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1.
NASN Sch Nurse ; 35(4): 196-197, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-657165

ABSTRACT

Annually, the National Association of School Nurses (NASN) sets advocacy goals. The goals include legislative and policy priorities. This article sets forth current NASN legislative priorities and results of advocacy that benefit students. The NASN Board of Directors are instrumental in moving policy priorities forward. In addition, this article shares NASN advocacy during the COVID-19 pandemic.


Subject(s)
Betacoronavirus , Prejudice/legislation & jurisprudence , Prejudice/prevention & control , School Health Services/standards , School Nursing/standards , Tobacco Smoking/legislation & jurisprudence , Tobacco Smoking/prevention & control , Adolescent , Child , Coronavirus Infections/prevention & control , Female , Guidelines as Topic , Humans , Lunch , Male , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , United States
2.
J Adolesc Health ; 67(3): 354-361, 2020 09.
Article in English | MEDLINE | ID: covidwho-654937

ABSTRACT

PURPOSE: The overarching goal of this study was to provide key information on how adolescents' substance use has changed since the corona virus disease (COVID)-19 pandemic, in addition to key contexts and correlates of substance use during social distancing. METHODS: Canadian adolescents (n = 1,054, Mage = 16.68, standard deviation = .78) completed an online survey, in which they reported on their frequency of alcohol use, binge drinking, cannabis use, and vaping in the 3 weeks before and directly after social distancing practices had taken effect. RESULTS: For most substances, the percentage of users decreased; however, the frequency of both alcohol and cannabis use increased. Although the greatest percentage of adolescents was engaging in solitary substance use (49.3%), many were still using substances with peers via technology (31.6%) and, shockingly, even face to face (23.6%). Concerns for how social distancing would affect peer reputation was a significant predictor of face-to-face substance use with friends among adolescents with low self-reported popularity, and a significant predictor of solitary substance use among average and high popularity teens. Finally, adjustment predictors, including depression and fear of the infectivity of COVID-19, predicted using solitary substance use during the pandemic. CONCLUSIONS: Our results provide preliminary evidence that adolescent substance use, including that which occurs face to face with peers, thereby putting adolescents at risk for contracting COVID-19, may be of particular concern during the pandemic. Further, solitary adolescent substance use during the pandemic, which is associated with poorer mental health and coping, may also be a notable concern worthy of further investigation.


Subject(s)
Adolescent Behavior/psychology , Coronavirus Infections/epidemiology , Pandemics , Pneumonia, Viral/epidemiology , Substance-Related Disorders/epidemiology , Adolescent , Alcoholism/epidemiology , Canada/epidemiology , Coronavirus Infections/prevention & control , Female , Health Surveys , Humans , Male , Marijuana Abuse/epidemiology , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Risk Factors , Social Distance , Vaping/epidemiology
3.
Euro Surveill ; 25(28)2020 Jul.
Article in English | MEDLINE | ID: covidwho-647502

ABSTRACT

Serological reactivity was analysed in plasma from 436 individuals with a history of disease compatible with COVID-19, including 256 who had been laboratory-confirmed with SARS-CoV-2 infection. Over 99% of laboratory-confirmed cases developed a measurable antibody response (254/256) and 88% harboured neutralising antibodies (226/256). Antibody levels declined over 3 months following diagnosis, emphasising the importance of the timing of convalescent plasma collections. Binding antibody measurements can inform selection of convalescent plasma donors with high neutralising antibody levels.


Subject(s)
Antibodies, Neutralizing/blood , Betacoronavirus/immunology , Coronavirus Infections/blood , Coronavirus Infections/therapy , Pneumonia, Viral/blood , Pneumonia, Viral/therapy , Adolescent , Adult , Aged , Antibodies, Neutralizing/therapeutic use , Antibody Specificity , Blood Donors/statistics & numerical data , Coronavirus Infections/diagnosis , Coronavirus Infections/immunology , England , Humans , Immunization, Passive/statistics & numerical data , Middle Aged , Pandemics , Pneumonia, Viral/diagnosis , Pneumonia, Viral/immunology , Statistics, Nonparametric , Time Factors , Young Adult
4.
J Clin Microbiol ; 58(9)2020 08 24.
Article in English | MEDLINE | ID: covidwho-636249

