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1.
mBio ; 12(1)2021 01 08.
Article in English | MEDLINE | ID: covidwho-1066816

ABSTRACT

In December 2019 a new coronavirus (CoV) emerged as a human pathogen, SARS-CoV-2. There are few data on human coronavirus infections among individuals living with HIV. In this study we probed the role of pneumococcal coinfections with seasonal CoVs among children living with and without HIV hospitalized for pneumonia. We also described the prevalence and clinical manifestations of these infections. A total of 39,836 children who participated in a randomized, double-blind, placebo-controlled clinical trial on the efficacy of a 9-valent pneumococcal conjugate vaccine (PCV9) were followed for lower respiratory tract infection hospitalizations until 2 years of age. Nasopharyngeal aspirates were collected at the time of hospitalization and were screened by PCR for four seasonal CoVs. The frequency of CoV-associated pneumonia was higher in children living with HIV (19.9%) than in those without HIV (7.6%, P < 0.001). Serial CoV infections were detected in children living with HIV. The case fatality risk among children with CoV-associated pneumonia was higher in those living with HIV (30.4%) than without HIV (2.9%, P = 0.001). C-reactive protein and procalcitonin levels were elevated in 36.8% (≥40 mg/liter) and 64.7% (≥0.5 ng/ml), respectively, of the fatal cases living with HIV. Among children without HIV, there was a 64.0% (95% CI: 22.9% to 83.2%) lower incidence of CoV-associated pneumonia hospitalizations among PCV9 recipients compared to placebo recipients. These data suggest that Streptococcus pneumoniae infections might have a role in the development of pneumonia associated with endemic CoVs, that PCV may prevent pediatric CoV-associated hospitalization, and that children living with HIV with CoV infections develop more severe outcomes.IMPORTANCE SARS-CoV-2 may cause severe hospitalization, but little is known about the role of secondary bacterial infection in these severe cases, beyond the observation of high levels of reported inflammatory markers, associated with bacterial infection, such as procalcitonin. We did a secondary analysis of a double-blind randomized trial of PCV to examine its impact on human CoV infections before the pandemic. We found that both children living with and without HIV randomized to receive PCV had evidence of less hospitalization due to seasonal CoV, suggesting that pneumococcal coinfection may play a role in severe hospitalized CoV infections.


Subject(s)
AIDS-Related Opportunistic Infections/prevention & control , Coronavirus Infections/prevention & control , Pneumococcal Vaccines/administration & dosage , Pneumonia, Viral/prevention & control , Streptococcus pneumoniae/immunology , AIDS-Related Opportunistic Infections/epidemiology , AIDS-Related Opportunistic Infections/pathology , Coinfection/epidemiology , Coinfection/microbiology , Coinfection/prevention & control , Coinfection/virology , Coronavirus/classification , Coronavirus/isolation & purification , Coronavirus Infections/epidemiology , Coronavirus Infections/pathology , Follow-Up Studies , Hospitalization/statistics & numerical data , Humans , Incidence , Infant , Pneumonia, Pneumococcal/epidemiology , Pneumonia, Pneumococcal/prevention & control , Pneumonia, Viral/epidemiology , Prevalence , Randomized Controlled Trials as Topic
2.
Nat Commun ; 12(1): 141, 2021 01 08.
Article in English | MEDLINE | ID: covidwho-1065862

ABSTRACT

Coronaviruses spike (S) glycoproteins mediate viral entry into host cells by binding to host receptors. However, how the S1 subunit undergoes conformational changes for receptor recognition has not been elucidated in Alphacoronavirus. Here, we report the cryo-EM structures of the HCoV-229E S trimer in prefusion state with two conformations. The activated conformation may pose the potential exposure of the S1-RBDs by decreasing of the interaction area between the S1-RBDs and the surrounding S1-NTDs and S1-RBDs compared to the closed conformation. Furthermore, structural comparison of our structures with the previously reported HCoV-229E S structure showed that the S trimers trended to open the S2 subunit from the closed conformation to open conformation, which could promote the transition from pre- to postfusion. Our results provide insights into the mechanisms involved in S glycoprotein-mediated Alphacoronavirus entry and have implications for vaccine and therapeutic antibody design.


