Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 197
Filter
Add filters

Year range
1.
MMWR Morb Mortal Wkly Rep ; 69(41): 1485-1491, 2020 Oct 16.
Article in English | MEDLINE | ID: covidwho-874994

ABSTRACT

Frequent hand hygiene, including handwashing with soap and water or using a hand sanitizer containing ≥60% alcohol when soap and water are not readily available, is one of several critical prevention measures recommended to reduce the spread of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19).* Previous studies identified demographic factors associated with handwashing among U.S. adults during the COVID-19 pandemic (1,2); however, demographic factors associated with hand sanitizing and experiences and beliefs associated with hand hygiene have not been well characterized. To evaluate these factors, an Internet-based survey was conducted among U.S. adults aged ≥18 years during June 24-30, 2020. Overall, 85.2% of respondents reported always or often engaging in hand hygiene following contact with high-touch public surfaces such as shopping carts, gas pumps, and automatic teller machines (ATMs).† Respondents who were male (versus female) and of younger age reported lower handwashing and hand sanitizing rates, as did respondents who reported lower concern about their own infection with SARS-CoV-2§ and respondents without personal experience with COVID-19. Focused health promotion efforts to increase hand hygiene adherence should include increasing visibility and accessibility of handwashing and hand sanitizing materials in public settings, along with targeted communication to males and younger adults with focused messages that address COVID-19 risk perception.


Subject(s)
Coronavirus Infections/prevention & control , Hand Hygiene/statistics & numerical data , Health Knowledge, Attitudes, Practice , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Adolescent , Adult , Age Factors , Aged , Continental Population Groups/psychology , Continental Population Groups/statistics & numerical data , Coronavirus Infections/epidemiology , Coronavirus Infections/ethnology , Ethnic Groups/psychology , Ethnic Groups/statistics & numerical data , Female , Health Knowledge, Attitudes, Practice/ethnology , Humans , Male , Middle Aged , Pneumonia, Viral/epidemiology , Pneumonia, Viral/ethnology , Sex Factors , Surveys and Questionnaires , United States/epidemiology , Young Adult
2.
Psychol Trauma ; 12(S1): S73-S75, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-867504

ABSTRACT

As a result of the COVID-19 pandemic, many school districts have closed for the remainder of the academic year. These closures are unfortunate because, for many students, schools are their only source of trauma-informed care and supports. When schools reopen, they must develop a comprehensive plan to address the potential mental health needs of their students. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Subject(s)
Coronavirus Infections , Mental Health Services , Pandemics , Pneumonia, Viral , Psychological Trauma , School Health Services , Students , Academic Success , Adolescent , Child , Child, Preschool , Coronavirus Infections/ethnology , Coronavirus Infections/psychology , Humans , Pneumonia, Viral/ethnology , Pneumonia, Viral/psychology , Psychological Trauma/psychology , Psychological Trauma/therapy , Schools , Students/psychology
5.
N Z Med J ; 133(1521): 28-39, 2020 09 04.
Article in English | MEDLINE | ID: covidwho-807838

ABSTRACT

AIMS: There is limited evidence as to how clinical outcomes of COVID-19 including fatality rates may vary by ethnicity. We aim to estimate inequities in infection fatality rates (IFR) in New Zealand by ethnicity. METHODS: We combine existing demographic and health data for ethnic groups in New Zealand with international data on COVID-19 IFR for different age groups. We adjust age-specific IFRs for differences in unmet healthcare need, and comorbidities by ethnicity. We also adjust for life expectancy reflecting evidence that COVID-19 amplifies the existing mortality risk of different groups. RESULTS: The IFR for Maori is estimated to be 50% higher than that of non-Maori, and could be even higher depending on the relative contributions of age and underlying health conditions to mortality risk. CONCLUSIONS: There are likely to be significant inequities in the health burden from COVID-19 in New Zealand by ethnicity. These will be exacerbated by racism within the healthcare system and other inequities not reflected in official data. Highest risk communities include those with elderly populations, and Maori and Pacific communities. These factors should be included in future disease incidence and impact modelling.


