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1.
BMJ Case Rep ; 15(3)2022 Mar 09.
Article in English | MEDLINE | ID: covidwho-1736044

ABSTRACT

Acquired haemophilia A (AHA) is a rare bleeding disorder with high morbidity and mortality, but it is eminently treatable if diagnosis and treatment are prompt. We report a case of AHA in Southeast Asia following the administration of the Pfizer-BioNTech COVID-19 vaccine. A man in his 80s developed multiple bruises 2 weeks after his first dose of the COVID-19 vaccine. Diagnosis was delayed due to his cognitive impairment and low clinical suspicion. This led to a representation with worsening ecchymosis, a left thigh haematoma and symptomatic anaemia. Laboratory testing was notable for an isolated prolongation of the activated partial thromboplastin time, which remained uncorrected in the mixing test. Further testing confirmed the presence of factor VIII (FVIII) inhibitors and low FVIII titres of 6.7%. He responded to treatment with intravenous methylprednisolone and recombinant activated FVII. Screening for autoimmune diseases and malignancies was negative.


Subject(s)
COVID-19 , Hemophilia A , Asia, Southeastern , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Factor VIII/therapeutic use , Hemophilia A/diagnosis , Hemophilia A/drug therapy , Hemophilia A/etiology , Humans , Male , SARS-CoV-2
2.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-306374

ABSTRACT

Background: The current COVID-19 pandemic has demonstrated that personal protective equipment (PPE) is essential, to prevent the acquisition and transmission of infectious diseases, yet its use is often sub-optimal in the clinical setting. Training and education are important to ensure and sustain the safe and effective use of PPE by medical interns, but current methods are often inadequate in providing the relevant knowledge and skills. The purpose of this study was to explore medical graduates’ experiences of the use of PPE and identify opportunities for improvement in education and training programmes, to improve occupational and patient safety. Methods: This study was undertaken in 2018 in a large tertiary-care teaching hospital in Sydney, Australia, to explore medical interns’ self-reported experiences of PPE use, at the beginning of their internship. Reflexive groups were conducted immediately after theoretical and practical PPE training, during hospital orientation. Transcripts of recorded discussions were analysed, using a thematic approach that drew on the COM-B (capability, opportunity, motivation - behaviour) framework for behaviour. Results: 80% of 90 eligible graduates participated. Many interns had not previously received formal training in the specific skills required for optimal PPE use and had developed potentially unsafe habits. Their experiences as medical students in clinical areas contrasted sharply with recommended practice taught at hospital orientation and impacted on their ability to cultivate correct PPE use. Conclusions: Undergraduate teaching should be consistent with best practice PPE use, and include practical training that embeds correct and safe practices.

3.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-325449

ABSTRACT

COVID-19 has outbreaked in Wuhan city, Hubei province of China since December 30 th 2019, and spread nationwide and widely spilled over to other countries around the world that has been declared a public health emergency. However, there is no specific drug for the treatment of the disease. Therefore, identifying effective antiviral drugs to combat the disease is urgently needed. Angiotensin converting enzyme 2 (ACE2) has become the promising target to discovery new antiviral drugs to treat COVID-19, we have attempted to discover novel ACE2 inhibitors through ligand-based virtual screening. Finally, eight compounds were selected and tested ACE2 kinase inhibitory assay using fluorescence assays method. The results showed that four compounds (monoammonium glycyrrhizinate, glycyrrhizic acid methyl ester, ginsenoside Rg6 and ginsenoside F1) from 101 kinds of Chinese medicinal and edible plants which could inhibit ACE2 activity in vitro. Further efforts on chemical modification of these lead compounds are undergoing can lead to discover better agents against COVID-19.

4.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-322475

ABSTRACT

Background: During the COVID-19 pandemic, Malaysian consumers were more likely to purchase food online and have it delivered to their doorstep. To stay afloat, many restaurants were pushed to provide online food delivery services (OFDS), and this sector has grown tremendously. However, will the trend persist after the pandemic? This study aims to look into how consumers’ perceptions of OFDS affect their attitude towards them. It investigates the relationship between convenience motivation, perceived ease of use, time-saving orientation and price-saving orientation in terms of future intent to use OFDS. Method: Primary data was collected from 307 respondents in Malaysia using convenience sampling method through an online survey. Respondents’ demographic background was presented statistically in cross tabulation tables to study the ratio comparison implicitly. Consistent Partial Least Square approach and bootstrapping techniques with 5,000 subsamples was employed, with the aid of SmartPLS.V3 software, to identify the significant factors influencing consumers’ continuance intention after the pandemic. Result: Perceived ease of use does not contribute significantly to continuance intention as most consumers have prior online purchase experience.  Nevertheless, time-saving orientation has a positive correlation with perceived ease of use due to the simplicity of placing an order with just a click.  It is also found that price-saving orientation is related to convenience motivation, particularly when prices can be compared on the websites or online ordering platforms. Consumers’ intention to continue using OFDS even after the COVID-19 pandemic is positively influenced by all the parameters studied, except for perceived ease of use. Conclusion: Limited work has been done on the continuance intention to use OFDS beyond the pandemic. This study provides insight for food retailers on how to enhance their business and retain their customers with the support of technology, even after the COVID-19 pandemic.

