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1.
Postepy Biochem ; 66(2): 83-90, 2020 05 09.
Article in Polish | MEDLINE | ID: covidwho-689005

ABSTRACT

In December 2019 in Wuhan, China the first cases of previously unknown, coronaviral infection-induced pneumonia have been reported. The new virus SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) was named after SARS-CoV due to their similarities and the disease caused by the pathogen is COVID-19 (Coronavirus Disease 2019). On 11 March 2020 WHO (World Health Organization) defined the rapidly increasing number of incidents of COVID-19 as a pandemic. In this review we will present recent information about the SARS-CoV-2 focusing on the origin, clinical picture, diagnostic methods, structure, replication cycle of SARS-CoV-2 and potential pharmaceutical measures against COVID-19.


Subject(s)
Betacoronavirus , Coronavirus Infections/drug therapy , Coronavirus Infections/virology , Pneumonia, Viral/drug therapy , Pneumonia, Viral/virology , Betacoronavirus/growth & development , Betacoronavirus/isolation & purification , Betacoronavirus/pathogenicity , China/epidemiology , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Humans , Pandemics , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , SARS Virus
2.
J Infect ; 80(6): 639-645, 2020 06.
Article in English | MEDLINE | ID: covidwho-688316

ABSTRACT

OBJECTIVE: To investigate the characteristics and prognostic factors in the elderly patients with COVID-19. METHODS: Consecutive cases over 60 years old with COVID-19 in Renmin Hospital of Wuhan University from Jan 1 to Feb 6, 2020 were included. The primary outcomes were death and survival till March 5. Data of demographics, clinical features, comorbidities, laboratory tests and complications were collected and compared for different outcomes. Cox regression was performed for prognostic factors. RESULTS: 339 patients with COVID-19 (aged 71±8 years,173 females (51%)) were enrolled, including 80 (23.6%) critical, 159 severe (46.9%) and 100 moderate (29.5%) cases. Common comorbidities were hypertension (40.8%), diabetes (16.0%) and cardiovascular disease (15.7%). Common symptoms included fever (92.0%), cough (53.0%), dyspnea (40.8%) and fatigue (39.9%). Lymphocytopenia was a common laboratory finding (63.2%). Common complications included bacterial infection (42.8%), liver enzyme abnormalities (28.7%) and acute respiratory distress syndrome (21.0%). Till Mar 5, 2020, 91 cases were discharged (26.8%), 183 cases stayed in hospital (54.0%) and 65 cases (19.2%) were dead. Shorter length of stay was found for the dead compared with the survivors (5 (3-8) vs. 28 (26-29), P < 0.001). Symptoms of dyspnea (HR 2.35, P = 0.001), comorbidities including cardiovascular disease (HR 1.86, P = 0.031) and chronic obstructive pulmonary disease (HR 2.24, P = 0.023), and acute respiratory distress syndrome (HR 29.33, P < 0.001) were strong predictors of death. And a high level of lymphocytes was predictive of better outcome (HR 0.10, P < 0.001). CONCLUSIONS: High proportion of severe to critical cases and high fatality rate were observed in the elderly COVID-19 patients. Rapid disease progress was noted in the dead with a median survival time of 5 days after admission. Dyspnea, lymphocytopenia, comorbidities including cardiovascular disease and chronic obstructive pulmonary disease, and acute respiratory distress syndrome were predictive of poor outcome. Close monitoring and timely treatment should be performed for the elderly patients at high risk.


Subject(s)
Betacoronavirus/isolation & purification , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Aged , China/epidemiology , Comorbidity , Coronavirus Infections/mortality , Coronavirus Infections/pathology , Female , Follow-Up Studies , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/mortality , Pneumonia, Viral/pathology , Prognosis , Survival Analysis
3.
J Infect Dis ; 221(11): 1762-1769, 2020 05 11.
Article in English | MEDLINE | ID: covidwho-688308