Subject(s)
Betacoronavirus , Coronavirus Infections/ethnology , Ethnic Groups/statistics & numerical data , Health Status Disparities , Life Expectancy/ethnology , Oceanic Ancestry Group/statistics & numerical data , Pneumonia, Viral/ethnology , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Coronavirus Infections/mortality , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , New Zealand , Pandemics , Pneumonia, Viral/mortality , Survival Rate , Young Adult
6.
PLoS Med ; 17(9): e1003379, 2020 09.
Article in English | MEDLINE | ID: covidwho-796633

ABSTRACT

BACKGROUND: There is growing concern that racial and ethnic minority communities around the world are experiencing a disproportionate burden of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and coronavirus disease 2019 (COVID-19). We investigated racial and ethnic disparities in patterns of COVID-19 testing (i.e., who received testing and who tested positive) and subsequent mortality in the largest integrated healthcare system in the United States. METHODS AND FINDINGS: This retrospective cohort study included 5,834,543 individuals receiving care in the US Department of Veterans Affairs; most (91%) were men, 74% were non-Hispanic White (White), 19% were non-Hispanic Black (Black), and 7% were Hispanic. We evaluated associations between race/ethnicity and receipt of COVID-19 testing, a positive test result, and 30-day mortality, with multivariable adjustment for a wide range of demographic and clinical characteristics including comorbid conditions, health behaviors, medication history, site of care, and urban versus rural residence. Between February 8 and July 22, 2020, 254,595 individuals were tested for COVID-19, of whom 16,317 tested positive and 1,057 died. Black individuals were more likely to be tested (rate per 1,000 individuals: 60.0, 95% CI 59.6-60.5) than Hispanic (52.7, 95% CI 52.1-53.4) and White individuals (38.6, 95% CI 38.4-38.7). While individuals from minority backgrounds were more likely to test positive (Black versus White: odds ratio [OR] 1.93, 95% CI 1.85-2.01, p < 0.001; Hispanic versus White: OR 1.84, 95% CI 1.74-1.94, p < 0.001), 30-day mortality did not differ by race/ethnicity (Black versus White: OR 0.97, 95% CI 0.80-1.17, p = 0.74; Hispanic versus White: OR 0.99, 95% CI 0.73-1.34, p = 0.94). The disparity between Black and White individuals in testing positive for COVID-19 was stronger in the Midwest (OR 2.66, 95% CI 2.41-2.95, p < 0.001) than the West (OR 1.24, 95% CI 1.11-1.39, p < 0.001). The disparity in testing positive for COVID-19 between Hispanic and White individuals was consistent across region, calendar time, and outbreak pattern. Study limitations include underrepresentation of women and a lack of detailed information on social determinants of health. CONCLUSIONS: In this nationwide study, we found that Black and Hispanic individuals are experiencing an excess burden of SARS-CoV-2 infection not entirely explained by underlying medical conditions or where they live or receive care. There is an urgent need to proactively tailor strategies to contain and prevent further outbreaks in racial and ethnic minority communities.


Subject(s)
Clinical Laboratory Techniques/statistics & numerical data , Coronavirus Infections/diagnosis , Coronavirus Infections/mortality , Ethnic Groups/statistics & numerical data , Pneumonia, Viral/diagnosis , Pneumonia, Viral/mortality , Veterans/statistics & numerical data , Adult , African Americans/statistics & numerical data , Aged , Aged, 80 and over , Betacoronavirus , Cohort Studies , Coronavirus Infections/ethnology , European Continental Ancestry Group/statistics & numerical data , Female , Hispanic Americans/statistics & numerical data , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/ethnology , Retrospective Studies , United States/epidemiology , Young Adult
8.
JAMA Netw Open ; 3(9): e2021892, 2020 09 01.
Article in English | MEDLINE | ID: covidwho-795041

