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1.
PLoS Comput Biol ; 17(12): e1009675, 2021 12.
Article in English | MEDLINE | ID: covidwho-1619980

ABSTRACT

Identifying the epitope of an antibody is a key step in understanding its function and its potential as a therapeutic. Sequence-based clonal clustering can identify antibodies with similar epitope complementarity, however, antibodies from markedly different lineages but with similar structures can engage the same epitope. We describe a novel computational method for epitope profiling based on structural modelling and clustering. Using the method, we demonstrate that sequence dissimilar but functionally similar antibodies can be found across the Coronavirus Antibody Database, with high accuracy (92% of antibodies in multiple-occupancy structural clusters bind to consistent domains). Our approach functionally links antibodies with distinct genetic lineages, species origins, and coronavirus specificities. This indicates greater convergence exists in the immune responses to coronaviruses than is suggested by sequence-based approaches. Our results show that applying structural analytics to large class-specific antibody databases will enable high confidence structure-function relationships to be drawn, yielding new opportunities to identify functional convergence hitherto missed by sequence-only analysis.


Subject(s)
Antigens, Viral/chemistry , COVID-19/immunology , COVID-19/virology , Epitopes, B-Lymphocyte/chemistry , SARS-CoV-2/chemistry , SARS-CoV-2/immunology , Amino Acid Sequence , Animals , Antibodies, Neutralizing/chemistry , Antibodies, Neutralizing/genetics , Antibodies, Viral/chemistry , Antibodies, Viral/genetics , Antibodies, Viral/metabolism , Antibody Specificity , Antigen-Antibody Complex/chemistry , Antigen-Antibody Complex/genetics , Antigen-Antibody Reactions/genetics , Antigen-Antibody Reactions/immunology , Computational Biology , Coronavirus/chemistry , Coronavirus/genetics , Coronavirus/immunology , Databases, Chemical , Epitope Mapping , Epitopes, B-Lymphocyte/genetics , Humans , Mice , Models, Molecular , Pandemics , SARS-CoV-2/genetics , Single-Domain Antibodies/immunology
2.
Cell Rep ; 37(13): 110169, 2021 12 28.
Article in English | MEDLINE | ID: covidwho-1616407

ABSTRACT

The importance of pre-existing immune responses to seasonal endemic coronaviruses (HCoVs) for the susceptibility to SARS-CoV-2 infection and the course of COVID-19 is the subject of an ongoing scientific debate. Recent studies postulate that immune responses to previous HCoV infections can either have a slightly protective or no effect on SARS-CoV-2 pathogenesis and, consequently, be neglected for COVID-19 risk stratification. Challenging this notion, we provide evidence that pre-existing, anti-nucleocapsid antibodies against endemic α-coronaviruses and S2 domain-specific anti-spike antibodies against ß-coronavirus HCoV-OC43 are elevated in patients with COVID-19 compared to pre-pandemic donors. This finding is particularly pronounced in males and in critically ill patients. Longitudinal evaluation reveals that antibody cross-reactivity or polyclonal stimulation by SARS-CoV-2 infection are unlikely to be confounders. Thus, specific pre-existing immunity to seasonal coronaviruses may increase susceptibility to SARS-CoV-2 and predispose individuals to an adverse COVID-19 outcome, guiding risk management and supporting the development of universal coronavirus vaccines.


Subject(s)
COVID-19/immunology , Coronavirus/immunology , SARS-CoV-2/immunology , Adult , Antibodies/immunology , Antibodies, Viral/immunology , COVID-19/etiology , Coronavirus Infections/immunology , Coronavirus OC43, Human/immunology , Coronavirus OC43, Human/pathogenicity , Cross Reactions/immunology , Female , Germany , Humans , Immunity, Humoral/immunology , Immunoglobulin G/immunology , Longitudinal Studies , Male , Middle Aged , Pandemics , SARS-CoV-2/pathogenicity , Seasons , Severity of Illness Index , Spike Glycoprotein, Coronavirus/immunology
3.
Movimento (Porto Alegre) ; 27: e27011, 2021. tab, graf
Article in English | LILACS (Americas) | ID: covidwho-1609147

ABSTRACT

The situation created by the novel coronavirus disease has affected education worldwide, resulting in the urgent need for programs that promote physical activity at home and responsible use of internet-connected devices. This work provides a didactic proposal to perform Expressive Movement & Creative Dance (EMCD) at home adaptable to distinct educational levels and useful as a valuable online or face-to-face education experience even when the coronavirus crisis ends. The proposal is based on the Laban Movement Analysis, the Theatre of the Oppressed, and Lipdub. It seeks to develop students' own artistic body language, emotional intelligence, healthy physical activity and social awareness. Furthermore, it intends to promote the creation of a new social movement (#VIDLOP) using art and popular media as empowering and democratic channels for building a better world. In conclusion, this may be a promising proposal to develop the EMCD and human awareness in challenging scenarios and distinct educational settings.


