COVID 2019 Outbreak: The disappointment in Indian Teachers

Asian Journal of Psychiatry
Volume 50, April 2020, 102047

Bhat, Ritesh; Singh, Varun Kumar; Naik, Nithesh; Kamath C, Raghavendra; Mulimani, Prashant; Kulkarni, Niranjan.

Introduction

Coronavirus disease or commonly known as COVID19 is the news of every single second since it originated from Wuhan, China (Wang et al., 2020), which is declared as a pandemic disease by World Health Organization, said to be caused by a new strain of the virus. The disease is said to spread through droplets of saliva or discharge from the nose of an infected person, particularly when he/she sneezes or coughs (World Health Organization, 2020). Though the human coronaviruses have been recognized now for many years, the lack of immunity to the identified new strain, there is a large portion of the population susceptible to it (Goyal et al., 2020). Besides, the latest trend of the exponential increase in the infected people, with a steep rise of 69.17 % within three days from 21st March 2020 to 23rd March 2020 (Kiprosh, 2020), and because of the lack of preventive vaccine (El Zowalaty and Järhult, 2020), there has been a high panic situation amongst the local public.

Clinical Analysis Of Pregnant Women With 2019 Novel Coronavirus Pneumonia

Journal of Medical Virology

Chen, Siyu; Liao, E.; Shao, Yong

Abstract

The aim is to evaluate pregnant women infected with coronavirus disease 2019 (COVID‐19) and provide help for clinical prevention and treatment. All five cases of pregnant women confirmed COVID‐19 were collected among patients who admitted to the Maternal and Child Hospital of Hubei Province between January 20 and February 10, 2020. All patients, aging from 25 to 31 years old, had the gestational week from 38th weeks to 41st weeks. All pregnant women did not have an antepartum fever but developed a low‐grade fever (37.5℃‐38.5℃) within 24 hours after delivery. All patients had normal liver and renal function, two patients had elevated plasma levels of the myocardial enzyme. Unusual chest imaging manifestations, featured with ground‐grass opacity, were frequently observed in bilateral (three cases) or unilateral lobe (two cases) by computed tomography (CT) scan. All labors smoothly processed, the Apgar scores were 10 points 1 and 5 minutes after delivery, no complications were observed in the newborn. Pregnancy and perinatal outcomes of patients with COVID‐19 should receive more attention. It is probable that pregnant women diagnosed with COVID‐19 have no fever before delivery. Their primary initial manifestations were merely low‐grade postpartum fever or mild respiratory symptoms. Therefore, the protective measures are necessary on admission; the instant CT scan and real‐time reverse‐transcriptase polymerase‐chain‐reaction assay should be helpful in early diagnosis and avoid cross‐infection on the occasion that patients have fever and other respiratory signs.

Keywords

Clinical aspects, diagnosis, treatment; Epidemiology

Italy in a Time of Emergency and Scarce Resources: The Need for Embedding Ethical Reflection in Social and Clinical Settings

The Journal of Clinical Ethics
Volume 31, 2020, Issue 1, pp 92-94

Nicoli, F., Gasparetto, A.

Abstract

The COVID-19 virus is severely testing the Italian healthcare system, as the requests for intensive treatment are greater than the real capacity of the system to receive patients. Given this emergency situation, it follows that citizens are limited in their freedom of movement in order to limit infection, and that in hospitals a significant number of critical situations must be faced. This brief contribution aims to offer a reflection on the public and clinical role of the bioethicist: a figure able to promote dialogue between the world of medicine and the community, and to face ethical dilemmas even in emergent clinical settings.

Keywords

Epidemiology; Ethics, social science, economics

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

Spinal Anaesthesia For Patients With Coronavirus Disease 2019 And Possible Transmission Rates In Anaesthetists: Retrospective, Single-Centre, Observational Cohort Study

British Journal of Anaesthesia

Zhong, Qi; Liu, Yin Y.; Luo, Qiong; Zou, Yu F.; Jiang, Hai X.; Li, Hui; Zhang, Jing J.; Li, Zhen; Yang, Xin; Ma, Min; Tang, Li J.; Chen, Ying Y.; Zheng, Feng; Ke, Jian J.; Zhang, Zong Z.

 

Abstract

Background: The safety of performing spinal anaesthesia for both patients and anaesthetists alike in the presence of active infection with the novel coronavirus disease 2019 (COVID-19) is unclear. Here, we report the clinical characteristics and outcomes for both patients with COVID-19 and the anaesthetists who provided their spinal anaesthesia.

Methods: Forty-nine patients with radiologically confirmed COVID-19 for Caesarean section or lower-limb surgery undergoing spinal anaesthesia in Zhongnan Hospital, Wuhan, China participated in this retrospective study. Clinical characteristics and perioperative outcomes were recorded. For anaesthesiologists exposed to patients with COVID-19 by providing spinal anaesthesia, the level of personal protective equipment (PPE) used, clinical outcomes (pulmonary CT scans), and confirmed COVID-19 transmission rates (polymerase chain reaction [PCR]) were reviewed.

Results: Forty-nine patients with COVID-19 requiring supplementary oxygen before surgery had spinal anaesthesia (ropivacaine 0.75%), chiefly for Caesarean section (45/49 [91%]). Spinal anaesthesia was not associated with cardiorespiratory compromise intraoperatively. No patients subsequently developed severe pneumonia. Of 44 anaesthetists, 37 (84.1%) provided spinal anaesthesia using Level 3 PPE. Coronavirus disease 2019 infection was subsequently confirmed by PCR in 5/44 (11.4%) anaesthetists. One (2.7%) of 37 anaesthetists who wore Level 3 PPE developed PCR-confirmed COVID-19 compared with 4/7 (57.1%) anaesthetists who had Level 1 protection in the operating theatre (relative risk reduction: 95.3% [95% confidence intervals: 63.7–99.4]; P<0.01).

Conclusions: Spinal anaesthesia was delivered safely in patients with active COVID-19 infection, the majority of whom had Caesarean sections. Level 3 PPE appears to reduce the risk of transmission to anaesthetists who are exposed to mildly symptomatic surgical patients.

Keywords

Epidemiology

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

Syndromic Panels or the Panels' Syndrome? A Perspective Through the Lens of Respiratory Tract Infections

Clinical Microbiology and Infection

Zanella, Marie-Céline; Meylan, Pascal; Kaiser, Laurent 

To the Editor,

We thank Brendish et al for their interest in our commentary and they rightly point out that it was not a systematic review. Our main intention was to provide food for thought and discussion regarding the use of panel assays in the light of some relevant publications. In particular, we aimed at discussing the limitations of their analytical aspects and clinical validation. We respectfully disagree with the statement that “The authors suggest that the increasing use of rapid, automated, syndromic molecular panels for respiratory viruses (RVs) should be abandoned in favor of more limited PCR testing for RVs”. As microbiologists and clinicians, we rather suggest that we have the responsibility to promote diagnostic stewardship in order to integrate these new technologies in clinical management, while considering their strengths and limitations. We also highlight the value of a multiple-step approach of testing that does not necessarily preclude their use.

Keywords

Epidemiology

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