ABSTRACT

Importance: Initial public health data show that Black race may be a risk factor for worse outcomes of coronavirus disease 2019 (COVID-19). Objective: To characterize the association of race with incidence and outcomes of COVID-19, while controlling for age, sex, socioeconomic status, and comorbidities. Design, Setting, and Participants: This cross-sectional study included 2595 consecutive adults tested for COVID-19 from March 12 to March 31, 2020, at Froedtert Health and Medical College of Wisconsin (Milwaukee), the largest academic system in Wisconsin, with 879 inpatient beds (of which 128 are intensive care unit beds). Exposures: Race (Black vs White, Native Hawaiian or Pacific Islander, Native American or Alaska Native, Asian, or unknown). Main Outcomes and Measures: Main outcomes included COVID-19 positivity, hospitalization, intensive care unit admission, mechanical ventilation, and death. Additional independent variables measured and tested included socioeconomic status, sex, and comorbidities. Reverse transcription polymerase chain reaction assay was used to test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Results: A total of 2595 patients were included. The mean (SD) age was 53.8 (17.5) years, 978 (37.7%) were men, and 785 (30.2%) were African American patients. Of the 369 patients (14.2%) who tested positive for COVID-19, 170 (46.1%) were men, 148 (40.1%) were aged 60 years or older, and 218 (59.1%) were African American individuals. Positive tests were associated with Black race (odds ratio [OR], 5.37; 95% CI, 3.94-7.29; P = .001), male sex (OR, 1.55; 95% CI, 1.21-2.00; P = .001), and age 60 years or older (OR, 2.04; 95% CI, 1.53-2.73; P = .001). Zip code of residence explained 79% of the overall variance in COVID-19 positivity in the cohort (ρ = 0.79; 95% CI, 0.58-0.91). Adjusting for zip code of residence, Black race (OR, 1.85; 95% CI, 1.00-3.65; P = .04) and poverty (OR, 3.84; 95% CI, 1.20-12.30; P = .02) were associated with hospitalization. Poverty (OR, 3.58; 95% CI, 1.08-11.80; P = .04) but not Black race (OR, 1.52; 95% CI, 0.75-3.07; P = .24) was associated with intensive care unit admission. Overall, 20 (17.2%) deaths associated with COVID-19 were reported. Shortness of breath at presentation (OR, 10.67; 95% CI, 1.52-25.54; P = .02), higher body mass index (OR per unit of body mass index, 1.19; 95% CI, 1.05-1.35; P = .006), and age 60 years or older (OR, 22.79; 95% CI, 3.38-53.81; P = .001) were associated with an increased likelihood of death. Conclusions and Relevance: In this cross-sectional study of adults tested for COVID-19 in a large midwestern academic health system, COVID-19 positivity was associated with Black race. Among patients with COVID-19, both race and poverty were associated with higher risk of hospitalization, but only poverty was associated with higher risk of intensive care unit admission. These findings can be helpful in targeting mitigation strategies for racial disparities in the incidence and outcomes of COVID-19.


Subject(s)
African Americans , Coronavirus Infections/ethnology , Health Status Disparities , Hospitalization , Intensive Care Units , Pneumonia, Viral/ethnology , Adult , Aged , Betacoronavirus , Body Mass Index , Cohort Studies , Comorbidity , Coronavirus Infections/complications , Coronavirus Infections/mortality , Coronavirus Infections/virology , Cross-Sectional Studies , Dyspnea/epidemiology , Dyspnea/etiology , Female , Humans , Incidence , Male , Middle Aged , Minority Groups , Odds Ratio , Pandemics , Pneumonia, Viral/complications , Pneumonia, Viral/mortality , Pneumonia, Viral/virology , Poverty , Respiration, Artificial , Wisconsin/epidemiology
9.
Fam Process ; 59(3): 832-846, 2020 09.
Article in English | MEDLINE | ID: covidwho-787776

ABSTRACT

The COVID-19 pandemic brings to the forefront the complex interconnected dilemmas of globalization, health equity, economic security, environmental justice, and collective trauma, severely impacting the marginalized and people of color in the United States. This lack of access to and the quality of healthcare, affordable housing, and lack of financial resources also continue to have a more significant impact on documented and undocumented immigrants. This paper aims at examining these critical issues and developing a framework for family therapists to address these challenges by focusing on four interrelated dimensions: cultural values, social determinants of health, collective trauma, and the ethical and moral responsibility of family therapists. Given the fact that family therapists may unwittingly function as the best ally of an economic and political system that perpetuates institutionalized racism and class discrimination, we need to utilize a set of principles, values, and practices that are not just palliative or after the fact but bring forth into the psychotherapeutic and policy work a politics of care. Therefore, a strong call to promote and advocate for the broader continuum of health and critical thinking preparing professionals to meet the challenges of health equity, as well as economic and environmental justice, is needed. The issues discussed in this paper are specific to the United States despite their relevance to family therapy as a field. We are mindful not to generalize the United States' reality to the rest of the world, recognizing that issues discussed in this paper could potentially contribute to international discourse.