ABSTRACT

BACKGROUND: In December 2019, novel coronavirus (SARS-CoV-2) pneumonia (COVID-19) was reported in Wuhan and has since rapidly spread throughout China. We aimed to clarify the characteristics and clinical significance of peripheral lymphocyte subset alteration in COVID-19. METHODS: The levels of peripheral lymphocyte subsets were measured by flow cytometry in 60 hospitalized COVID-19 patients before and after treatment, and their association with clinical characteristics and treatment efficacy was analyzed. RESULTS: Total lymphocytes, CD4+ T cells, CD8+ T cells, B cells, and natural killer (NK) cells decreased in COVID-19 patients, and severe cases had a lower level than mild cases. The subsets showed a significant association with inflammatory status in COVID-19, especially CD8+ T cells and CD4+/CD8+ ratio. After treatment, 37 patients (67%) showed clinical response, with an increase in CD8+ T cells and B cells. No significant change in any subset was detected in nonresponsive cases. In multivariate analysis, posttreatment decrease in CD8+ T cells and B cells and increase in CD4+/CD8+ ratio were indicated as independent predictors of poor efficacy. CONCLUSIONS: Peripheral lymphocyte subset alteration was associated with clinical characteristics and treatment efficacy of COVID-19. CD8+ T cells tended to be an independent predictor for COVID-19 severity and treatment efficacy.


Subject(s)
Coronavirus Infections/complications , Coronavirus Infections/physiopathology , Lymphocyte Subsets , Pneumonia, Viral/complications , Pneumonia, Viral/physiopathology , Pneumonia/etiology , Pneumonia/physiopathology , Adult , Aged , Betacoronavirus/isolation & purification , China , Coronavirus Infections/diagnosis , Coronavirus Infections/therapy , Female , Flow Cytometry , Humans , Lymphocyte Count , Lymphocyte Subsets/immunology , Male , Middle Aged , Pandemics , Pneumonia/diagnosis , Pneumonia/therapy , Pneumonia, Viral/diagnosis , Pneumonia, Viral/therapy , Prognosis , Treatment Outcome
4.
Neurologia ; 35(5): 318-322, 2020 Jun.
Article in English, Spanish | MEDLINE | ID: covidwho-688165

ABSTRACT

INTRODUCTION: Contradictory data have been reported on the incidence of stroke in patients with COVID-19 and the risk of SARS-CoV-2 infection among patients with history of stroke. METHODS: This study systematically reviews case series reporting stroke as a complication of COVID-19, and analyses the prognosis of patients with COVID-19 and history of stroke. The pathophysiological mechanisms of stroke in patients with COVID-19 are also reviewed. CONCLUSIONS: History of stroke increases the risk of death due to COVID-19 by 3 times. Stroke currently seems not to be one of the main complications of COVID-19.


Subject(s)
Central Nervous System Viral Diseases/pathology , Central Nervous System Viral Diseases/virology , Central Nervous System/virology , Coronavirus Infections/complications , Pneumonia, Viral/complications , Stroke/virology , Betacoronavirus/isolation & purification , Coronavirus Infections/virology , Humans , Pandemics , Pneumonia, Viral/virology , Prognosis
5.
Eur Rev Med Pharmacol Sci ; 24(9): 5186-5188, 2020 05.
Article in English | MEDLINE | ID: covidwho-687446

ABSTRACT

From two COVID-19-related deaths, samples of lung, heart and kidney were collected and processed for Transmission and Scanning Electron Microscopy (TEM and SEM) with the aim of identifying the virus. Virions of SARS-CoV-2 were found in all tissues by TEM and SEM, corroborating the hypothesis that the virus enters the cells of different organs. This is the first report identifying SARS-CoV-2 in different human tissues by TEM and SEM.


Subject(s)
Betacoronavirus/isolation & purification , Betacoronavirus/ultrastructure , Coronavirus Infections/virology , Heart/virology , Kidney/virology , Lung/virology , Pneumonia, Viral/virology , Aged , Aged, 80 and over , Coronavirus Infections/pathology , Female , Humans , Kidney/pathology , Lung/pathology , Male , Microscopy, Electron, Scanning , Microscopy, Electron, Transmission , Pandemics , Pneumonia, Viral/pathology
6.
Circulation ; 142(2): 114-128, 2020 07 14.
Article in English | MEDLINE | ID: covidwho-684109

