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1.
AIMS Public Health ; 7(2): 258-273, 2020.
Article in English | MEDLINE | ID: covidwho-1792331

ABSTRACT

BACKGROUND: In December 2019, the infection caused by 2019 novel coronavirus (COVID-19) led to an outbreak in Wuhan, situated in the Hubei Province of China. Following this, there has been a rapid increase in the number of cases. On 12th March 2020, there were over 100,000 confirmed cases and almost 4,300 deaths worldwide. The clinical profile of children with COVID-19 is unknown due to the few number of cases reported. Currently, available data suggest they may have a milder form of illness. METHODS: A review of the literature published from June 2019 to March 2020 was undertaken to evaluate the clinical presentation, management and outcomes of COVID-19 in in children. Data sources included EMBASE, MEDLINE, Cochrane library, ISI Web of Knowledge and references within identified articles. RESULTS: We identified 303 potential studies, and 295 were excluded for reasons including duplicates, experimental studies and case reports. Eight studies were eligible for inclusion, including a total of 820 paediatric cases of COVID-19. Asymptomatic cases represented 14.3% (n = 117) of the total number of cases identified, and thus the remaining 85.7% (n = 703) experienced symptoms. Fever was the commonest symptom in 53.9% (n = 48) of cases, followed by cough in 39.3% (n = 35) of cases, and rhinorrhoea or pharyngeal congestion in 13.5% (n = 12) of cases. Diarrhoea and sore throats were less common symptoms, 7.9% (n = 7) and 9.0% (n = 8) respectively. Other symptoms, including fatigue, headache and dizziness were rare. CONCLUSION: Children are disproportionately affected by COVID-19 and are more likely to run a milder cause of illness following this infection compared to adults. This outbreak only started 3 months ago, therefore, further population wide studies are needed to validate these findings.

2.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-322776

ABSTRACT

Background: Coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first reported in Wuhan, China in December 2019. On 11 March 2020, the World Health Organization (WHO) declared COVID-19 to be a pandemic. As of mid-March 2020, more than a total of 150,000 cases have been reported in 122 countries, including 1,543 in the United Kingdom. Within London, there are five universities with medical schools each faced with difficult decisions on how to respond to this unprecedented situation, having to balance the education of future doctors who will soon be joining the front lines and their safety. In this paper, the responses and timeliness of medical schools are collated and compared. This will help guide medical schools’ responses in the future. Methods: : Information was gathered from the official university websites and social media platforms. Thematic analysis was performed to obtain overarching categories of responses by the medical schools. Results: : All five medical schools displayed similar responses to COVID-19, following guidance provided by Public Health England (PHE), Foreign & Commonwealth Office (FCO) and Medical Schools Council (MSC). Eight broad themes of responses were identified to have been undertaken by most London medical schools. Responses such as suspending clinical placements, keeping university facilities open and not banning on-campus events were universally adopted by all five medical schools. Other responses such as specific exam rearrangements and elective travel advice were more heterogeneous amongst the medical schools. Conclusion: Medical schools must take extraordinary measures in response to a pandemic. The experience gained from the COVID-19 pandemic will help future administrations be more confident in providing a more rapid response to similar health crises.

3.
World Allergy Organ J ; 15(1): 100622, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1586263

ABSTRACT

Introduction: Hong Kong has had a low incidence of COVID-19 vaccine related anaphylaxis, partly due to its Vaccine Allergy Safety (VAS) guidelines for screening those at higher risk of COVID-19 vaccine-associated allergic reactions. We characterize the initial experience of the VAS clinics, as well as the impact of unnecessary referrals to the vaccination program. Methods: All patients attending the VAS Clinics of the public and private health services between February and June 2021 were reviewed. Results: Out of 1127 patients assessed at VAS clinics, 1102 (97.8%) patients were recommended for vaccination. Out of those contacted, more than 80% (450/558) received vaccination successfully; the remaining had not yet booked their vaccinations. The majority (87.5%) of patients not recommended was due to potential excipient allergies. Males were significantly more likely to be recommended (OR = 5.822, 95% CI = 1.361-24.903, p = 0.007), but no other features were associated with recommendation for vaccination. Almost half (45.1%) of public service referrals were rejected due to insufficient information or incorrect indications for referral. The majority of cases (56.2%) of patients referred for suspected "anaphylaxis" did not fulfil diagnostic criteria. Discussion: COVID-19 vaccination is very safe and 98% of high-risk patients were recommended for vaccination. Barriers to VAS include a high proportion of inappropriate referrals, inaccurate diagnoses of anaphylaxis and inability to diagnose excipient allergies. Our data validates that a prior history of COVID-vaccine unrelated anaphylaxis should be removed as a precaution for vaccination. Closer collaborations between primary care and allergy specialists and changes in pharmaceutical legislation should be made a priority to promote vaccination uptake.

4.
Semin Arthritis Rheum ; 50(5): 885-889, 2020 10.
Article in English | MEDLINE | ID: covidwho-665551

ABSTRACT

OBJECTIVES: Patients with rheumatologic diseases might be more susceptible to COVID-19 and carry a poorer prognosis. The aim of this study is to examine the incidence and outcomes of all COVID-19 patients with rheumatologic conditions in Hong Kong. METHODS: This is a population-based retrospective study. All patients tested positive for SARS-CoV-2 by PCR with a previous diagnosis of rheumatologic diseases were reviewed. The incidence of COVID-19 in patients with rheumatologic conditions was calculated and compared to the general population in Hong Kong. Descriptive data of those rheumatologic patients with COVID-19 and the clinical course of the index infection were presented. RESULTS: Up till 27 May 2020, there were 1067 cases of COVID-19 diagnosed in Hong Kong which had a population of 7.5 million. Out of the 39,835 patients with underlying rheumatologic diseases, we identified 5 PCR confirmed COVID-19 cases. The estimated incidence of COVID-19 was 0.0126% patients with rheumatologic diseases, compared to 0.0142% in the general population. All 5 patients had inflammatory arthropathies. One patient was on hydroxychloroquine and sulphasalazine, and one was on methotrexate. None of the 3534 patients on b/tsDMARDs was infected. Four patients had leucopenia/lymphopenia and stool viral PCR was positive in 3 patients. All patients made uneventful recovery without complications or flare of underlying diseases. CONCLUSIONS: We found no alarming signals of increased frequency or severity of COVID-19 in patients with rheumatologic diseases, although extrapolation of the results to other populations with different infection control strategies should be made with caution.


Subject(s)
Antirheumatic Agents , Betacoronavirus/isolation & purification , Clinical Laboratory Techniques , Coronavirus Infections , Joint Diseases , Pandemics , Pneumonia, Viral , Rheumatic Diseases , Adult , Antirheumatic Agents/classification , Antirheumatic Agents/therapeutic use , COVID-19 , COVID-19 Testing , Clinical Laboratory Techniques/methods , Clinical Laboratory Techniques/statistics & numerical data , Comorbidity , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Female , Hong Kong/epidemiology , Humans , Incidence , Joint Diseases/drug therapy , Joint Diseases/epidemiology , Joint Diseases/etiology , Male , Middle Aged , Outcome Assessment, Health Care , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Prognosis , Retrospective Studies , Rheumatic Diseases/diagnosis , Rheumatic Diseases/epidemiology , Risk Assessment , Risk Factors , SARS-CoV-2
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