Subject(s)
Family Therapy/ethics , Health Status Disparities , Pandemics/ethics , Politics , Racism/ethics , Betacoronavirus , Climate Change , Coronavirus Infections/ethnology , Coronavirus Infections/psychology , Healthcare Disparities , Humans , Morals , Pneumonia, Viral/ethnology , Pneumonia, Viral/psychology , Racism/psychology , Social Determinants of Health , Social Marginalization , Social Values , United States/epidemiology
10.
PLoS One ; 15(9): e0239443, 2020.
Article in English | MEDLINE | ID: covidwho-781671

ABSTRACT

OBJECTIVE: In the setting of the Coronavirus Disease 2019 (COVID-19) global pandemic caused by SARS-CoV-2, a potential association of this disease with stroke has been suggested. We aimed to describe the characteristics of patients who were admitted with COVID-19 and had an acute ischemic stroke (AIS). METHODS: This is a case series of PCR-confirmed COVID-19 patients with ischemic stroke admitted to an academic health system in metropolitan Atlanta, Georgia (USA) between March 24th, 2020 and July 17th, 2020. Demographic, clinical, and radiographic characteristics were described. RESULTS: Of 396 ischemic stroke patients admitted during this study period, 13 (2.5%) were also diagnosed with COVID-19. The mean age of patients was 61.6 ± 10.8 years, 10 (76.9%) male, 8 (61.5%) were Black Americans, mean time from last normal was 4.97 ± 5.1 days, and only one received acute reperfusion therapy. All 13 patients had at least one stroke-associated co-morbidity. The predominant pattern of ischemic stroke was embolic with 4 explained by atrial fibrillation. COVID-19 patients had a significantly higher rate of cryptogenic stroke than non-COVID-19 patients during the study period (69% vs 17%, p = 0.0001). CONCLUSIONS: In our case series, ischemic stroke affected COVID-19 patients with traditional stroke risk factors at an age typically seen in non-COVID populations, and mainly affecting males and Black Americans. We observed a predominantly embolic pattern of stroke with a higher than expected rate of cryptogenic strokes, a prolonged median time to presentation and symptom recognition limiting the use of acute reperfusion treatments. These results highlight the need for increased community awareness, early identification, and management of AIS in COVID-19 patients.


Subject(s)
Betacoronavirus , Brain Ischemia/etiology , Coronavirus Infections/complications , Pneumonia, Viral/complications , Stroke/etiology , African Americans , Aged , Atrial Fibrillation/complications , Brain Ischemia/ethnology , Brain Ischemia/virology , Comorbidity , Coronavirus Infections/ethnology , Disease Management , Early Diagnosis , Embolism/complications , Female , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/ethnology , Stroke/ethnology , Stroke/virology
12.
Epidemiol Prev ; 44(4): 304-307, 2020.
Article in English | MEDLINE | ID: covidwho-776941

ABSTRACT

It has been hypothesized that bacille Calmette-Guerin (BCG), the anti-tuberculosis vaccine, can be protective against Covid-19. Using data of performed swabs and RT-PCR results for SARS-CoV-2 in the Reggio Emilia province (Emilia-Romagna Region, Northern Italy) from March 6th to March 26th, 2020, we computed age, gender, and place of birth (Italy or abroad) specific risk of being tested, prevalence of positive tests, and probability of testing positive given that a swab has been taken during the epidemic peak. We report that immigrants resident in Reggio Emilia province, mostly coming from Countries with high BCG vaccination coverage, and Italians had a similar prevalence of infection (odds ratio - OR 0.99; 95%CI 0.82-1.20) and similar probability of being tested (OR 0.93; 95%CI 0.81-1.10). Our data do not support the hypothesis that immigrants from Countries where BCG vaccination is recommended have a lower risk of Covid-19 infection.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Emigrants and Immigrants/statistics & numerical data , Pandemics , Pneumonia, Viral/epidemiology , Adult , Africa/ethnology , Aged , Asia/ethnology , BCG Vaccine , Betacoronavirus/isolation & purification , Clinical Laboratory Techniques , Coronavirus Infections/diagnosis , Coronavirus Infections/ethnology , Coronavirus Infections/prevention & control , Female , Humans , Italy/epidemiology , Male , Middle Aged , Nasopharynx/virology , Pandemics/prevention & control , Pneumonia, Viral/diagnosis , Pneumonia, Viral/ethnology , Pneumonia, Viral/prevention & control , Poland/ethnology , Prevalence , Procedures and Techniques Utilization , Vaccination Coverage
13.
J Pain Symptom Manage ; 60(2): e90-e92, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-773464

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic presents unique challenges to Asian countries like Singapore with a predominantly Confucian culture. Palliative care providers play an important role in supporting their patients and family members in these difficult times.