5.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315048

ABSTRACT

The emergence of the coronavirus disease 2019 (COVID-19) caused a large-scale outbreak and has rapidly spread across China and multiple countries. We reported countermeasures in infection control for diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS- CoV-2) infection and the experiences of point of care diagnostics and medical quarantine for presumed SARS-CoV-2-infected subjects. We conducted a retrospective cohort study on subjects came to Chung Shan Medical University Hospital with suspicion of SARS-CoV-2 infection during January to March, 2020. We performed the real-time reverse-transcription polymerase chain reaction testing (rRT-PCR) for SARS-CoV-2-infection and reported the results of testing and treatment. A total of 212 participants were enrolled due to suspicion of SARS-CoV-2 infection. Five of those were confirmed COVID-19 cases after monitoring for a period of 14 days and were cured. The time to rRT-PCR test conversion after treatment is variate. The infection control measures of home quarantine and mandatory medical quarantine combined with rapid diagnosis seem to postpone the speed of transmission of SARS-CoV-2 infection at once in Taiwan. Due to lack of vaccination and confirmed antiviral therapy, it is important to strictly abide by the infection control measures.

6.
Clin Infect Dis ; 2021 Dec 10.
Article in English | MEDLINE | ID: covidwho-1566002

ABSTRACT

BACKGROUND: Following SARS-CoV-2 infection or vaccination there is significant variability between individuals in protective antibody levels against SARS-CoV-2, and within individuals against different virus variants. However, host demographic or clinical characteristics that predict variability in cross-reactive antibody levels are not well-described. These data could inform clinicians, researchers, and policy makers on the populations most likely to require vaccine booster shots. METHODS: In an institutional review board-approved prospective observational cohort study of staff at St. Jude Children's Research Hospital, we identified participants with plasma samples collected after SARS-CoV-2 infection, after mRNA vaccination, and after vaccination following infection, and quantitated IgG levels by ELISA to the spike receptor binding domain (RBD) from five important SARS-CoV-2 variants (Wuhan Hu-1, B.1.1.7, B.1.351, P.1 and B.1.617.2). We used regression models to identify factors that contributed to cross-reactive IgG against one or multiple viral variants. RESULTS: Following infection, a minority of the cohort generated cross-reactive antibodies, IgG antibodies that bound all tested variants. Those that did had increased disease severity, poor metabolic health, and were of a particular ancestry. Vaccination increased the levels of cross-reactive IgG levels in all populations including immunocompromised, elderly and persons with poor metabolic health. Younger people with a healthy weight mounted the highest responses. CONCLUSIONS: Our findings provide important new information on individual antibody responses to infection/vaccination that could inform clinicians on the populations that may require follow-on immunization.

8.
Clin Hematol Int ; 2(4): 173-175, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-1448685
9.
Res Social Adm Pharm ; 18(1): 2157-2163, 2022 01.
Article in English | MEDLINE | ID: covidwho-1199057

ABSTRACT

Video-reflexive ethnography (VRE) is a qualitative methodology that explores the complex nature of healthcare 'as it really is'. Its collaborative and reflexive process invites stakeholders (e.g. pharmacists and pharmacy support staff) to participate in analysing their everyday work practices as captured on video footage. Through close collaboration with practitioners and attention to their work contexts, VRE may be a useful methodology to engage a time-poor pharmacy workforce in research about themselves, encouraging more practitioner involvement in practice-based research. Aside from research, VRE has also been used effectively as an intervention to facilitate learning and change in healthcare settings, and could be effective in provoking change in otherwise resistant pharmacy environments. Much like traditional ethnographic approaches, VRE researchers have relied on being present 'in the field' to observe, record and make sense of practices with participants. The COVID-19 pandemic however, has introduced restrictions around travel and physical distancing, which has required researchers to contemplate the conduct of VRE 'at a distance', and to imagine new ways in which the methodological 'closeness' to stakeholders and their workplace contexts can be maintained when researchers cannot be on site. In this commentary, we outline the rationale for participatory methods, in the form of VRE, in pharmacy research. We describe the underlying principles of this innovative methodology, and offer examples of how VRE can be used in pharmacy research. Finally, we offer a reflexive account of how we have adapted the method for use in community pharmacy research, to adapt to physical distancing, without sacrificing its methodological principles. This paper offers not only a new methodology to examine the complexity of pharmacy work, but demonstrates also the responsiveness of VRE itself to complexity, and the potential breadth of future research applications in pharmacy both during and beyond the current pandemic.