ABSTRACT

The clinical performances of six molecular diagnostic tests and a rapid antigen test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were clinically evaluated for the diagnosis of coronavirus disease 2019 (COVID-19) in self-collected saliva. Saliva samples from 103 patients with laboratory-confirmed COVID-19 (15 asymptomatic and 88 symptomatic) were collected on the day of hospital admission. SARS-CoV-2 RNA in saliva was detected using a quantitative reverse transcription-PCR (RT-qPCR) laboratory-developed test (LDT), a cobas SARS-CoV-2 high-throughput system, three direct RT-qPCR kits, and reverse transcription-loop-mediated isothermal amplification (RT-LAMP). The viral antigen was detected by a rapid antigen immunochromatographic assay. Of the 103 samples, viral RNA was detected in 50.5 to 81.6% of the specimens by molecular diagnostic tests, and an antigen was detected in 11.7% of the specimens by the rapid antigen test. Viral RNA was detected at significantly higher percentages (65.6 to 93.4%) in specimens collected within 9 days of symptom onset than in specimens collected after at least 10 days of symptoms (22.2 to 66.7%) and in specimens collected from asymptomatic patients (40.0 to 66.7%). Self-collected saliva is an alternative specimen option for diagnosing COVID-19. The RT-qPCR LDT, a cobas SARS-CoV-2 high-throughput system, direct RT-qPCR kits (except for one commercial kit), and RT-LAMP showed sufficient sensitivities in clinical use to be selectively used in clinical settings and facilities. The rapid antigen test alone is not recommended for an initial COVID-19 diagnosis because of its low sensitivity.


Subject(s)
Clinical Laboratory Techniques , Coronavirus Infections/diagnosis , Immunoassay , Nucleic Acid Amplification Techniques , Pneumonia, Viral/diagnosis , Saliva/virology , Adolescent , Adult , Aged , Aged, 80 and over , Antigens, Viral/analysis , Betacoronavirus/genetics , Betacoronavirus/isolation & purification , Clinical Laboratory Techniques/methods , Clinical Laboratory Techniques/standards , Clinical Laboratory Techniques/statistics & numerical data , Female , Humans , Immunoassay/methods , Immunoassay/standards , Immunoassay/statistics & numerical data , Male , Middle Aged , Nucleic Acid Amplification Techniques/methods , Nucleic Acid Amplification Techniques/standards , Nucleic Acid Amplification Techniques/statistics & numerical data , Pandemics , RNA, Viral/analysis , RNA, Viral/genetics , Sensitivity and Specificity , Specimen Handling , Young Adult
5.
Epidemiol Health ; 42: e2020047, 2020.
Article in English | MEDLINE | ID: covidwho-646722

ABSTRACT

OBJECTIVES: To estimate time-variant reproductive number (Rt) of coronavirus disease 19 based on either number of daily confirmed cases or their onset date to monitor effectiveness of quarantine policies. METHODS: Using number of daily confirmed cases from January 23, 2020 to March 22, 2020 and their symptom onset date from the official website of the Seoul Metropolitan Government and the district office, we calculated Rt using program R's package "EpiEstim". For asymptomatic cases, their symptom onset date was considered as -2, -1, 0, +1, and +2 days of confirmed date. RESULTS: Based on the information of 313 confirmed cases, the epidemic curve was shaped like 'propagated epidemic curve'. The daily Rt based on Rt_c peaked to 2.6 on February 20, 2020, then showed decreased trend and became <1.0 from March 3, 2020. Comparing both Rt from Rt_c and from the number of daily onset cases, we found that the pattern of changes was similar, although the variation of Rt was greater when using Rt_c. When we changed assumed onset date for asymptotic cases (-2 days to +2 days of the confirmed date), the results were comparable. CONCLUSIONS: Rt can be estimated based on Rt_c which is available from daily report of the Korea Centers for Disease Control and Prevention. Estimation of Rt would be useful to continuously monitor the effectiveness of the quarantine policy at the city and province levels.