Subject(s)
Coronavirus Infections/ethnology , Coronavirus Infections/psychology , Pneumonia, Viral/ethnology , Pneumonia, Viral/psychology , Coronavirus Infections/therapy , Culturally Competent Care , Culture , Family/ethnology , Family/psychology , Humans , Palliative Care/methods , Pandemics , Patient Compliance/ethnology , Patient Compliance/psychology , Pneumonia, Viral/therapy , Singapore
14.
J Sport Health Sci ; 9(4): 302-312, 2020 07.
Article in English | MEDLINE | ID: covidwho-773436

ABSTRACT

PURPOSE: The coronavirus disease-2019 (COVID-19) pandemic in the United States led to nationwide stay-at-home orders and school closures. Declines in energy expenditure resulting from canceled physical education classes and reduced physical activity may elevate childhood obesity risk. This study estimated the impact of COVID-19 on childhood obesity. METHODS: A microsimulation model simulated the trajectory of a nationally representative kindergarten cohort's body mass index z-scores and childhood obesity prevalence from April 2020 to March 2021 under the control scenario without COVID-19 and under the 4 alternative scenarios with COVID-19-Scenario 1: 2-month nationwide school closure in April and May 2020; Scenario 2: Scenario 1 followed by a 10% reduction in daily physical activity in the summer from June to August; Scenario 3: Scenario 2 followed by 2-month school closure in September and October; and Scenario 4: Scenario 3 followed by an additional 2-month school closure in November and December. RESULTS: Relative to the control scenario without COVID-19, Scenarios 1, 2, 3, and 4 were associated with an increase in the mean body mass index z-scores by 0.056 (95% confidence interval (95%CI): 0.055-0.056), 0.084 (95%CI: 0.084-0.085), 0.141 (95%CI: 0.140-0.142), and 0.198 (95%CI: 0.197-0.199), respectively, and an increase in childhood obesity prevalence by 0.640 (95%CI: 0.515-0.765), 0.972 (95%CI: 0.819-1.126), 1.676 (95%CI: 1.475-1.877), and 2.373 (95%CI: 2.135-2.612) percentage points, respectively. Compared to girls and non-Hispanic whites and Asians, the impact of COVID-19 on childhood obesity was modestly larger among boys and non-Hispanic blacks and Hispanics, respectively. CONCLUSION: Public health interventions are urgently called to promote an active lifestyle and engagement in physical activity among children to mitigate the adverse impact of COVID-19 on unhealthy weight gains and childhood obesity.


Subject(s)
Coronavirus Infections/epidemiology , Pandemics , Pediatric Obesity/epidemiology , Pneumonia, Viral/epidemiology , African Continental Ancestry Group/statistics & numerical data , Betacoronavirus , Body Height , Body Mass Index , Body Weight , Comorbidity , Computer Simulation , Coronavirus Infections/ethnology , Energy Metabolism , Hispanic Americans/statistics & numerical data , Humans , Pediatric Obesity/ethnology , Pneumonia, Viral/ethnology , Prevalence , Sex Distribution , United States/epidemiology
15.
AIDS ; 34(12): 1781-1787, 2020 10 01.
Article in English | MEDLINE | ID: covidwho-772526

ABSTRACT

BACKGROUND: Many people living with HIV (PLWH) have comorbidities which are risk factors for severe coronavirus disease 2019 (COVID-19) or have exposures that may lead to acquisition of severe acute respiratory distress syndrome coronavirus 2. There are few studies, however, on the demographics, comorbidities, clinical presentation, or outcomes of COVID-19 in people with HIV. OBJECTIVE: To evaluate risk factors, clinical manifestations, and outcomes in a large cohort of PLWH with COVID-19. METHODS: We systematically identified all PLWH who were diagnosed with COVID-19 at a large hospital from 3 March to 26 April 2020 during an outbreak in Massachusetts. We analyzed each of the cases to extract information including demographics, medical comorbidities, clinical presentation, and illness course after COVID-19 diagnosis. RESULTS: We describe a cohort of 36 PLWH with confirmed COVID-19 and another 11 patients with probable COVID-19. Almost 85% of PLWH with confirmed COVID-19 had a comorbidity associated with severe disease, including obesity, cardiovascular disease, or hypertension. Approximately 77% of PLWH with COVID-19 were non-Hispanic Black or Latinx whereas only 40% of the PLWH in our clinic were Black or Latinx. Nearly half of PLWH with COVID-19 had exposure to congregate settings. In addition to people with confirmed COVID-19, we identified another 11 individuals with probable COVID-19, almost all of whom had negative PCR testing. CONCLUSION: In the largest cohort to date of PLWH and confirmed COVID-19, almost all had a comorbidity associated with severe disease, highlighting the importance of non-HIV risk factors in this population. The racial disparities and frequent link to congregate settings in PLWH and COVID-19 need to be explored urgently.