Subject(s)
COVID-19 , Pharmacies , Pharmacy Research , Anthropology, Cultural , Community-Based Participatory Research , Humans , Pandemics , Pharmacists , SARS-CoV-2
10.
Nat Commun ; 12(1): 802, 2021 02 05.
Article in English | MEDLINE | ID: covidwho-1065865

ABSTRACT

Coronavirus disease 2019 (COVID-19) is a highly contagious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Diagnosis of COVID-19 depends on quantitative reverse transcription PCR (qRT-PCR), which is time-consuming and requires expensive instrumentation. Here, we report an ultrasensitive electrochemical biosensor based on isothermal rolling circle amplification (RCA) for rapid detection of SARS-CoV-2. The assay involves the hybridization of the RCA amplicons with probes that were functionalized with redox active labels that are detectable by an electrochemical biosensor. The one-step sandwich hybridization assay could detect as low as 1 copy/µL of N and S genes, in less than 2 h. Sensor evaluation with 106 clinical samples, including 41 SARS-CoV-2 positive and 9 samples positive for other respiratory viruses, gave a 100% concordance result with qRT-PCR, with complete correlation between the biosensor current signals and quantitation cycle (Cq) values. In summary, this biosensor could be used as an on-site, real-time diagnostic test for COVID-19.


Subject(s)
Biosensing Techniques/methods , COVID-19/diagnosis , Electrochemical Techniques/methods , SARS-CoV-2/isolation & purification , COVID-19/virology , Humans , Nucleic Acid Amplification Techniques/methods , RNA, Viral/genetics , SARS-CoV-2/genetics , SARS-CoV-2/physiology , Sensitivity and Specificity
11.
PLoS One ; 16(2): e0245842, 2021.
Article in English | MEDLINE | ID: covidwho-1060990

ABSTRACT

BACKGROUND: Thailand is among the top five countries with effective COVID-19 transmission control. This study examines how news of presence of COVID-19 in Thailand, as well as varying levels of government restriction on movement, affected human mobility in a rural Thai population along the border with Myanmar. METHODS: This study makes use of mobility data collected using a smartphone app. Between November 2019 and June 2020, four major events concerning information dissemination or government intervention give rise to five time intervals of analysis. Radius of gyration is used to analyze movement in each interval, and movement during government-imposed curfew. Human mobility network visualization is used to identify changes in travel patterns between main geographic locations of activity. Cross-border mobility analysis highlights potential for intervillage and intercountry disease transmission. RESULTS: Inter-village and cross-border movement was common in the pre-COVID-19 period. Radius of gyration and cross-border trips decreased following news of the first imported cases. During the government lockdown period, radius of gyration was reduced by more than 90% and cross-border movement was mostly limited to short-distance trips. Human mobility was nearly back to normal after relaxation of the lockdown. CONCLUSIONS: This study provides insight into the impact of the government lockdown policy on an area with extremely low socio-economic status, poor healthcare resources, and highly active cross-border movement. The lockdown had a great impact on reducing individual mobility, including cross-border movement. The quick return to normal mobility after relaxation of the lockdown implies that close monitoring of disease should be continued to prevent a second wave.


Subject(s)
COVID-19/pathology , Cell Phone , Travel/statistics & numerical data , COVID-19/virology , Humans , Rural Population , SARS-CoV-2/isolation & purification , Thailand
12.
J Zhejiang Univ Sci B ; 21(12): 921-939, 2020.
Article in English | MEDLINE | ID: covidwho-999888

ABSTRACT

The coronavirus disease 2019 (COVID-19) is an emerging infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Within a matter of months, this highly contagious novel virus has led to a global outbreak and is still spreading rapidly across continents. In patients with COVID-19, underlying chronic diseases and comorbidities are associated with dismal treatment outcomes. Owing to their immunosuppressive status, patients with hematological malignancies (HMs) are at an increased risk of infection and have a worse prognosis than patients without HMs. Accordingly, intensive attention should be paid to this cohort. In this review, we summarize and analyze specific clinical manifestations for patients with coexisting COVID-19 and HMs. Furthermore, we briefly describe customized management strategies and interventions for this susceptible cohort. This review is intended to guide clinical practice.


