yang, Hong; Qian, Jiaming

Introduction

Coronavirus disease 2019 [COVID-19] has swept Wuhan and other cities in China since January 2020.1 Despite the preliminary victory of containing the infection following 2 months of effort in China, the pandemic has posed a challenge regarding the routine clinical attention to patients with chronic disease. Inflammatory bowel disease [IBD] is a chronic disease which requires elaborate management. Due to the relative low incidence and prevalence of IBD,2 the limited number of specialists, and the individualised therapeutic approaches in our country, treatment recommendations still depend on the collaborative effort of experts in the high-volume hospitals. Nevertheless, given the severity of COVID-19, patients are adviseded to follow local primary physicians, which may result in unmet medical needs. In addition, most patients with IBD require glucocorticoids, immunomodulators, or biologic agents for a long time, which increases the likelihood of experiencing side effects and compromises the treatment outcome..

Keywords

Clinical aspects, diagnosis, treatment

Antibody Responses To SARS-CoV-2 In Patients Of Novel Coronavirus Disease 2019

Clinical Infectious Diseases

Zhao, Juanjuan; Yuan, Quan; Wang, Haiyan; Liu, Wei; Liao, Xuejiao; Su, Yingying; Wang, Xin; Yuan, Jing; Li, Tingdong; Li, Jinxiu; Qian, Shen; Hong, Congming; Wang, Fuxiang; Liu, Yingxia; Wang, Zhaoqin; He, Qing; Li, Zhiyong; He, Bin; Zhang, Tianying; Fu, Yang; Ge, Shengxiang; Liu, Lei; Zhang, Jun; Xia, Ningshao; Zhang, Zheng.

Abstract

Background

The novel coronavirus SARS-CoV-2 is a newly emerging virus. The antibody response in infected patient remains largely unknown, and the clinical values of antibody testing have not been fully demonstrated.

Methods

A total of 173 patients with SARS-CoV-2 infection were enrolled. Their serial plasma samples (n=535) collected during the hospitalization were tested for total antibodies (Ab), IgM and IgG against SARS-CoV-2. The dynamics of antibodies with the disease progress was analyzed.

Results

Among 173 patients, the seroconversion rate for Ab, IgM and IgG was 93.1%, 82.7% and 64.7%, respectively. The reason for the negative antibody findings in 12 patients might due to the lack of blood samples at the later stage of illness. The median seroconversion time for Ab, IgM and then IgG were day-11, day-12 and day-14, separately. The presence of antibodies was <40% among patients within 1-week since onset, and rapidly increased to 100.0% (Ab), 94.3% (IgM) and 79.8% (IgG) since day-15 after onset. In contrast, RNA detectability decreased from 66.7% (58/87) in samples collected before day-7 to 45.5% (25/55) during day 15-39. Combining RNA and antibody detections significantly improved the sensitivity of pathogenic diagnosis for COVID-19 (p<0.001), even in early phase of 1-week since onset (p=0.007). Moreover, a higher titer of Ab was independently associated with a worse clinical classification (p=0.006).

Conclusions

The antibody detection offers vital clinical information during the course of SARS-CoV-2 infection. The findings provide strong empirical support for the routine application of serological testing in the diagnosis and management of COVID-19 patients.

Keywords

Epidemiology, antibody, SARS-CoV-2, COVID-19.

Base Protocol For Real Time Active Random Surveillance Of Coronavirus Disease (COVID-19) – Adapting Veterinary Methodology To Public Health

One Health

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

Abstract

The pandemic of new coronavirus disease COVID-19 is threatening our health, economy and life style. Collaborations across countries and sectors as a One Health World could be a milestone.

We propose a general protocol, for setting timely active random surveillance of COVID-19, at the human community level, with systematic repeated detection efforts. Strengths and limitations are discussed.

If considered applicable by public health, the protocol could evaluate the status of COVID-19 epidemics consistently and objectively.

Keywords

Keywords

Pandemic, New coronavirus, COVID-19, Active random surveillance

COVID-19 in the Pediatric Population

Dermatologic Therapy

Abdelmaksoud, Ayman; Kroumpouzos, George; Jafferany, Mohammad; Lotti, Torello; Sadoughifar, Roxanna; Goldust, Mohamad

Dear Editor,

On 30 January 2020, the World Health Organization (WHO) declared Coronavirus (CoV) disease 2019 (COVID-19) epidemic as a public health emergency. All age groups are susceptible to COVID-19. Pregnant women are at high risk of acquiring the infection possibly due to the immunologic changes of gestation. However, there is no evidence so far for severe outcomes for mothers. Premature delivery was reported in pregnant patients with COVID1-9 but it was unclear whether it was related to the infection.

Keywords

Epidemiology

Familial Cluster Of COVID-19 Infection From An Asymptomatic

Critical Care
Volume 24, Issue 1, Page 119

Zhang, Jinjun; Tian, Sijia; Lou, Jing; Chen, Yuguo

Introduction

Since December 2019, the first case of a novel coronavirus (COVID-19) infection pneumonia was detected in Wuhan, and the outbreak has been spreading rapidly in the world. As of February 18, 2020, a total of 73,332 cases of confirmed COVID-19 infection have been detected in the world as reported by the WHO [1, 2]. Given that the asymptomatic persons are potential sources of COVID-19 infection [3], we report a familial cluster case of five patients infected with COVID-19 from an asymptomatic confirmed case in Beijing. We obtained the data of patients, which included demographic, epidemiological, and clinical features; chest radiography; laboratory test; and outcomes. Laboratory confirmation of COVID-19 was detected in the first hospital admission and verified by the Beijing Center for Disease Control and Prevention (CDC).