Subject(s)
Basic Reproduction Number/statistics & numerical data , Coronavirus Infections/epidemiology , Epidemics , Pneumonia, Viral/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Child , Coronavirus Infections/prevention & control , Female , Humans , Male , Middle Aged , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Public Policy , Quarantine , Seoul/epidemiology , Time Factors , Young Adult
6.
J Adolesc Young Adult Oncol ; 9(3): 453-454, 2020 06.
Article in English | MEDLINE | ID: covidwho-633806

ABSTRACT

After the video tutorials created a few months ago and published in the Journal of Adolescent and Young Adult Oncology, Milan's Youth Project young cancer patients decided to record another video: a "special issue" dedicated to the coronavirus disease 2019 pandemic. The video addresses critical issues of the social isolation imposed by the lockdown and the fear the patients face in addition to their actual worries related to the disease. When many people across the world are forced to social distance for the imposed lockdown, the positive attitude and the advice of young cancer patients who experience social isolation regularly may be of great support and a fine example.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Adolescent , Humans , Pandemics , Pneumonia, Viral , Young Adult
7.
BMC Med Res Methodol ; 20(1): 159, 2020 06 16.
Article in English | MEDLINE | ID: covidwho-628826

ABSTRACT

BACKGROUND: We aimed to assess the feasibility of using multiple technologies to recruit and conduct cognitive interviews among young people across the United States to test items measuring sexual and reproductive empowerment. We sought to understand whether these methods could achieve a diverse sample of participants. With more researchers turning to approaches that maintain social distancing in the context of COVID-19, it has become more pressing to refine these remote research methods. METHODS: We used several online sites to recruit for and conduct cognitive testing of survey items. To recruit potential participants we advertised the study on the free online bulletin board, Craigslist, and the free online social network, Reddit. Interested participants completed an online Qualtrics screening form. To maximize diversity, we purposefully selected individuals to invite for participation. We used the video meeting platform, Zoom, to conduct the cognitive interviews. The interviewer opened a document with the items to be tested, shared the screen with the participant, and gave them control of the mouse and keyboard. After the participant self-administered the survey, the interviewer asked about interpretation and comprehension. After completion of the interviews we sent participants a follow-up survey about their impressions of the research methods and technologies used. We describe the processes, the advantages and disadvantages, and offer recommendations for researchers. RESULTS: We recruited and interviewed 30 young people from a range of regions, gender identities, sexual orientations, ages, education, and experiences with sexual activity. These methods allowed us to recruit a purposefully selected diverse sample in terms of race/ethnicity and region. It also may have offered potential participants a feeling of safety and anonymity leading to greater participation from gay, lesbian, and transgender people who would not have agreed to participate in-person. Conducting the interviews using video chat may also have facilitated the inclusion of individuals who would not volunteer for in-person meetings. Disadvantages of video interviewing included participant challenges to finding a private space for the interview and problems with electronic devices. CONCLUSIONS: Online technologies can be used to achieve a diverse sample of research participants, contributing to research findings that better respond to young people's unique identities and situations.


Subject(s)
Cognition/physiology , Health Surveys/statistics & numerical data , Interviews as Topic/statistics & numerical data , Psychometrics/statistics & numerical data , Sexual Behavior/statistics & numerical data , Sexual and Gender Minorities/statistics & numerical data , Adolescent , Betacoronavirus/physiology , Coronavirus Infections/epidemiology , Coronavirus Infections/virology , Feasibility Studies , Female , Health Surveys/methods , Humans , Internet , Interviews as Topic/methods , Male , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology , Psychometrics/methods , Reproducibility of Results , United States/epidemiology , Young Adult
8.
Percept Mot Skills ; 127(5): 960-979, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-626367

ABSTRACT

As the Covid 19 crisis has revealed, the internet is a first-line tool for learning critical health-related information. However, internet searches are a complex and dynamic process that can be fraught with subtleties and potential error. The mechanics of searching for and using electronic health (eHealth) information is ostensibly cognitively demanding; yet we know little about the role of neurocognitive abilities in this regard. Fifty-six young adults completed two naturalistic eHealth search tasks: fact-finding (eHealth Fact) and symptom-diagnosis (eHealth Search). Participants also completed neurocognitive tests of attention, psychomotor speed, learning/memory, and executive functions. Shorter eHealth symptom-diagnosis search time was related to better executive functions, while better eHealth symptom-diagnosis search accuracy was related to better episodic and prospective memory. In contrast, neither eHealth Fact search time nor its accuracy were related to any of the neurocognitive measures. Our findings suggest a differential relationship between neurocognitive abilities and eHealth search behaviors among young adults such that higher-order abilities may be implicated in eHealth searches requiring greater synthesis of information. Future work should examine the cognitive architecture of eHealth search in persons with neurocognitive disorders, as well as that of other aspects of eHealth search behaviors (e.g., search term generation, website reliability, and decision-making).