ABSTRACT

BACKGROUND: To investigate deep vein thrombosis (DVT) in hospitalized patients with coronavirus disease 2019 (COVID-19), we performed a single institutional study to evaluate its prevalence, risk factors, prognosis, and potential thromboprophylaxis strategies in a large referral and treatment center. METHODS: We studied a total of 143 patients with COVID-19 from January 29, 2020 to February 29, 2020. Demographic and clinical data, laboratory data, including ultrasound scans of the lower extremities, and outcome variables were obtained, and comparisons were made between groups with and without DVT. RESULTS: Of the 143 patients hospitalized with COVID-19 (age 63±14 years, 74 [51.7%] men), 66 patients developed lower extremity DVT (46.1%: 23 [34.8%] with proximal DVT and 43 [65.2%] with distal DVT). Compared with patients who did not have DVT, patients with DVT were older and had a lower oxygenation index, a higher rate of cardiac injury, and worse prognosis, including an increased proportion of deaths (23 [34.8%] versus 9 [11.7%]; P=0.001) and a decreased proportion of patients discharged (32 [48.5%] versus 60 [77.9%]; P<0.001). Multivariant analysis showed an association only between CURB-65 (confusion status, urea, respiratory rate, and blood pressure) score 3 to 5 (odds ratio, 6.122; P=0.031), Padua prediction score ≥4 (odds ratio, 4.016; P=0.04), D-dimer >1.0 µg/mL (odds ratio, 5.818; P<0.014), and DVT in this cohort, respectively. The combination of a CURB-65 score 3 to 5, a Padua prediction score ≥4, and D-dimer >1.0 µg/mL has a sensitivity of 88.52% and a specificity of 61.43% for screening for DVT. In the subgroup of patients with a Padua prediction score ≥4 and whose ultrasound scans were performed >72 hours after admission, DVT was present in 18 (34.0%) patients in the subgroup receiving venous thromboembolism prophylaxis versus 35 (66.0%) patients in the nonprophylaxis group (P=0.010). CONCLUSIONS: The prevalence of DVT is high and is associated with adverse outcomes in hospitalized patients with COVID-19. Prophylaxis for venous thromboembolism may be protective in patients with a Padua protection score ≥4 after admission. Our data seem to suggest that COVID-19 is probably an additional risk factor for DVT in hospitalized patients.


Subject(s)
Coronavirus Infections/diagnosis , Pneumonia, Viral/diagnosis , Venous Thrombosis/diagnosis , Adult , Aged , Anticoagulants/therapeutic use , Betacoronavirus/isolation & purification , Blood Pressure , China/epidemiology , Coronavirus Infections/complications , Coronavirus Infections/mortality , Coronavirus Infections/physiopathology , Female , Fibrin Fibrinogen Degradation Products/analysis , Humans , Kaplan-Meier Estimate , Lower Extremity/diagnostic imaging , Male , Middle Aged , Odds Ratio , Pandemics , Pneumonia, Viral/complications , Pneumonia, Viral/mortality , Pneumonia, Viral/physiopathology , Prevalence , Prognosis , Respiratory Rate , Retrospective Studies , Risk Factors , Treatment Outcome , Venous Thrombosis/complications , Venous Thrombosis/drug therapy , Venous Thrombosis/epidemiology
7.
Invest Radiol ; 55(5): 257-261, 2020 05.
Article in English | MEDLINE | ID: covidwho-684015

ABSTRACT

OBJECTIVES: The aim of this study was to investigate the chest computed tomography (CT) findings in patients with confirmed coronavirus disease 2019 (COVID-19) and to evaluate its relationship with clinical features. MATERIALS AND METHODS: Study sample consisted of 80 patients diagnosed as COVID-19 from January to February 2020. The chest CT images and clinical data were reviewed, and the relationship between them was analyzed. RESULTS: Totally, 80 patients diagnosed with COVID-19 were included. With regards to the clinical manifestations, 58 (73%) of the 80 patients had cough, and 61 (76%) of the 80 patients had high temperature levels. The most frequent CT abnormalities observed were ground glass opacity (73/80 cases, 91%), consolidation (50/80 cases, 63%), and interlobular septal thickening (47/80, 59%). Most of the lesions were multiple, with an average of 12 ± 6 lung segments involved. The most common involved lung segments were the dorsal segment of the right lower lobe (69/80, 86%), the posterior basal segment of the right lower lobe (68/80, 85%), the lateral basal segment of the right lower lobe (64/80, 80%), the dorsal segment of the left lower lobe (61/80, 76%), and the posterior basal segment of the left lower lobe (65/80, 81%). The average pulmonary inflammation index value was (34% ± 20%) for all the patients. Correlation analysis showed that the pulmonary inflammation index value was significantly correlated with the values of lymphocyte count, monocyte count, C-reactive protein, procalcitonin, days from illness onset, and body temperature (P < 0.05). CONCLUSIONS: The common chest CT findings of COVID-19 are multiple ground glass opacity, consolidation, and interlobular septal thickening in both lungs, which are mostly distributed under the pleura. There are significant correlations between the degree of pulmonary inflammation and the main clinical symptoms and laboratory results. Computed tomography plays an important role in the diagnosis and evaluation of this emerging global health emergency.