Subject(s)
COVID-19/complications , Hematologic Neoplasms/complications , COVID-19/diagnosis , COVID-19/prevention & control , Diagnosis, Differential , Disease Management , Hematologic Neoplasms/diagnosis , Hematologic Neoplasms/virology , Hospitalization , Humans , Immunocompromised Host , Risk Factors
13.
J Allergy Clin Immunol Pract ; 8(10): 3251-3258, 2020.
Article in English | MEDLINE | ID: covidwho-731806

ABSTRACT

There is a striking age-related disparity in the prevalence and severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-induced coronavirus disease 2019 infections, which might be explained by age-dependent immunological mechanisms. These include age-related physiological differences in immunological responses, cross-neutralizing antibodies, and differences in levels and binding affinity of angiotensin-converting enzyme 2, the SARS-CoV-2 target receptor; antibody-dependent enhancement in adults manifesting with an overexuberant systemic inflammation in response to infection; and the increased likelihood of comorbidities in adults and the elderly. Emerging immunological phenomena such as Pediatric Multi-System Inflammatory Disorder Temporally associated with SARS-CoV-2 or Multisystem Inflammatory Syndrome in Children are now being observed, though the underlying mechanisms are still unclear. Understanding the mechanisms through which pediatric patients are protected from severe novel coronaviruses infections will provide critical clues to the pathophysiology of coronavirus disease 2019 infection and inform future therapeutic and prophylactic interventions. Asymptomatic carriage in children may have major public health implications, which will have an impact on social and health care policies on screening and isolation practices, school reopening, and safe distancing requirements in the community.


Subject(s)
Age Factors , Antibody-Dependent Enhancement/immunology , Betacoronavirus/immunology , Broadly Neutralizing Antibodies/immunology , Coronavirus Infections/immunology , Cytokine Release Syndrome/immunology , Immunosenescence/immunology , Pneumonia, Viral/immunology , Systemic Inflammatory Response Syndrome/immunology , Adolescent , Adult , Aged , Aged, 80 and over , Angiotensin-Converting Enzyme 2 , Asymptomatic Infections , B-Lymphocytes/immunology , COVID-19 , Child , Child, Preschool , Comorbidity , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Disease Susceptibility , Humans , Infant , Inflammation/immunology , Middle Aged , Pandemics , Peptidyl-Dipeptidase A/metabolism , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Policy Making , Renin-Angiotensin System/immunology , SARS-CoV-2 , Severity of Illness Index , Spike Glycoprotein, Coronavirus/immunology , T-Lymphocytes/immunology , Young Adult
14.
Curr Res Transl Med ; 68(3): 111-118, 2020 08.
Article in English | MEDLINE | ID: covidwho-622221

ABSTRACT

The pandemic of coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is spreading rapidly across the world. Currently, the COVID-19 pandemic is affecting the continuity of essential routine healthcare services and procedures, including chimeric antigen receptor T-cell (CAR-T) therapy, a life-saving option for patients with relapsed/refractory (R/R) hematologic malignancies. Due to the rapid disease progression of hematological malignancies, there is an urgent need to manufacture and utilize CAR T-cells. However, CAR-T treatment has become extraordinarily challenging during this COVID-19 pandemic. Thus, many medical and technical factors must now be taken into consideration before, during, and after CAR-T therapy. The purpose of this review is to provide brief suggestions for rational decision-making strategies in evaluating and selecting CAR T-cell treatment and appropriate CAR T-cell products, and protective strategies for medical staff and patients to prevent infection in the midst of the current COVID-19 pandemic.


Subject(s)
Coronavirus Infections/prevention & control , Delivery of Health Care/organization & administration , Hematologic Neoplasms/therapy , Immunotherapy, Adoptive , Infection Control/organization & administration , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Receptors, Antigen, T-Cell/immunology , Betacoronavirus/physiology , COVID-19 , Coronavirus Infections/epidemiology , Delivery of Health Care/methods , Delivery of Health Care/standards , Delivery of Health Care/trends , Hematologic Neoplasms/epidemiology , Humans , Immunotherapy, Adoptive/methods , Immunotherapy, Adoptive/trends , Infection Control/methods , Infection Control/standards , Infection Control/trends , Pneumonia, Viral/epidemiology , Preventive Health Services/methods , Preventive Health Services/organization & administration , Preventive Health Services/standards , Preventive Health Services/trends , SARS-CoV-2
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