Subject(s)
Aptitude , Attention , Cognition , Consumer Health Information , Executive Function , Information Seeking Behavior , Internet , Memory , Adolescent , Adult , Betacoronavirus , Coronavirus Infections , Decision Making , Female , Health Behavior , Health Literacy , Humans , Learning , Male , Pandemics , Pneumonia, Viral , Psychomotor Performance , Telemedicine , Young Adult
9.
JMIR Mhealth Uhealth ; 8(8): e19857, 2020 08 28.
Article in English | MEDLINE | ID: covidwho-769046

ABSTRACT

BACKGROUND: The COVID-19 pandemic is the greatest public health crisis of the last 100 years. Countries have responded with various levels of lockdown to save lives and stop health systems from being overwhelmed. At the same time, lockdowns entail large socioeconomic costs. One exit strategy under consideration is a mobile phone app that traces the close contacts of those infected with COVID-19. Recent research has demonstrated the theoretical effectiveness of this solution in different disease settings. However, concerns have been raised about such apps because of the potential privacy implications. This could limit the acceptability of app-based contact tracing in the general population. As the effectiveness of this approach increases strongly with app uptake, it is crucial to understand public support for this intervention. OBJECTIVE: The objective of this study is to investigate the user acceptability of a contact-tracing app in five countries hit by the pandemic. METHODS: We conducted a largescale, multicountry study (N=5995) to measure public support for the digital contact tracing of COVID-19 infections. We ran anonymous online surveys in France, Germany, Italy, the United Kingdom, and the United States. We measured intentions to use a contact-tracing app across different installation regimes (voluntary installation vs automatic installation by mobile phone providers) and studied how these intentions vary across individuals and countries. RESULTS: We found strong support for the app under both regimes, in all countries, across all subgroups of the population, and irrespective of regional-level COVID-19 mortality rates. We investigated the main factors that may hinder or facilitate uptake and found that concerns about cybersecurity and privacy, together with a lack of trust in the government, are the main barriers to adoption. CONCLUSIONS: Epidemiological evidence shows that app-based contact tracing can suppress the spread of COVID-19 if a high enough proportion of the population uses the app and that it can still reduce the number of infections if uptake is moderate. Our findings show that the willingness to install the app is very high. The available evidence suggests that app-based contact tracing may be a viable approach to control the diffusion of COVID-19.


Subject(s)
Contact Tracing/methods , Coronavirus Infections/prevention & control , Intention , Mobile Applications , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Adolescent , Adult , Aged , Coronavirus Infections/epidemiology , Cross-Cultural Comparison , Female , France/epidemiology , Germany/epidemiology , Humans , Italy/epidemiology , Male , Middle Aged , Pneumonia, Viral/epidemiology , Surveys and Questionnaires , United Kingdom/epidemiology , United States/epidemiology , Young Adult
11.
Pol Arch Intern Med ; 130(7-8): 615-621, 2020 08 27.
Article in English | MEDLINE | ID: covidwho-761203

ABSTRACT

INTRODUCTION: Coronavirus disease 2019 (COVID­19) is an infectious disease caused by the novel severe acute respiratory syndrome coronavirus 2. OBJECTIVES: Our aim was to present an epidemiological analysis of the first 2 months (March and April 2020) of the COVID­19 epidemic in Poland. PATIENTS AND METHODS: This analysis was based on data from epidemiological reports collected between March 4 and April 30, 2020, by the Chief Sanitary Inspectorate. These epidemiological reports include data on sociodemographic characteristics of new laboratory­confirmed COVID 19 cases, the number of COVID­19-related deaths, the number of recovered COVID-19 patients as well as the number of laboratory tests performed. RESULTS: From March 4 to April 30, 2020, a total of 12 877 laboratory­confirmed COVID 19 cases were registered in Poland (55.7% women; mean [SD] age, 50.6 [20.5] years). The RT­ PCR test was performed in 338 000 patients. The notification rate for COVID­19 was 33.2 per 100 000 inhabitants. One third of laboratory­confirmed COVID 19 cases were among quarantined persons, 26.1% were related to the healthcare system (hospital or clinic), and 13.3% occurred in nursing homes. As of April 30, 2020, 644 COVID­19-related deaths were registered in Poland (46.5% women). The death rate for the whole country was 1.7 per 100 000 inhabitants. CONCLUSIONS: Our data showed higher notification rate for COVID­19 among women than men, but men were more likely to die from COVID­19. The notification rate for COVID-19 in Poland among women aged 45 to 54 years was 2­fold higher than among men.