Subject(s)
Coronavirus Infections/diagnostic imaging , Coronavirus Infections/pathology , Lung/diagnostic imaging , Pneumonia, Viral/diagnostic imaging , Pneumonia, Viral/pathology , Adult , Aged , Betacoronavirus/isolation & purification , Coronavirus Infections/virology , Cough/virology , Female , Fever/virology , Humans , Lung/pathology , Lung/virology , Male , Middle Aged , Pandemics , Pneumonia, Viral/virology , Retrospective Studies , Thorax/diagnostic imaging , Thorax/virology , Tomography, X-Ray Computed/methods , Young Adult
10.
Geriatr Gerontol Int ; 20(7): 715-719, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-682347

ABSTRACT

AIM: To clarify the association of cluster number and size of coronavirus disease 2019 (COVID-19) in long-term care (LTC) hospitals/facilities, general medical/welfare facilities and non-medical/welfare facilities with morbidity and mortality in 47 prefectures during 16 January to 9 May 2020 in Japan. METHODS: Information on COVID-19 clusters (n ≥2), and morbidity and mortality of COVID-19 was collected. RESULTS: A total of 381 clusters with 3786 infected cases were collected, accounting for 23.9% of 15 852 cumulated cases on 9 May 2020. Although the cluster number (/107 subjects) in LTC hospitals/facilities was significantly smaller compared with those in the other two groups, the cluster size in LTC hospitals/facilities was significantly larger than that in non-medical/welfare facilities. Cluster numbers in general medical/welfare facilities and in non-medical/welfare facilities were significantly positively correlated with morbidity (/105 ), indicating relatively early identification of clusters in these facilities. Unlike in these facilities, cluster size in LTC hospitals/facilities was significantly positively correlated with morbidity, indicating that clusters in LTC hospitals/facilities were finally identified after already having grown to a large size in areas where infection was prevalent. Multivariate logistic regression analysis showed that both cluster number and cluster size only in LTC hospitals/facilities were independently associated with higher mortality (≥median 0.64/105 subjects) after adjustment. CONCLUSIONS: Preventive efforts against COVID-19 outbreaks even at the early phase of the epidemic are critically important in LTC hospitals/facilities, as both the larger number and size of clusters only in LTC hospitals/facilities were independently linked to higher mortality in prefectures in Japan. Geriatr Gerontol Int 2020; 20: 715-719.


Subject(s)
Coronavirus Infections , Hospitals, Chronic Disease/statistics & numerical data , Long-Term Care , Pandemics , Pneumonia, Viral , Skilled Nursing Facilities/statistics & numerical data , Aged , Betacoronavirus/isolation & purification , Cluster Analysis , Coronavirus Infections/mortality , Coronavirus Infections/prevention & control , Female , Humans , Infection Control/organization & administration , Japan/epidemiology , Long-Term Care/methods , Long-Term Care/organization & administration , Long-Term Care/trends , Male , Mortality , Pandemics/prevention & control , Pneumonia, Viral/mortality , Pneumonia, Viral/prevention & control
11.
Neurologia ; 35(6): 357-362, 2020.
Article in English, Spanish | MEDLINE | ID: covidwho-680554

ABSTRACT

INTRODUCTION: The COVID-19 pandemic is changing approaches to diagnosis, treatment, and care provision in multiple sclerosis (MS). During both the initial and peak phases of the epidemic, the administration of disease-modifying drugs, typically immunosuppressants administered in pulses, was suspended due to the uncertainty about their impact on SARS-CoV-2 infection, mainly in contagious asymptomatic/presymptomatic patients. The purpose of this study is to present a safety algorithm enabling patients to resume pulse immunosuppressive therapy (PIT) during the easing of lockdown measures. METHODS: We developed a safety algorithm based on our clinical experience with MS and the available published evidence; the algorithm assists in the detection of contagious asymptomatic/presymptomatic cases and of patients with mild symptoms of SARS-CoV-2 infection with a view to withdrawing PIT in these patients and preventing new infections at day hospitals. RESULTS: We developed a clinical/microbiological screening algorithm consisting of a symptom checklist, applied during a teleconsultation 48hours before the scheduled session of PIT, and PCR testing for SARS-CoV-2 in nasopharyngeal exudate 24hours before the procedure. CONCLUSION: The application of our safety algorithm presents a favourable risk-benefit ratio despite the fact that the actual proportion of asymptomatic and presymptomatic individuals is unknown. Systematic PCR testing, which provides the highest sensitivity for detecting presymptomatic cases, combined with early detection of symptoms of SARS-CoV-2 infection may reduce infections and improve detection of high-risk patients before they receive PIT.