Subject(s)
CD13 Antigens/metabolism , Coronavirus 229E, Human/physiology , Spike Glycoprotein, Coronavirus/metabolism , Virus Internalization , Cell Line, Tumor , Coronavirus Infections/prevention & control , Coronavirus Infections/virology , Cryoelectron Microscopy , Humans , Models, Molecular , Protein Conformation, alpha-Helical , Protein Multimerization/physiology , Protein Structure, Quaternary , Protein Subunits/metabolism , Spike Glycoprotein, Coronavirus/ultrastructure
3.
Biomed Res Int ; 2021: 8870425, 2021.
Article in English | MEDLINE | ID: covidwho-1052344

ABSTRACT

Severe Acute Respiratory Syndrome (SARS), Middle East Respiratory Syndrome (MERS), and Coronavirus Disease 2019 (COVID-19) infections are the three epidemiological diseases caused by the Coronaviridae family. Perceiving the immune responses in these infections and the escape of viruses could help us design drugs and vaccines for confronting these infections. This review investigates the innate and adaptive immune responses reported in the infections of the three coronaviruses SARS, MERS, and COVID-19. Moreover, the present study can trigger researchers to design and develop new vaccines and drugs based on immune system responses. In conclusion, due to the need for an effective and efficient immune stimulation against coronavirus, a combination of several strategies seems necessary for developing the vaccine.


Subject(s)
/immunology , Coronavirus Infections/immunology , Middle East Respiratory Syndrome Coronavirus/immunology , SARS Virus/immunology , Severe Acute Respiratory Syndrome/immunology , Adaptive Immunity , Animals , Coronavirus Infections/prevention & control , Humans , Immunity, Innate , Severe Acute Respiratory Syndrome/prevention & control
4.
Otolaryngol Clin North Am ; 53(6): 1159-1170, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-1027957

ABSTRACT

This review explores the changes to practice associated with COVID-19 for providers treating patients with head and neck cancer and laryngeal pathology. The aim of the review is to highlight some of the challenges and considerations associated with treating this patient population during the pandemic. Additionally, it seeks to discuss some of the areas of concern related to ramping up clinical volume.


Subject(s)
Coronavirus Infections/prevention & control , Elective Surgical Procedures/statistics & numerical data , Head and Neck Neoplasms/surgery , Infection Control/methods , Laryngectomy/methods , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Telemedicine/statistics & numerical data , Adult , Aged , Coronavirus Infections/epidemiology , Elective Surgical Procedures/methods , Female , Head and Neck Neoplasms/diagnosis , Humans , Laryngectomy/adverse effects , Male , Middle Aged , Occupational Health/statistics & numerical data , Pandemics/statistics & numerical data , Patient Safety/statistics & numerical data , Personal Protective Equipment/statistics & numerical data , Pneumonia, Viral/epidemiology , Safety Management , Telemedicine/methods , United States
10.
J Perinatol ; 40(5): 820-826, 2020 05.
Article in English | MEDLINE | ID: covidwho-1023850

ABSTRACT

BACKGROUND: Little is known about the perinatal aspects of COVID-19. OBJECTIVE: To summarize available evidence and provide perinatologists/neonatologists with tools for managing their patients. METHODS: Analysis of available literature on COVID-19 using Medline and Google scholar. RESULTS: From scant data: vertical transmission from maternal infection during the third trimester probably does not occur or likely it occurs very rarely. Consequences of COVID-19 infection among women during early pregnancy remain unknown. We cannot conclude if pregnancy is a risk factor for more severe disease in women with COVID-19. Little is known about disease severity in neonates, and from very few samples, the presence of SARS-CoV-2 has not been documented in human milk. Links to websites of organizations with updated COVID-19 information are provided. Infographics summarize an approach to the pregnant woman or neonate with suspected or confirmed COVID-19. CONCLUSIONS: As the pandemic continues, more data will be available that could lead to changes in current knowledge and recommendations.


Subject(s)
Coronavirus Infections , Infectious Disease Transmission, Vertical/prevention & control , Pandemics , Pneumonia, Viral , Pregnancy Complications, Infectious/virology , Betacoronavirus , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Female , Humans , Infant, Newborn , Male , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Pregnancy , Risk Factors
12.
J Hosp Infect ; 106(3): 536-553, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-1023641