Subject(s)
Betacoronavirus/isolation & purification , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Adolescent , Adult , Age Distribution , Aged , Clinical Laboratory Techniques , Female , Health Services Accessibility/statistics & numerical data , Humans , Male , Middle Aged , Pandemics , Poland/epidemiology , Real-Time Polymerase Chain Reaction , Sex Distribution , Young Adult
13.
J Clin Microbiol ; 58(9)2020 08 24.
Article in English | MEDLINE | ID: covidwho-751568

ABSTRACT

The clinical performances of six molecular diagnostic tests and a rapid antigen test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were clinically evaluated for the diagnosis of coronavirus disease 2019 (COVID-19) in self-collected saliva. Saliva samples from 103 patients with laboratory-confirmed COVID-19 (15 asymptomatic and 88 symptomatic) were collected on the day of hospital admission. SARS-CoV-2 RNA in saliva was detected using a quantitative reverse transcription-PCR (RT-qPCR) laboratory-developed test (LDT), a cobas SARS-CoV-2 high-throughput system, three direct RT-qPCR kits, and reverse transcription-loop-mediated isothermal amplification (RT-LAMP). The viral antigen was detected by a rapid antigen immunochromatographic assay. Of the 103 samples, viral RNA was detected in 50.5 to 81.6% of the specimens by molecular diagnostic tests, and an antigen was detected in 11.7% of the specimens by the rapid antigen test. Viral RNA was detected at significantly higher percentages (65.6 to 93.4%) in specimens collected within 9 days of symptom onset than in specimens collected after at least 10 days of symptoms (22.2 to 66.7%) and in specimens collected from asymptomatic patients (40.0 to 66.7%). Self-collected saliva is an alternative specimen option for diagnosing COVID-19. The RT-qPCR LDT, a cobas SARS-CoV-2 high-throughput system, direct RT-qPCR kits (except for one commercial kit), and RT-LAMP showed sufficient sensitivities in clinical use to be selectively used in clinical settings and facilities. The rapid antigen test alone is not recommended for an initial COVID-19 diagnosis because of its low sensitivity.


Subject(s)
Clinical Laboratory Techniques , Coronavirus Infections/diagnosis , Immunoassay , Nucleic Acid Amplification Techniques , Pneumonia, Viral/diagnosis , Saliva/virology , Adolescent , Adult , Aged , Aged, 80 and over , Antigens, Viral/analysis , Betacoronavirus/genetics , Betacoronavirus/isolation & purification , Clinical Laboratory Techniques/methods , Clinical Laboratory Techniques/standards , Clinical Laboratory Techniques/statistics & numerical data , Female , Humans , Immunoassay/methods , Immunoassay/standards , Immunoassay/statistics & numerical data , Male , Middle Aged , Nucleic Acid Amplification Techniques/methods , Nucleic Acid Amplification Techniques/standards , Nucleic Acid Amplification Techniques/statistics & numerical data , Pandemics , RNA, Viral/analysis , RNA, Viral/genetics , Sensitivity and Specificity , Specimen Handling , Young Adult
14.
BMC Public Health ; 20(1): 1384, 2020 Sep 10.
Article in English | MEDLINE | ID: covidwho-751220