Subject(s)
Algorithms , Betacoronavirus/isolation & purification , Coronavirus Infections/prevention & control , Immunosuppressive Agents/administration & dosage , Multiple Sclerosis/drug therapy , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Ambulatory Care , Asymptomatic Diseases , Checklist , Clinical Laboratory Techniques , Contraindications, Drug , Coronavirus Infections/diagnosis , Disease Susceptibility , Humans , Immunocompromised Host , Immunosuppressive Agents/adverse effects , Immunosuppressive Agents/therapeutic use , Mass Screening/methods , Nasopharynx/virology , Pneumonia, Viral/diagnosis , Polymerase Chain Reaction , Pulse Therapy, Drug , Quarantine , Risk Assessment , Symptom Assessment , Telemedicine
12.
Medicine (Baltimore) ; 99(29): e21334, 2020 Jul 17.
Article in English | MEDLINE | ID: covidwho-676910

ABSTRACT

RATIONALE: The outbreak of coronavirus disease 2019 (COVID-19) in 2019 has become a global pandemic. It is not known whether the disease is associated with a higher risk of infection in pregnant women or whether intrauterine vertical transmission can occur. We report 2 cases of pregnant women diagnosed with COVID-19. PATIENT CONCERNS: In all of Yichang city from January 20, 2020, to April 9, 2020, only 2 pregnant women, who were in the late stage of pregnancy, were diagnosed with COVID-19; one patient was admitted for fever with limb asthenia, and the other patient was admitted for abnormal chest computed tomography results. DIAGNOSES: Both pregnant women were diagnosed with COVID-19. INTERVENTIONS: After the medical staff prepared for isolation and protection, the 2 pregnant women quickly underwent cesarean sections. A series of tests, such as laboratory, imaging, and SARS-CoV-2 nucleic acid examinations, were performed on the 2 women with COVID-19 and their newborns. OUTCOMES: One of the 2 infected pregnant women had severe COVID-19, and the other had mild disease. Both babies were delivered by cesarean section. Both of the women with COVID-19 worsened 3 to 6 days after delivery. Chest computed tomography suggested that the lesions due to SARS-CoV-2 infection increased. These women began to exhibit fever or reduced blood oxygen saturation again. One of the 2 newborns was born prematurely, and the other was born at full term. Neither infant was infected with COVID-19, but both had increased prothrombin time and fibrinogen, lactate dehydrogenase, phosphocreatine kinase, and creatine kinase isoenzyme contents. LESSONS: SARS-CoV-2 infection was not found in the newborns born to the 2 pregnant women with COVID-19, but transient coagulation dysfunction and myocardial damage occurred in the 2 newborns. Effective management strategies for pregnant women with COVID-19 will help to control the outbreak of COVID-19 among pregnant women.


Subject(s)
Betacoronavirus/genetics , Coronavirus Infections/diagnosis , Coronavirus Infections/virology , Pneumonia, Viral/diagnosis , Pneumonia, Viral/virology , Adult , Asthenia/etiology , Betacoronavirus/isolation & purification , Cesarean Section/methods , China/epidemiology , Coronavirus Infections/drug therapy , Disease Outbreaks/prevention & control , Female , Fever/etiology , Humans , Infant, Newborn/blood , Infant, Newborn/metabolism , Infectious Disease Transmission, Vertical/prevention & control , Pandemics , Pneumonia, Viral/drug therapy , Pregnancy , Pregnancy Complications, Infectious/epidemiology , Pregnancy Complications, Infectious/virology , Pregnancy Outcome/epidemiology , Premature Birth/epidemiology , Thorax/diagnostic imaging , Tomography, X-Ray Computed/methods
13.
Medicine (Baltimore) ; 99(29): e21081, 2020 Jul 17.
Article in English | MEDLINE | ID: covidwho-676465