Subject(s)
Coronavirus Infections/epidemiology , HIV Infections/epidemiology , Pneumonia, Viral/epidemiology , Adult , African Americans/statistics & numerical data , Aged , Betacoronavirus , Cohort Studies , Comorbidity , Coronavirus Infections/ethnology , Cost of Illness , Female , HIV Infections/ethnology , Hispanic Americans/statistics & numerical data , Humans , Male , Massachusetts/epidemiology , Middle Aged , Pandemics , Pneumonia, Viral/ethnology , Risk Factors
16.
PLoS One ; 15(9): e0238255, 2020.
Article in English | MEDLINE | ID: covidwho-771804

ABSTRACT

It was shown that the human Angiotensin-converting enzyme 2 (ACE2) is the receptor of recent coronavirus SARS-CoV-2, and variation in this gene may affect the susceptibility of a population. Therefore, we have analysed the sequence data of ACE2 among 393 samples worldwide, focusing on South Asia. Genetically, South Asians are more related to West Eurasian populations rather than to East Eurasians. In the present analyses of ACE2, we observed that the majority of South Asian haplotypes are closer to East Eurasians rather than to West Eurasians. The phylogenetic analysis suggested that the South Asian haplotypes shared with East Eurasians involved two unique event polymorphisms (rs4646120 and rs2285666). In contrast with the European/American populations, both of the SNPs have largely similar frequencies for East Eurasians and South Asians, Therefore, it is likely that among the South Asians, host susceptibility to the novel coronavirus SARS-CoV-2 will be more similar to that of East Eurasians rather than to that of Europeans.


Subject(s)
Asian Continental Ancestry Group/genetics , Coronavirus Infections/genetics , Peptidyl-Dipeptidase A/genetics , Pneumonia, Viral/genetics , Polymorphism, Single Nucleotide , Receptors, Virus/genetics , Asia/epidemiology , Betacoronavirus/physiology , Coronavirus Infections/ethnology , European Continental Ancestry Group/genetics , Haplotypes/genetics , Human Migration , Humans , Linkage Disequilibrium , Pandemics , Phylogeny , Pneumonia, Viral/ethnology
17.
Arch Pathol Lab Med ; 144(9): 1041-1047, 2020 09 01.
Article in English | MEDLINE | ID: covidwho-771246

ABSTRACT

Since making its debut on the global stage in December 2019, coronavirus disease 2019 (COVID-19) has afflicted nearly 4 million people and caused hundreds of thousands of deaths. Case reports and case series depicting the clinical effects of the causative virus-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-have been published, yet few demonstrate the cytopathologic alterations of this disease. We present a clinical-pathologic correlation report of a previously healthy Hispanic woman with laboratory-confirmed COVID-19 who had typical features of acute respiratory distress syndrome (ARDS) and also showed cardiac abnormalities thought to represent fulminant viral myocarditis. Congruent with the ARDS clinical impression, autopsy findings were remarkable for extensive and markedly severe acute lung injury consistent with viral pneumonia, characterized by diffuse alveolar damage, pulmonary infarction, severe pulmonary edema, desquamation of pneumocytes with intra-alveolar aggregation, and pneumocyte morphologic alterations suggestive of viral cytopathic effect. However, there was incongruence between the clinical impression and the cardiovascular pathology findings in that viral myocarditis was not detected on histopathologic evaluation. This case highlights the importance of pathologic corroboration of the clinical impression and, in addition, illuminates the key role autopsy plays during a pandemic by providing valuable insight into viral pathology in tissues.


Subject(s)
Betacoronavirus , Coronavirus Infections/pathology , Lung/pathology , Mexican Americans , Myocardium/pathology , Pneumonia, Viral/pathology , Adult , Betacoronavirus/isolation & purification , Coronavirus Infections/diagnosis , Coronavirus Infections/ethnology , Coronavirus Infections/physiopathology , Fatal Outcome , Female , Heart/virology , Humans , Lung/virology , Pandemics , Pneumonia, Viral/diagnosis , Pneumonia, Viral/ethnology , Pneumonia, Viral/physiopathology
SELECTION OF CITATIONS
SEARCH DETAIL