ABSTRACT

BACKGROUND: In light of the COVID-19 pandemic, many have flagged racial and ethnic differences in health outcomes in western countries as an urgent global public health priority. Kuwait has a unique demographic profile with two-thirds of the population consisting of non-nationals, most of which are migrant workers. We aimed to explore whether there is a significant difference in health outcomes between non-Kuwaiti and Kuwaiti patients diagnosed with COVID-19. METHODS: We used a prospective COVID-19 registry of all patients (symptomatic and asymptomatic) in Kuwait who tested positive from February 24th to April 20th, 2020, collected from Jaber Al-Ahmad Al-Sabah Hospital, the officially-designated COVID-19 healthcare facility in the country. We ran separate logistic regression models comparing non-Kuwaitis to Kuwaitis for death, intensive care unit (ICU) admission, acute respiratory distress syndrome (ARDS) and pneumonia. RESULTS: The first 1123 COVID-19 positive patients in Kuwait were all recruited in the study. About 26% were Kuwaitis and 73% were non-Kuwaiti. With adjustments made to age, gender, smoking and selected co-morbidities, non-Kuwaitis had two-fold increase in the odds of death or being admitted to the intensive care unit compared to Kuwaitis (OR: 2.14, 95% CI 1.12-4.32). Non-Kuwaitis had also higher odds of ARDS (OR:2.44, 95% CI 1.23-5.09) and pneumonia (OR: 2.24, 95% CI 1.27-4.12). CONCLUSION: This is the first study to report on COVID-19 outcomes between Kuwaiti and non-Kuwaiti patients. The current pandemic may have amplified the differences of health outcomes among marginalized subpopulations. A number of socioeconomic and environmental factors could explain this health disparity. More research is needed to advance the understanding of policymakers in Kuwait in order to make urgent public health interventions.


Subject(s)
Coronavirus Infections/ethnology , Coronavirus Infections/therapy , Ethnic Groups/statistics & numerical data , Health Status Disparities , Pneumonia, Viral/ethnology , Pneumonia, Viral/therapy , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Infant , Kuwait/epidemiology , Male , Middle Aged , Pandemics , Prospective Studies , Registries , Treatment Outcome , Young Adult
15.
Rev Lat Am Enfermagem ; 28: e3360, 2020 Sep 07.
Article in English, Spanish, Portuguese | MEDLINE | ID: covidwho-750913

ABSTRACT

OBJECTIVE: to identify the factors associated with the use and reuse of masks among Brazilian individuals in the context of the COVID-19 pandemic. METHOD: cross-sectional study conducted in the five Brazilian regions, among adult individuals, via an electronic form disseminated in social media, addressing general information and the use of masks. Bivariate analysis and binary logistic regression were used to identify the factors associated with the use and reuse of masks. RESULTS: 3,981 (100%) individuals participated in the study. In total, 95.5% (CI 95%: 94.8-96.1) reported using masks. Fabric masks were more frequently reported (72.7%; CI 95%: 71.3-74.1), followed by surgical masks (27.8%; CI 95%: 26.5-29.2). The percentage of reuse was 71.1% (CI 95%: 69.7-72.5). Most (55.8%; CI 95%: 51.7-60.0) of those exclusively wearing surgical masks reported its reuse. Being a woman and having had contact with individuals presenting respiratory symptoms increased the likelihood of wearing masks (p≤0.001). Additionally, being a woman decreased the likelihood of reusing surgical masks (p≤0.001). CONCLUSION: virtually all the participants reported the use of masks, most frequently fabric masks. The findings draw attention to a risky practice, that of reusing surgical and paper masks. Therefore, guidelines, public policies, and educational strategies are needed to promote the correct use of masks to control and prevent COVID-19.


Subject(s)
Coronavirus Infections/prevention & control , Equipment Reuse , Masks , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Adolescent , Adult , Betacoronavirus , Brazil , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Young Adult
16.
Rev Inst Med Trop Sao Paulo ; 62: e65, 2020 Sep 04.
Article in English | MEDLINE | ID: covidwho-750871

ABSTRACT

This narrative review summarizes the main aspects underlying the new coronavirus SARS-CoV-2, its epidemiology, pathophysiology, pointing to differences of SARS-CoV-2 main receptors ACE2, in terms of expression and the amount of soluble ACE2 in the circulation of children, men and women, and also in those with risk factors such as the smokers and pregnant women or presenting with comorbidities (diabetes, obesity, hypertension and other cardiovascular diseases, renal and CNS pre-existing diseases). Clinical manifestations in adults and children were also described, emphasizing the particularities already seen in children, regarding signs, symptoms, viral excretion time and the involvement of all organs and systems. The COVID-19 in the pediatric population was divided into two sections: one dedicated to previously healthy children and adolescents with COVID-19, and the other to those who live with comorbidities and acquired COVID-19. A few paragraphs were reserved to the recently described severe multisystemic inflammatory syndrome associated with COVID-19 (MIS-C) that shares certain characteristics with Kawasaki disease. Some studies on the infection in pregnant and postpartum women, as well as neonates were shown. This review has also covered the laboratory diagnosis of COVID-19, passing through the imaging diagnosis made by the chest tomography revealing ground glass patching opacities, and results of non-specific exams such as the total blood with lymphopenia, the coagulation tests with increased prothrombin times, as well as marked increments of the D-dimer, troponin and proinflammatory cytokines. In the section devoted to the specific laboratory diagnosis of COVID-19, the most used RT-PCR protocols were described and some studies on the serological diagnosis with IgA, IgM and IgG detection were detailed, including the use of rapid immunochromatographic assays and discussing the ideal period after the onset of symptoms to perform each type of test. In the end, the management of pediatric patients with COVID-19 based mainly on supportive measures has been briefly commented.