ABSTRACT

The World Health Organization has declared coronavirus disease 2019 (COVID-19) a pandemic. Polymerase chain reaction testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the diagnostic gold standard of COVID-19. We have developed a simulation-based training program for mobile prehospital diagnostic teams in the province of Styria, Austria, and performed a prospective observational study on its applicability and effectivity.The 1-day curriculum uses theoretical instruction, technical skills training, and simulator-based algorithm training to teach and train prehospital patient identification and communication, donning the personal protective equipment, collection of naso-/oropharyngeal swabs for SARS-CoV-2 polymerase chain reaction testing, doffing the personal protective equipment, and sample logistics. Trainings were conducted at the SIM CAMPUS simulation hospital, Eisenerz, using high-fidelity patient simulation. To ensure achievement of predefined learning outcomes, participants had to undergo a final simulator-based objective structured clinical examination.In March 2020, 45 emergency medical assistants and 1 physician of the Austrian Red Cross participated on a voluntary basis. Forty-five of the 46 participants (97.8%) completed the curriculum successfully, with mean objective structured clinical examination ratings of 98.6%.Using several proven educational concepts, we have successfully drafted and implemented a training program for mobile prehospital SARS-CoV-2 diagnostic teams. Based on simulation-based objective structured examinations, it has prepared participants effectively for preclinical duties.


Subject(s)
Betacoronavirus/genetics , Coronavirus Infections/diagnosis , Pneumonia, Viral/diagnosis , Simulation Training/methods , Ambulances/statistics & numerical data , Austria/epidemiology , Betacoronavirus/isolation & purification , Body Fluids/virology , Coronavirus Infections/epidemiology , Curriculum , Female , Health Personnel/education , Humans , Male , Pandemics , Personal Protective Equipment , Pneumonia, Viral/epidemiology , Polymerase Chain Reaction/methods , Polymerase Chain Reaction/standards , Prospective Studies , Specimen Handling/methods
14.
Medicine (Baltimore) ; 99(29): e20781, 2020 Jul 17.
Article in English | MEDLINE | ID: covidwho-676380

ABSTRACT

BACKGROUND: No specific anti-virus drugs or vaccines have been available for the treatment of COVID-19. Integrative traditional Chinese and western medicine has been proposed as a therapeutic option with substantial applications in China. This protocol is proposed for a systematic review and meta-analysis that aims to evaluate the efficacy of integrative traditional Chinese and western medicine treatment on patients with COVID-19. METHODS: Ten databases including PubMed, EMBASE, Cochrane Library, CIHAHL, Web of Science, Chinese National Knowledge Infrastructure (CNKI), Chinese Scientific Journals Database (VIP), Wanfang database, China Biomedical Literature Database (CBM) and Chinese Biomedical Literature Service System (SinoMed) will be searched. All published randomized controlled trials, clinical controlled trials, case-control, and case series that meet the pre-specified eligibility criteria will be included. Primary outcome measures include mortality, clinical recovery rate, duration of fever, progression rate from mild or moderate to severe, improvement of symptoms, biomarkers of laboratory examination and changes in computed tomography. Secondary outcomes include dosage of hormonotherapy, incidence and severity of adverse events and quality of life. Study selection, data extraction and assessment of bias risk will be conducted by 2 reviewers independently. RevMan software (V.5.3.5) will be used to perform data synthesis. Subgroup and sensitivity analysis will be performed when necessary. The strength of evidence will be assessed by the GRADE system. RESULTS: This study will provide a well-reported and high-quality synthesis on the efficacy of integrative traditional Chinese and western medicine treatment on patients with COVID-19. CONCLUSION: This systematic review protocol will be helpful for providing evidence of whether integrative traditional Chinese and western medicine treatment is an effective therapeutic approach for patients with COVID-19. ETHICS AND DISSEMINATION: Ethical approval is unnecessary as no individual patient or privacy data is collected. The results of this study will be disseminated in a peer-reviewed scientific journal and/or conference presentation. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020167205.


Subject(s)
Betacoronavirus/isolation & purification , Coronavirus Infections/therapy , Medicine, Chinese Traditional/methods , Pneumonia, Viral/therapy , Biomarkers/analysis , Case-Control Studies , China/epidemiology , Coronavirus Infections/diagnostic imaging , Coronavirus Infections/epidemiology , Coronavirus Infections/mortality , Humans , Outcome Assessment, Health Care , Pandemics , Pneumonia, Viral/diagnostic imaging , Pneumonia, Viral/epidemiology , Pneumonia, Viral/mortality , Quality of Life , Randomized Controlled Trials as Topic , Research Design , Tomography, X-Ray Computed/methods , Treatment Outcome
15.
Medicine (Baltimore) ; 99(29): e21359, 2020 Jul 17.
Article in English | MEDLINE | ID: covidwho-675946