ABSTRACT

BACKGROUND: In pandemics such as COVID-19, shortages of personal protective equipment are common. One solution may be to decontaminate equipment such as facemasks for reuse. AIM: To collect and synthesize existing information on decontamination of N95 filtering facepiece respirators (FFRs) using microwave and heat-based treatments, with special attention to impacts on mask function (aerosol penetration, airflow resistance), fit, and physical traits. METHODS: A systematic review (PROSPERO CRD42020177036) of literature available from Medline, Embase, Global Health, and other sources was conducted. Records were screened independently by two reviewers, and data was extracted from studies that reported on effects of microwave- or heat-based decontamination on N95 FFR performance, fit, physical traits, and/or reductions in microbial load. FINDINGS: Thirteen studies were included that used dry/moist microwave irradiation, heat, or autoclaving. All treatment types reduced pathogen load by a log10 reduction factor of at least three when applied for sufficient duration (>30 s microwave, >60 min dry heat), with most studies assessing viral pathogens. Mask function (aerosol penetration <5% and airflow resistance <25 mmH2O) was preserved after all treatments except autoclaving. Fit was maintained for most N95 models, though all treatment types caused observable physical damage to at least one model. CONCLUSIONS: Microwave irradiation and heat may be safe and effective viral decontamination options for N95 FFR reuse during critical shortages. The evidence does not support autoclaving or high-heat (>90°C) approaches. Physical degradation may be an issue for certain mask models, and more real-world evidence on fit is needed.


Subject(s)
Coronavirus Infections/prevention & control , Decontamination/standards , Equipment Reuse/standards , Guidelines as Topic , Hot Temperature , Respiratory Protective Devices/virology , Ultraviolet Rays , Humans
13.
Health Place ; 64: 102398, 2020 07.
Article in English | MEDLINE | ID: covidwho-1023585

ABSTRACT

Schools have closed worldwide as part of measures to prevent SARS-CoV-2 transmission but are beginning to reopen in some countries. Various measures are being pursued to minimise transmission but existing guidance has not developed a comprehensive framework or theory of change. We present a framework informed by the occupational health hierarchy of control and a theory of change informed by realist approaches. We present measures focused on elimination, substitution, engineering, administration, education and personal protective equipment. We theorise that such measures offer a means of disrupting SARS-CoV-2 transmission via routes involving fomites, faeco-oral routes, droplets and aerosols.


Subject(s)
Coronavirus Infections/prevention & control , Evidence-Based Practice , Infection Control/standards , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Schools/standards , Betacoronavirus/isolation & purification , Humans , Schools/organization & administration
16.
PLoS One ; 15(9): e0239113, 2020.
Article in English | MEDLINE | ID: covidwho-798750

ABSTRACT

Social distancing interventions can be effective against epidemics but are potentially detrimental for the economy. Businesses that rely heavily on face-to-face communication or close physical proximity when producing a product or providing a service are particularly vulnerable. There is, however, no systematic evidence about the role of human interactions across different lines of business and about which will be the most limited by social distancing. Here we provide theory-based measures of the reliance of U.S. businesses on human interaction, detailed by industry and geographic location. We find that, before the pandemic hit, 43 million workers worked in occupations that rely heavily on face-to-face communication or require close physical proximity to other workers. Many of these workers lost their jobs since. Consistently with our model, employment losses have been largest in sectors that rely heavily on customer contact and where these contacts dropped the most: retail, hotels and restaurants, arts and entertainment and schools. Our results can help quantify the economic costs of social distancing.


Subject(s)
Commerce/trends , Coronavirus Infections/prevention & control , Employment/trends , Infection Control/economics , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Betacoronavirus/pathogenicity , Commerce/standards , Commerce/statistics & numerical data , Coronavirus Infections/economics , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Datasets as Topic , Employment/economics , Employment/statistics & numerical data , Humans , Infection Control/methods , Infection Control/standards , Pandemics/economics , Pneumonia, Viral/economics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , United States
18.
Cytometry A ; 97(9): 882-886, 2020 09.
Article in English | MEDLINE | ID: covidwho-790373

ABSTRACT

Operating shared resource laboratories (SRLs) in times of pandemic is a challenge for research institutions. In a multiuser, high-turnover working space, the transmission of infectious agents is difficult to control. To address this challenge, imaging core facility managers being members of German BioImaging discussed how shared microscopes could be operated with minimal risk of spreading SARS-CoV-2 between users and staff. Here, we describe the resulting guidelines and explain their rationale, with a focus on separating users in space and time, protective face masks, and keeping surfaces virus-free. These recommendations may prove useful for other types of SRLs. © 2020 The Authors. Cytometry Part A published by Wiley Periodicals LLC. on behalf of International Society for Advancement of Cytometry.


Subject(s)
Betacoronavirus/pathogenicity , Biomedical Research/organization & administration , Coronavirus Infections/prevention & control , Infection Control , Laboratories/organization & administration , Microscopy , Occupational Health , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Cooperative Behavior , Coronavirus Infections/transmission , Coronavirus Infections/virology , Decontamination , Equipment Contamination/prevention & control , Germany , Humans , Occupational Exposure/prevention & control , Personal Protective Equipment , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , Protective Factors , Research Personnel/organization & administration , Risk Assessment , Risk Factors , Workflow
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