Subject(s)
Coronavirus Infections/diagnosis , Coronavirus Infections/physiopathology , Pneumonia, Viral/diagnosis , Pneumonia, Viral/physiopathology , Adolescent , Adult , Betacoronavirus , Child , Coronavirus Infections/therapy , Female , Humans , Infant, Newborn , Male , Pandemics , Pneumonia, Viral/therapy , Pregnancy , Pregnancy Complications, Infectious/virology , Systemic Inflammatory Response Syndrome/virology
17.
JMIR Public Health Surveill ; 6(3): e20572, 2020 09 01.
Article in English | MEDLINE | ID: covidwho-749048

ABSTRACT

BACKGROUND: To track and reduce the spread of COVID-19, apps have been developed to identify contact with individuals infected with SARS-CoV-2 and warn those who are at risk of having contracted the virus. However, the effectiveness of these apps depends highly on their uptake by the general population. OBJECTIVE: The present study investigated factors influencing app use intention, based on the health belief model. In addition, associations with respondents' level of news consumption and their health condition were investigated. METHODS: A survey was administered in Flanders, Belgium, to 1500 respondents, aged 18 to 64 years. Structural equation modeling was used to investigate relationships across the model's constructs. RESULTS: In total, 48.70% (n=730) of respondents indicated that they intend to use a COVID-19 tracing app. The most important predictor was the perceived benefits of the app, followed by self-efficacy and perceived barriers. Perceived severity and perceived susceptibility were not related to app uptake intention. Moreover, cues to action (ie, individuals' exposure to [digital] media content) were positively associated with app use intention. As the respondents' age increased, their perceived benefits and self-efficacy for app usage decreased. CONCLUSIONS: Initiatives to stimulate the uptake of contact tracing apps should enhance perceived benefits and self-efficacy. A perceived barrier for some potential users is privacy concerns. Therefore, when developing and launching an app, clarification on how individuals' privacy will be protected is needed. To sustain perceived benefits in the long run, supplementary options could be integrated to inform and assist users.


Subject(s)
Coronavirus Infections , Mobile Applications , Pandemics , Pneumonia, Viral , Smartphone , Adolescent , Adult , Belgium , Betacoronavirus , Contact Tracing , Humans , Middle Aged , Privacy , Young Adult
18.
J Am Acad Dermatol ; 83(3): 870-875, 2020 09.
Article in English | MEDLINE | ID: covidwho-747574

ABSTRACT

BACKGROUND: During the coronavirus disease 2019 pandemic, several acral chilblain-like lesions were observed in young patients with suspected, but mostly unconfirmed, infection with severe acute respiratory syndrome coronavirus 2. The histopathologic aspect of these lesions is as yet poorly known. OBJECTIVE: To investigate the pathologic features of chilblain-like lesions. METHODS: Biopsies were obtained from 17 cases of chilblain-like lesions during the coronavirus disease 2019 pandemic in France and were studied by routine histologic examination, immunohistochemistry, and direct immunofluorescence. The patients had suspected but unconfirmed infection with severe acute respiratory syndrome coronavirus 2 (negative nasopharyngeal polymerase chain reaction and serologic test results). RESULTS: Chilblain-like lesions showed many features in common with those reported in idiopathic and autoimmune-related chilblains, including epidermal necrotic keratinocytes, dermal edema, perivascular and perieccrine sweat gland lymphocytic (predominantly CD3/CD4+) inflammation, and frequent vascular changes (endothelialitis, microthromboses, fibrin deposition, and immunoreactant deposits on vessels). CONCLUSIONS: Chilblain-like lesions show histopathologic features similar to those of idiopathic and autoimmune-related chilblains, with a high rate of vascular changes and direct immunofluorescence positivity. The role of severe acute respiratory syndrome coronavirus 2 in the development of these puzzling lesions remains to be elucidated.