A situação causada pela nova doença do coronavírus afetou a educação em todo o mundo, sendo urgente a aplicação de programas que promovam a atividade física em casa e o uso responsável de dispositivos conectados à internet. O presente trabalho apresenta uma proposta didática de Expressão Corporal (EC) para a sua prática desde casa, adaptável a diferentes níveis educacionais, e útil também como uma valiosa experiência educacional on-line ou presencial mesmo quando a crise do coronavírus acabe. Esta proposta baseia-se na Análise Laban de Movimento, no Teatro do Oprimido e no Lipdub. Procura desenvolver a linguagem corporal artística própria, a inteligência emocional, comportamentos saudáveis de atividade física e a consciência social dos alunos; e promover a criação de um novo movimento social (#VIDLOP), usando a arte e a mídia popular como canais democráticos e de poder para construir um mundo melhor. Em conclusão, esta pode ser uma proposta promissora para o desenvolvimento da EC e da consciência humana em cenários desafiadores e em diferentes ambientes educacionais.


La situación provocada por la nueva enfermedad del coronavirus ha afectado a la educación en todo el mundo, por lo que es urgente la aplicación de programas que promuevan la actividad física en el hogar y el uso responsable de dispositivos conectados a internet. El presente trabajo presenta una propuesta didáctica de Expresión Corporal (EC) para practicar desde casa, adaptable a diferentes niveles educativos, y útil también como una valiosa experiencia educativa online o presencial, incluso cuando la crisis del coronavirus acabe. Esta propuesta se basa en el Análisis del Movimiento de Laban, en el Teatro del Oprimido y en el Lipdub. Busca desarrollar el lenguaje corporal artístico propio, la inteligencia emocional, comportamientos saludables de actividad física y la conciencia social de los alumnos, además de promover la creación de un nuevo movimiento social (#VIDLOP), utilizando arte y medios de comunicación populares como canales democráticos y de poder para construir un mundo mejor. En conclusión, esta puede ser una propuesta prometedora para el desarrollo de la EC y la conciencia humana en escenarios desafiantes y en diferentes entornos educativos.


Subject(s)
Humans , Male , Female , Social Isolation , Health , Coronavirus Infections , Coronavirus , Motor Activity , Physical Education and Training , Internet , Kinesics
6.
Texto & contexto enferm ; 30: e20210135, 2021. tab
Article in English | LILACS (Americas) | ID: covidwho-1599698

ABSTRACT

ABSTRACT Objective: to identify the occurrence of the factors associated with: (1) suspected infection by the virus that causes COVID-19; (2) absenteeism at work due to suspected infection or diagnosis of infection by the virus that causes COVID-19; and (3) performance of tests for the screening of infection by the virus that causes COVID-19 among Nursing professionals. Method: a cross-sectional study conducted with 890 nurses in June and July 2020. The associations between the outcomes and the other variables were explored using Poisson regression models with robust variance estimators. Results: occurrence of the outcomes was (1) 35.5%, (2) 16.2% and (3) 38.2%, respectively. For suspected infection, associations were observed with assessment of the working conditions as deficient (RR: 1.55; 95% CI: 1.21-1.99) and with lack of Personal Protective Equipment (RR: 1.27; 95% CI: 1.06-1.51). Absenteeism at work was associated with the adoption of moderate social distancing (RR: 1.49; 95% CI: 1.00-2.21). To perform the screening tests, the associations with links to outpatient (RR: 2.47; 95% CI: 1.52-4.01) and hospital (RR: 2.49; 95% CI: 1.60-3.89) services stood out, in addition to direct contact with patients with confirmed COVID-19 diagnoses (RR: 1.65; 95% CI: 1.33-2.05). Conclusion: despite the high occurrence of suspected infection and a considerable incidence of absenteeism at work among professionals from the various services under study, disparity in access to the screening tests was evidenced, especially with regard to the professionals who work in Primary Care.


