Efficacy of personal protective equipment to prevent environmental infection of COVID-19 among healthcare workers: a systematic review.

BACKGROUND: Healthcare workers (HCWs) employed personal protective equipment (PPE) during the COVID-19 pandemic, crucial to protecting themselves from infection. To highlight the efficacy of PPE in preventing environmental infection among HCWs, a systematic review was conducted in line with PRISMA guidance. METHODS: A search of the PubMed and Web of Science databases was conducted from January 2019 to April 2021 using pre-defined search terms. Articles were screened by three researchers. The approved papers were read in full and included in this review if relevance was mutually agreed upon. Data were extracted by study design and types of PPEs. RESULTS: 47 of 108 identified studies met the inclusion criteria, with seven reviews and meta-analyses, seven cohort, nine case-control, fifteen cross-sectional studies, four before and after, four case series, and one modeling studies. Wearing PPE offered COVID-19 protection in HCWs but required adequate training. Wearing surgical masks provided improved protection over cloth masks, while the benefit of powered air-purifying respirators is less clear, as are individual gowns, gloves, and/or face shields. CONCLUSIONS: Wearing PPE, especially facial masks, is necessary among HCWs, while training in proper use of PPE is also important to prevent COVID-19 infection.

Diabetes Mellitus May Exacerbate Liver Injury in Patients with COVID-19: A Single-Center, Observational, Retrospective Study.

INTRODUCTION: The spread of coronavirus disease 2019 (COVID-19) is having a profound effect on global health. In this study, we investigated early predictors of severe prognosis from the perspective of liver injury and risk factors for severe liver injury in patients with COVID-19. METHODS: We examined prognostic markers and risk factors for severe liver injury by analyzing clinical data measured throughout the course of the illness and the disease severity of 273 patients hospitalized for COVID-19. We assessed liver injury on the basis of aminotransferase concentrations and fibrosis-4 (FIB-4) index on admission, peak aminotransferase concentration during hospitalization, aminotransferase peak-to-average ratio, and albumin and total bilirubin concentrations. Furthermore, we analyzed age, aspartate aminotransferase (AST) concentrations, FIB-4 index on admission, hypertension, diabetes mellitus (DM), dyslipidemia, cerebral infarction, myocardial infarction, and body mass index as mortality risk factors. RESULTS: We identified advanced age as a risk factor. Among biochemical variables, AST concentration and FIB-4 index on admission were associated with high mortality. AST on admission and peak AST during hospitalization were significantly higher in the non-surviving (n = 45) than the discharged group (n = 228). Multivariable Cox hazards analyses for mortality showed significant hazard ratios for age, peak AST, and FIB-4 index on admission (p = 0.0001 and 0.0108, respectively), but not in a model including AST and FIB-4 index on admission. Furthermore, the AST peak was significantly higher among non-surviving patients with DM than in those without DM. CONCLUSIONS: We found that advanced age, high AST, and FIB-4 index on admission and a higher peak AST during hospitalization are risk factors for poor COVID-19 prognosis. Furthermore, DM was a risk factor for exacerbation of liver injury among non-surviving patients. The AST concentration and FIB-4 index should be assessed periodically throughout hospitalization, especially in patients with high AST values on admission and those with DM.

Socio-economic factors do also matter: comments on the article "Can climatic factors explain the differences in COVID-19 incidence and severity across the spanish regions?: an ecological study".

A report published in this journal showed an inversely significant association between ultraviolet radiation (UVR) before the pandemic and cumulative COVID-19 cases in Spain. The analyses employed several meteorological factors, but socio-economic factors were not included. We examined the associations of COVID-19 cases with selected factors and found a significance on gross domestic product per capita (p = 0.037 by Spearman's correlation). Hence, simple regression analyses of UVR would be confounded with regional difference in economic activities. In addition, we raised several questions for limitations due to the study design and analyses.

Serological Tests for SARS-CoV-2 Coronavirus by Commercially Available Point-of-Care and Laboratory Diagnostics in Pre-COVID-19 Samples in Japan.

The number of COVID-19 patients in Japan is considered low, compared with U.S. and European countries. However, recent serological survey reported that several percent of population showed IgG positive to SARS-CoV-2. Specificity in the assays might influence the estimate, and possibility of overdiagnosis should be investigated. Serological tests for SARS-CoV-2 coronavirus were performed in pre-COVID-19 sera in Japan (400 healthy subjects in 2012-2015). Lateral flow assay (LFA) and enzyme-linked immunosorbent assay (ELISA) showed 1.5% (6/400) and 1.75% (7/400) IgG positives, respectively. Among those false positive samples, only one sample was positive in both LFA and ELISA (0.25%; 95% CI: 0.006-1.39%). Possible bias from pooling method was examined by Monte Carlo method and the possibility was unlikely at low false positive rate. Previous surveys might overestimate COVID-19 seroprevalence in several populations of Japan. These false positives could be excluded by combination of different diagnostics. Nonetheless, the result of seroprevalence should be carefully interpreted in less prevalent areas.

Serological Tests for SARS-CoV-2 Coronavirus by Commercially Available Point-of-Care and Laboratory Diagnostics in Pre-COVID-19 Samples in Japan

The number of COVID-19 patients in Japan is considered low, compared with U.S. and European countries. However, recent serological survey reported that several percent of population showed IgG positive to SARS-CoV-2. Specificity in the assays might influence the estimate, and possibility of overdiagnosis should be investigated. Serological tests for SARS-CoV-2 coronavirus were performed in pre-COVID-19 sera in Japan (400 healthy subjects in 2012-2015). Lateral flow assay (LFA) and enzyme-linked immunosorbent assay (ELISA) showed 1.5% (6/400) and 1.75% (7/400) IgG positives, respectively. Among those false positive samples, only one sample was positive in both LFA and ELISA (0.25%;95% CI: 0.006-1.39%). Possible bias from pooling method was examined by Monte Carlo method and the possibility was unlikely at low false positive rate. Previous surveys might overestimate COVID-19 seroprevalence in several populations of Japan. These false positives could be excluded by combination of different diagnostics. Nonetheless, the result of seroprevalence should be carefully interpreted in less prevalent areas.