Subject(s)
Betacoronavirus/isolation & purification , Chilblains/diagnosis , Coronavirus Infections/complications , Pneumonia, Viral/complications , Skin Diseases/diagnosis , Skin/pathology , Adolescent , Adult , Betacoronavirus/immunology , Biopsy , Chilblains/immunology , Chilblains/pathology , Chilblains/virology , Coronavirus Infections/epidemiology , Coronavirus Infections/immunology , Coronavirus Infections/virology , Diagnosis, Differential , Female , Fluorescent Antibody Technique , France , Humans , Immunohistochemistry , Male , Middle Aged , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/immunology , Pneumonia, Viral/virology , Skin/immunology , Skin/virology , Skin Diseases/immunology , Skin Diseases/pathology , Skin Diseases/virology , Toes , Young Adult
20.
Trials ; 21(1): 766, 2020 Sep 05.
Article in English | MEDLINE | ID: covidwho-745676

ABSTRACT

OBJECTIVES: To investigate the potential efficacy of Acacia Senegal extract Gum Arabic (GA) supplementation as immunomodulatory and anti-inflammatory dietary intervention among newly diagnosed COVID 19 Sudanese patients. To study the effect of GA on the level of cytokines, TNFα, IL8, IL6 IL10, CRP and the viral load. Secondary outcomes will be the effect of GA oral intake on mortality rate and days of hospital admission. TRIAL DESIGN: Quadruple blind, randomized placebo-controlled clinical trial Phase II & III. Prospective, two-arm, parallel-group, randomised (1:1 allocation ratio) superiority trial of oral GA among seropositive COVID-19 patients. PARTICIPANTS: Inclusion criteria: COVID-19 infected (newly diagnosed) as proved by real-time PCR within 72 hours of PCR. Age 8-90 years Both genders Exclusion criteria: Intubated patients on parenteral treatment Allergy to Gum Arabic The study will be conducted in COVID Isolation Centres and Soba University Hospital Khartoum State Sudan. INTERVENTION AND COMPARATOR: Experimental: Intervention Group This arm will receive 100% natural Gum Arabic provided in a powder form in 30-grams-dose once daily for four weeks Placebo Comparator: Control group: This group will be provided with pectin powder provided as one-gram-dose once daily for four weeks Both GA and placebo will be in addition to standard care treatment based on local clinical guidelines. MAIN OUTCOMES: Mean change from baseline score of Immune Response to end of the trial. Changes of the level of Tumor Necrosis Factor (TNFα), interleukin IL8, IL6, and IL10 from the baseline values (Four weeks from the start of randomization). Mortality rate: The percentage of deaths among COVID 19 patients received Gum Arabic compared to placebo (Four weeks from the start of randomization]). RANDOMISATION: Randomization (1:1 allocation ratio) and will be conducted using a sequence of computer-generated random numbers by an independent individual. Each participating centre will be assigned a special code generated by the computer. The randomization will be kept by the PI and a research assistant. BLINDING (MASKING): Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor) NUMBERS TO BE RANDOMISED (SAMPLE SIZE): 110 eligible patients will be randomly assigned to either GA (n=55) or placebo (n=55) groups. TRIAL STATUS: Protocol Version no 2, 30th June 2020. Recruitment will start on 15th September 2020. The intended completion date is 15th January 2021. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04381871 . Date of trial registration: 11 May 2020. FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.


Subject(s)
Betacoronavirus/drug effects , Coronavirus Infections/drug therapy , Gum Arabic/therapeutic use , Immunologic Factors/therapeutic use , Pneumonia, Viral/drug therapy , Adolescent , Adult , Aged , Aged, 80 and over , Betacoronavirus/immunology , Betacoronavirus/pathogenicity , Child , Clinical Trials, Phase II as Topic , Clinical Trials, Phase III as Topic , Coronavirus Infections/diagnosis , Coronavirus Infections/immunology , Coronavirus Infections/virology , Female , Gum Arabic/adverse effects , Host Microbial Interactions , Humans , Immunologic Factors/adverse effects , Male , Middle Aged , Pandemics , Pneumonia, Viral/diagnosis , Pneumonia, Viral/immunology , Pneumonia, Viral/virology , Prospective Studies , Randomized Controlled Trials as Topic , Time Factors , Treatment Outcome , Young Adult
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