RESUMEN Objetivo: identificar la incidencia y los factores asociados con: (1) sospecha de infección por el virus que causa COVID-19; (2) ausencia laboral debido a sospecha o diagnóstico de infección por el virus que causa COVID-19; y (3) pruebas para detectar la infección por el virus que causa COVID-19 entre profesionales de Enfermería. Método: estudio transversal realizado con 890 profesionales de Enfermería durante los meses de junio y julio de 2020. Las asociaciones entre los resultados y las demás variables se estudiaron por medio de modelos de regresión de Poisson con estimadores robustos de varianza. Resultados: la incidencia de los resultados fue: (1) 35,5%, (2) 16,2% y (3) 38,2%. Para la sospecha de infección, se observaron asociaciones con condiciones de trabajo evaluadas como deficientes (RR: 1,55; IC 95%: 1,21-1,99) y con la falta de Equipos de Protección Personal (RR: 1,27; IC 95%: 1,06-1,51). La ausencia laboral se asoció con la adopción de distanciamiento social moderado (RR: 1,49; IC 95%: 1,00-2,21). Para llevar adelante las pruebas de detección, se destacaron las asociaciones con la vinculación a servicios ambulatorios (RR: 2,47; IC 95%: 1,52-4,01) y hospitalarios (RR: 2,49; IC 95%: 1,60-3,89), además del contacto directo con pacientes con diagnósticos confirmados da COVID-19 (RR: 1,65; IC 95%: 1,33-2,05). Conclusión: pese a la elevada incidencia de sospechas de infección y una considerable cantidad de ausencias laborales entre profesionales de los diversos servicios estudiados, se evidenció cierta disparidad en el acceso a las pruebas de detección, especialmente en lo que se refiere a los profesionales de Atención Primaria.


RESUMO Objetivo: identificar a ocorrência e os fatores associados a: (1) suspeita de infecção pelo vírus causador da COVID-19; (2) abstenção no trabalho devido a suspeita ou ao diagnóstico de infecção pelo vírus causador da COVID-19 e (3) realização de testes para o rastreio de infecção pelo vírus causador da COVID-19 entre profissionais de Enfermagem. Método: estudo transversal realizado com 890 enfermeiros entre os meses de junho e julho de 2020. As associações entre os desfechos e as demais variáveis foram exploradas com a utilização de modelos de regressão de Poisson com estimadores robustos de variância. Resultados: a ocorrência dos desfechos foi de (1) 35,5%, (2) 16,2% e (3) 38,2%. Para a suspeita de infecção, foram observadas associações com a avaliação das condições de trabalho como ruins (RR: 1,55; IC 95%: 1,21-1,99) e a falta de equipamentos de proteção individual (RR: 1,27; IC 95%: 1,06-1,51). A abstenção do trabalho esteve associada com a adoção de distanciamento social moderado (RR: 1,49; IC 95%: 1,00-2,21). Para a realização de testes de rastreio, destacam-se as associações com a vinculação a serviços ambulatoriais (RR: 2,47; IC 95%: 1,52-4,01) e hospitalares (RR: 2,49; IC 95%: 1,60-3,89), além do contato direto com pacientes confirmadamente acometidos pela COVID-19 (RR: 1,65; IC 95%: 1,33-2,05). Conclusão: apesar da elevada ocorrência de suspeitas de infecção e um número considerável de abstenção do trabalho entre profissionais dos diversos serviços estudados, foi evidenciada uma disparidade no acesso aos testes de rastreio, especialmente no que se refere aos profissionais da Atenção Primária.


Subject(s)
Humans , Nursing , Coronavirus Infections , Coronavirus , Laboratory Test , National Health Programs
7.
mBio ; 12(6): e0334721, 2021 12 21.
Article in English | MEDLINE | ID: covidwho-1599212

ABSTRACT

The world was unprepared for coronavirus disease 2019 (COVID-19) and remains ill-equipped for future pandemics. While unprecedented strides have been made developing vaccines and treatments for COVID-19, there remains a need for highly effective and widely available regimens for ambulatory use for novel coronaviruses and other viral pathogens. We posit that a priority is to develop pan-family drug cocktails to enhance potency, limit toxicity, and avoid drug resistance. We urge cocktail development for all viruses with pandemic potential both in the short term (<1 to 2 years) and longer term with pairs of drugs in advanced clinical testing or repurposed agents approved for other indications. While significant efforts were launched against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), in vitro and in the clinic, many studies employed solo drugs and had disappointing results. Here, we review drug combination studies against SARS-CoV-2 and other viruses and introduce a model-driven approach to assess drug pairs with the highest likelihood of clinical efficacy. Where component agents lack sufficient potency, we advocate for synergistic combinations to achieve therapeutic levels. We also discuss issues that stymied therapeutic progress against COVID-19, including testing of agents with low likelihood of efficacy late in clinical disease and lack of focus on developing virologic surrogate endpoints. There is a need to expedite efficient clinical trials testing drug combinations that could be taken at home by recently infected individuals and exposed contacts as early as possible during the next pandemic, whether caused by a coronavirus or another viral pathogen. The approach herein represents a proactive plan for global viral pandemic preparedness.