ABSTRACT

RATIONALE: In December 2019, an outbreak of coronavirus disease 2019 (COVID-19) occurred in Wuhan, China. The initial epidemiological investigations showed that COVID-19 occurred more likely in adults, with patients younger than 10 years old accounting for less than 1% of the total number of confirmed cases, and infant infections were more rare. In our case, we present an infant who was only 35 days old when he was tested positive for COVID-19. PATIENT CONCERNS: In this report, a 35 day-old male infant with atypical symptoms had close contact with 2 confirmed patients of COVID-19 who were his grandmother and mother. DIAGNOSIS: The patient was diagnosed as COVID-19 after his oropharyngeal swab tested positive for severe acute respiratory syndrome coronavirus 2 by reverse transcription-polymerase chain reaction assay. INTERVENTIONS: The therapeutic schedule included aerosol inhalation of recombinant human interferon α-2b and supportive therapy. OUTCOMES: Two consecutive (1 day apart) oropharyngeal swabs tested negative for severe acute respiratory syndrome coronavirus 2; then, the patient was discharged on February 27, 2020. LESSONS: Strengthening infants' virus screening in families with infected kins is important for early diagnosis, isolation, and treatment when symptoms are atypical. The infectivity of infants with mild or asymptomatic COVID-19 should not be ignored because this may be a source of transmission in the community.


Subject(s)
Betacoronavirus/genetics , Coronavirus Infections/diagnosis , Oropharynx/virology , Pneumonia, Viral/diagnosis , Administration, Inhalation , Antiviral Agents/administration & dosage , Antiviral Agents/therapeutic use , Betacoronavirus/isolation & purification , Coronavirus Infections/drug therapy , Coronavirus Infections/transmission , Coronavirus Infections/virology , Disease Transmission, Infectious/prevention & control , Humans , Infant , Interferon alpha-2/administration & dosage , Interferon alpha-2/therapeutic use , Male , Pandemics , Patient Isolation/methods , Pneumonia, Viral/drug therapy , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , Polymerase Chain Reaction/methods , Polymerase Chain Reaction/standards , Specimen Handling/methods , Treatment Outcome
16.
Postepy Biochem ; 66(2): 83-90, 2020 05 09.
Article in Polish | MEDLINE | ID: covidwho-671307

ABSTRACT

In December 2019 in Wuhan, China the first cases of previously unknown, coronaviral infection-induced pneumonia have been reported. The new virus SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) was named after SARS-CoV due to their similarities and the disease caused by the pathogen is COVID-19 (Coronavirus Disease 2019). On 11 March 2020 WHO (World Health Organization) defined the rapidly increasing number of incidents of COVID-19 as a pandemic. In this review we will present recent information about the SARS-CoV-2 focusing on the origin, clinical picture, diagnostic methods, structure, replication cycle of SARS-CoV-2 and potential pharmaceutical measures against COVID-19.


Subject(s)
Betacoronavirus , Coronavirus Infections/drug therapy , Coronavirus Infections/virology , Pneumonia, Viral/drug therapy , Pneumonia, Viral/virology , Betacoronavirus/growth & development , Betacoronavirus/isolation & purification , Betacoronavirus/pathogenicity , China/epidemiology , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Humans , Pandemics , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , SARS Virus
17.
BMC Infect Dis ; 20(1): 536, 2020 Jul 23.
Article in English | MEDLINE | ID: covidwho-670669

ABSTRACT

BACKGROUND: As the COVID-19 pandemic continues to spread, early, ideally real-time, identification of SARS-CoV-2 infected individuals is pivotal in interrupting infection chains. Volatile organic compounds produced during respiratory infections can cause specific scent imprints, which can be detected by trained dogs with a high rate of precision. METHODS: Eight detection dogs were trained for 1 week to detect saliva or tracheobronchial secretions of SARS-CoV-2 infected patients in a randomised, double-blinded and controlled study. RESULTS: The dogs were able to discriminate between samples of infected (positive) and non-infected (negative) individuals with average diagnostic sensitivity of 82.63% (95% confidence interval [CI]: 82.02-83.24%) and specificity of 96.35% (95% CI: 96.31-96.39%). During the presentation of 1012 randomised samples, the dogs achieved an overall average detection rate of 94% (±3.4%) with 157 correct indications of positive, 792 correct rejections of negative, 33 incorrect indications of negative or incorrect rejections of 30 positive sample presentations. CONCLUSIONS: These preliminary findings indicate that trained detection dogs can identify respiratory secretion samples from hospitalised and clinically diseased SARS-CoV-2 infected individuals by discriminating between samples from SARS-CoV-2 infected patients and negative controls. This data may form the basis for the reliable screening method of SARS-CoV-2 infected people.


