COVID-19 In Children: More Than Meets The Eye

Travel Medicine and Infectious Disease

Hagmann, Stefan H. F.

Abstract

The novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has so far resulted in more than 300,000 reported confirmed cases of Coronavirus virus disease 2019 (COVID-19) and about 15,000 deaths. Today's very high degree of international interconnectedness and mobility has favored the truly rapid global spread of this novel virus as COVID-19 cases have been so far reported from almost every country on earth (190 out of 195 countries recognized by the United Nations). Severe respiratory illness and acute respiratory distress syndrome (ARDS), mostly observed in older adults, that have in many instances in several countries overloaded hospital capacities have so far dominated the media reports and the clinical literature on COVID-19.

Keywords

SARS-CoV-2, COVID-19, Children, Morbidity

Can Companion Animals Become Infected With Covid-19?

The Veterinary Record
Volume 186, Issue 12, Pages 388-389

Almendros, Angel

Introduction

The veterinary community has been following the evolution of the global pandemic of Covid-19 to identify risks to animals and possible zoonotic transmission. With some exceptions, most coronavirus (CoV) infections in domestic animals are predominantly associated with gastrointestinal disease. Their genetic diversity and variety of hosts are likely to be connected to their high mutation frequency and their RNA instability. This makes CoVs a public health concern with future outbreaks being predicted.

Keywords

Ethics, social science, economics

The Effects Of Misleading Media Reports About COVID-19 On Chinese Tourists Mental Health: A Perspective Article

Anatolia

Zheng, Yi; Goh,Edmund; Wen, Jun.

Abstract

The novel coronavirus (COVID-19) has been declared a public health emergency of international concern by the World Health Organization. This pandemic has since saturated the headlines of major international media channels that disseminate information to global citizens. However, some media coverage of COVID-19 has negatively influenced Chinese travellers’ mental health due to the outbreak having been labelled “Chinese virus pandemonium.” Key world leaders have also parroted such sensationalism; for example, President Donald Trump called COVID-19 the “Chinese virus”. This discriminatory labelling has resulted in violent attacks on Chinese international travellers and students. This perspective article explores how misleading and discriminatory media reports may affect the mental well-being of ethnically Chinese travellers during the global COVID-19 pandemic.

Keywords

COVID-19 outbreak, misleading information, media coverage, mental health, psychological well-being

Quantitative Detection and Viral Load Analysis of SARS-CoV-2 in Infected Patients

Clinical Infectious Diseases

Yu, Fengting; Yan, Liting; Wang, Nan; Yang, Siyuan; Wang, Linghang; Tang, Yunxia; Gao, Guiju; Wang, Sa; Ma, Chengjie; Xie, Ruming; Wang, Fang; Tan, Chianru; Zhu, Lingxiang; Guo, Yong; Zhang, Fujie 

Abstract

Background

Coronavirus disease 2019 (COVID-19) has become a public health emergency. The widely used reverse transcription PCR (RT-PCR) method has limitations for clinical diagnosis and treatment.

Methods

A total of 323 samples from 76 COVID-19 confirmed patients were analyzed by droplet digital PCR (ddPCR) and RT-PCR based two target genes (ORF1ab and N). Nasal swabs, throat swabs, sputum, blood, and urine were collected. Clinical and imaging data were obtained for clinical staging.

Results

In 95 samples tested positive by both methods, the cycle threshold (Ct) of RT-PCR was highly correlated with the copy numbed of ddPCR (ORF1ab gene, R2 = 0.83; N gene, R2 = 0.87). 4 (4/161) negative and 41 (41/67) single-gene positive samples tested by RT-PCR were positive according to ddPCR with viral load ranging from 11.1 to 123.2 copies/test. Then the viral load of respiratory samples was compared and the average viral load in sputum (17429 ± 6920 copies/test) was found to be significantly higher than in throat swabs (2552 ± 1965 copies/test, p < 0.001) and nasal swabs (651 ± 501 copies/test, p < 0.001). Furthermore, the viral load in the early and progressive stages were significantly higher than that in the recovery stage (46800 ± 17272 vs 1252 ± 1027, p < 0.001) analyzed by sputum samples.

Conclusions

Quantitative monitoring of viral load in lower respiratory tract samples helps to evaluate disease progression, especially in cases of low viral load.

Keywords

COVID-19, SARS-CoV-2, RT-PCR, ddPCR, Viral load

Would everyone wearing face masks help us slow the pandemic?

Science

Servick, Kelly.

Introduction

As cases of coronavirus disease 2019 (COVID-19) ballooned last month, people in Europe and North America scrambled to get their hands on surgical masks to protect themselves. Health officials jumped in to discourage them, worried about the limited supply of masks for health care personnel. “Seriously people-STOP BUYING MASKS!” began a 29 February tweet from U.S. Surgeon General Jerome Adams. The World Health Organization and U.S. Centers for Disease Control and Prevention (CDC) have both said that only people with COVID-19 symptoms and those caring for them should wear masks. But some health experts, including the director of the Chinese Center for Disease Control and Prevention, think that’s a mistake. Health authorities in parts of Asia have encouraged all citizens to wear masks in public to prevent the spread of the virus, regardless of whether they have symptoms. And the Czech Republic took the uncommon step last week of making nose and mouth coverings mandatory in public spaces, prompting a grassroots drive to hand-make masks.

Keywords

COVID-19, SARS-CoV-2, Treatment

Spotlight on Jails: COVID-19 Mitigation Policies Needed Now

Clinical Infectious Diseases

Wurcel, Alysse G.; Dauria, Emily; Zaller, Nicholas; Nijhawan, Ank; Beckwith, Curt; Nowotny, Kathryn; Brinkley-Rubinstein, Lauren 

Dear Editor,

In response to the COVID-19 pandemic, healthcare institutions and public health experts are mobilizing to develop mitigation protocols based on the experiences of other countries, including China, South Korea, and Italy. Compared to these countries, the US has a higher incarceration rate, with 10.6 million people booked into jails each year.2 Jails pose a unique set of challenges to COVID-19 prevention, detection, and management mitigation that deserves immediate attention.

In Other Covid-19 News

The Veterinary Record
Volume 186, Issue 12, Pages 370-370

Introduction

Vet practices are putting aside human-compatible ventilators, oxygen supplies and personal protective equipment such as surgical masks, as well as anaesthetic machines and monitors, for use in saving human lives. The scheme has been promoted by the RCVS, the BVA and several other veterinary associations and businesses.

Keywords

Epidemiology

Papa Giovanni XXIII Bergamo Hospital At The Time Of The COVID-19 Outbreak: Letter From The Warfront

International journal of laboratory hematology

Buoro, Sabrina; Di Marco, Fabiano; Rizzi, Marco; Fabretti, Fabrizio; Lorini, Ferdinando Luca; Cesa, Simonetta; Fagiuoli, Stefano

Abstract

In early December 2019, the 2019 novel coronavirus (COVID-19) was identified as the agent responsible for the first pneumonia cases of unknown origin in Wuhan, the capital of the Hubei region in China. The virus has been identified as a novel enveloped RNA betacoronavirus2 , that has been promptly named SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2). The World Health Organization (WHO), on January 12, 2020 declared the COVID-19 a public health emergency of international concern. On March 11, the WHO made the assessment that COVID-19 can be characterized as a pandemic.

Keywords

Clinical aspects, diagnosis, treatment; Epidemiology

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