Keywords

Epidemiology

Negligible Risk Of The COVID-19 Resurgence Caused By Work Resuming In China (Outside Hubei): A Statistical Probability Study

Journal of Public Health

Zhao, Kedong; Long, Cheng; Wang, Yan; Zeng, Tieyong; Fu, Xinmiao

Abstract

The COVID-19 outbreak in China appears to reach the late stage since late March 2020, and a stepwise restoration of economic operations is implemented. Risk assessment for such economic restoration is of significance. Here, we estimated the probability of COVID-19 resurgence caused by work resuming in typical provinces/cities and found that such probability is very limited (&amp;lt;5% for all the regions except Beijing). Our work may inform provincial governments to make risk level-based, differentiated control measures.

Keywords

Clinical aspects, diagnosis, treatment

Reflections on Nursing Ingenuity During the COVID-19 Pandemic

The Journal of neuroscience nursing: journal of the American Association of Neuroscience Nurses

Newby, Jamison C.; Mabry, Madison C.; Carlisle, Byron A.; Olson, DaiWai M.; Lane, Blair E.

Abstract

Introduction: This reflections article provides insight toward nursing innovations to reduce the overuse of personal protective equipment while maintaining a safe environment for staff taking care of COVID-19 patients. The secondary aim of this paper to capitalize on recent advances in mass electronic communication through social media to encourage nurses across the globe to share their knowledge and expertise during this pandemic.The many innovations that have been implemented fall into 3 categories of: reducing unnecessary use of personal protective equipment (PPE), promoting staff safety and readiness, and reducing foot traffic.

Summary: These strategies are being shared to promote dissemination of innovative nursing interventions that will save lives during the COVID-19 pandemic.

Keywords

Clinical aspects, diagnosis, treatment

COVID-19 Global Pandemic: Options for Management of Gynecologic Cancers

International journal of gynecological cancer: official journal of the International Gynecological Cancer Society

Ramirez, Pedro T.; Chiva, Luis; Eriksson, Ane Gerda Z.; Frumovitz, Michael; Fagotti, Anna; Gonzalez Martin, Antonio; Jhingran, Anuja; Pareja, Rene

Abstract

Our world is facing a devastating crisis in the growing pandemic associated with the coronavirus (COVID-19) disease. As many nations take steps to implement strategies to contain the spread of this disease, we continue to see the tremendous impact this is having on the numerous healthcare workers who unite to overcome this tragic infection. We also recognize the concerns by both physicians and patients as it pertains to the management of patients diagnosed with cancer. We recognize that in this special situation we must continue to provide our gynecologic oncology patients with the highest quality of medical services and at the same time assure that we maximize the safety not only of our patients and their families but also of the medical staff and all associated teams that care for patients both in the inpatient and outpatient settings. To that end, the Editorial Team of the International Journal of Gynecological Cancer have compiled evidence-based data using established guidelines to propose strategies to optimize care of our patients while at the same time offering potential options to alleviate the burden to the healthcare system when resources may need to be diverted to the direct care of patients affected by the coronavirus (COVID-19) disease. Our proposal is intended as a tool for consideration and certainly not as a strategy for permanent change in patterns of practice. The goal is to share options, as gathered collectively by our team, in both the management and surveillance of patients diagnosed with gynecologic cancers during this time of global crisis.

Keywords

Epidemiology

Weakened Defences

New Scientist
Volume 245, Issue 3275, 28 March 2020, Pages 20-21

Whyte, Chelsea

Introduction

The way society functions in the US has made it more vulnerable to pandemics. Could things be different, asks Chelsea Whyte.

The coronavirus outbreak is a once-in-a-century event – and it seems the US has spent the past 100 years unwittingly weakening its defences.

In fact, the US is probably the developed economy with the worst type of healthcare system to tackle COVID-19. Many economic and healthcare policies it has enacted don't prioritise public health, and it is finding out first-hand how dangerous that can be.

The impact of this has been seen in the past month or so in the lack of testing – as of 23 March, the US has done 238,632 tests compared with 338,036 in South Korea, a far smaller country.

Keywords

Epidemiology

Separated pathways in the endoscopy unit for COVID-19 patients

Gastrointestinal Endoscopy

Valdivia, Pablo Cortegoso; le Grazie, Marco; Gaiani, Federica; Decembrino, Francesco; Luigi de’Angelis, Gian.

To the Editor:

Recently, Repici et al1 proposed a model for prevention of COVID-19 infection spread in endoscopic units. The topic is of utmost importance because of the potential for fecal–oral transmission of the SARS-CoV-2,2 its prolonged persistence on different surfaces,3 and the fact that, from now on, an increasing number of procedures in patients known to be COVID-19 positive will be performed.

Keywords

Clinical aspects, diagnosis, treatment

$100M in Dislocated Worker grants available

Federal Grants & Contracts
Volume 44, 2020, Issue

.

About

The U.S. Department of Labor (DOL) has announced the availability of up to $100 million for Dislocated Worker Grants (DWGs) to help address the workforce‐related impacts of the public health emergency related to COVID‐19, also known as novel coronavirus.

“As Americans make sacrifices to combat the spread of coronavirus, President Trump's priority is to protect and sustain America's workers and their families,” U.S. Secretary of Labor Eugene Scalia said in a statement. “The availability of Dislocated Worker Grants will help states and communities strengthen their economies as we fight to slow the spread of the virus and regain our economic momentum.”