Subject(s)
Betacoronavirus/isolation & purification , Coronavirus Infections/diagnosis , Coronavirus Infections/virology , Mass Screening/methods , Odorants/analysis , Pneumonia, Viral/diagnosis , Pneumonia, Viral/virology , Animals , Bronchi/chemistry , Bronchi/virology , Case-Control Studies , Dogs , Double-Blind Method , Humans , Pandemics/prevention & control , Pilot Projects , Saliva/chemistry , Saliva/virology , Sensitivity and Specificity
18.
Science ; 369(6499): 77-81, 2020 07 03.
Article in English | MEDLINE | ID: covidwho-667322

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in an unprecedented public health crisis. Because of the novelty of the virus, there are currently no SARS-CoV-2-specific treatments or vaccines available. Therefore, rapid development of effective vaccines against SARS-CoV-2 are urgently needed. Here, we developed a pilot-scale production of PiCoVacc, a purified inactivated SARS-CoV-2 virus vaccine candidate, which induced SARS-CoV-2-specific neutralizing antibodies in mice, rats, and nonhuman primates. These antibodies neutralized 10 representative SARS-CoV-2 strains, suggesting a possible broader neutralizing ability against other strains. Three immunizations using two different doses, 3 or 6 micrograms per dose, provided partial or complete protection in macaques against SARS-CoV-2 challenge, respectively, without observable antibody-dependent enhancement of infection. These data support the clinical development and testing of PiCoVacc for use in humans.


Subject(s)
Antibodies, Neutralizing/blood , Antibodies, Viral/blood , Betacoronavirus/immunology , Coronavirus Infections/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Viral Vaccines , Animals , Antibodies, Neutralizing/biosynthesis , Antibodies, Neutralizing/immunology , Antibodies, Viral/biosynthesis , Antibodies, Viral/immunology , Betacoronavirus/isolation & purification , Chlorocebus aethiops , Coronavirus Infections/immunology , Coronavirus Infections/virology , Dose-Response Relationship, Immunologic , Female , Immunogenicity, Vaccine , Immunoglobulin G/biosynthesis , Immunoglobulin G/blood , Immunoglobulin G/immunology , Macaca mulatta , Male , Mice , Mice, Inbred BALB C , Pilot Projects , Pneumonia, Viral/virology , Rats , Rats, Wistar , Vaccines, Inactivated/administration & dosage , Vaccines, Inactivated/adverse effects , Vaccines, Inactivated/immunology , Vero Cells , Viral Load , Viral Vaccines/administration & dosage , Viral Vaccines/adverse effects , Viral Vaccines/immunology
19.
J Stroke Cerebrovasc Dis ; 29(8): 104974, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-665314

ABSTRACT

Emerging evidence suggests that patients with coronavirus disease 2019 (COVID-19) are at risk of thromboembolic complications, including ischemic strokes. We present a case illustrating the value of CT perfusion to identify acute small subcortical infarcts in a patient with COVID-19 admitted to an intensive care unit for bilateral pneumonia and pulmonary embolism presenting with sudden right limb weakness.


Subject(s)
Betacoronavirus/isolation & purification , Brain Infarction/diagnostic imaging , Clinical Laboratory Techniques , Coronavirus Infections/diagnosis , Perfusion Imaging/methods , Pneumonia, Viral/diagnosis , Thalamic Diseases/diagnostic imaging , Tomography, X-Ray Computed , Anticoagulants/therapeutic use , Antiviral Agents/therapeutic use , Brain Infarction/therapy , Coronavirus Infections/drug therapy , Coronavirus Infections/therapy , Coronavirus Infections/virology , Diffusion Magnetic Resonance Imaging , Host Microbial Interactions , Humans , Male , Middle Aged , Noninvasive Ventilation , Pandemics , Pneumonia, Viral/therapy , Pneumonia, Viral/virology , Predictive Value of Tests , Prosthesis Implantation/instrumentation , Thalamic Diseases/therapy , Treatment Outcome , Vena Cava Filters
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