Subject(s)
Antiviral Agents/pharmacology , Coronavirus/drug effects , Drug Combinations , Animals , COVID-19/drug therapy , Coronavirus/classification , Coronavirus/pathogenicity , Coronavirus Infections/drug therapy , Humans , Mice , Pandemics/prevention & control , SARS-CoV-2/drug effects
8.
Ecohealth ; 18(4): 421-428, 2021 12.
Article in English | MEDLINE | ID: covidwho-1590480

ABSTRACT

We investigated the prevalence of coronaviruses in 44 bats from four families in northeastern Eswatini using high-throughput sequencing of fecal samples. We found evidence of coronaviruses in 18% of the bats. We recovered full or near-full-length genomes from two bat species: Chaerephon pumilus and Afronycteris nana, as well as additional coronavirus genome fragments from C. pumilus, Epomophorus wahlbergi, Mops condylurus, and Scotophilus dinganii. All bats from which we detected coronaviruses were captured leaving buildings or near human settlements, demonstrating the importance of continued surveillance of coronaviruses in bats to better understand the prevalence, diversity, and potential risks for spillover.


Subject(s)
Chiroptera , Coronavirus Infections , Coronavirus , Metagenomics , Animals , Chiroptera/virology , Coronavirus/genetics , Coronavirus Infections/veterinary , Eswatini , Genetic Variation , Genome, Viral , Phylogeny
10.
Viruses ; 13(12)2021 12 17.
Article in English | MEDLINE | ID: covidwho-1580424

ABSTRACT

Infectious bronchitis virus (IBV), a gammacoronavirus, is an economically important virus to the poultry industry, as well as a significant welfare issue for chickens. As for all positive strand RNA viruses, IBV infection causes rearrangements of the host cell intracellular membranes to form replication organelles. Replication organelle formation is a highly conserved and vital step in the viral life cycle. Here, we investigate the localization of viral RNA synthesis and the link with replication organelles in host cells. We have shown that sites of viral RNA synthesis and virus-related dsRNA are associated with one another and, significantly, that they are located within a membrane-bound compartment within the cell. We have also shown that some viral RNA produced early in infection remains within these membranes throughout infection, while a proportion is trafficked to the cytoplasm. Importantly, we demonstrate conservation across all four coronavirus genera, including SARS-CoV-2. Understanding more about the replication of these viruses is imperative in order to effectively find ways to control them.


Subject(s)
Coronavirus/metabolism , Intracellular Membranes/metabolism , RNA, Viral/biosynthesis , Animals , Cell Line , Coronavirus/classification , Coronavirus/growth & development , Cytoplasm/metabolism , Humans , Infectious bronchitis virus/growth & development , Infectious bronchitis virus/metabolism , RNA, Double-Stranded/metabolism , Viral Replication Compartments/metabolism
11.
Sci Rep ; 11(1): 24442, 2021 12 24.
Article in English | MEDLINE | ID: covidwho-1577650

ABSTRACT

Therapeutic interventions targeting viral infections remain a significant challenge for both the medical and scientific communities. While specific antiviral agents have shown success as therapeutics, viral resistance inevitably develops, making many of these approaches ineffective. This inescapable obstacle warrants alternative approaches, such as the targeting of host cellular factors. Respiratory syncytial virus (RSV), the major respiratory pathogen of infants and children worldwide, causes respiratory tract infection ranging from mild upper respiratory tract symptoms to severe life-threatening lower respiratory tract disease. Despite the fact that the molecular biology of the virus, which was originally discovered in 1956, is well described, there is no vaccine or effective antiviral treatment against RSV infection. Here, we demonstrate that targeting host factors, specifically, mTOR signaling, reduces RSV protein production and generation of infectious progeny virus. Further, we show that this approach can be generalizable as inhibition of mTOR kinases reduces coronavirus gene expression, mRNA transcription and protein production. Overall, defining virus replication-dependent host functions may be an effective means to combat viral infections, particularly in the absence of antiviral drugs.


Subject(s)
Coronavirus/metabolism , Respiratory Syncytial Virus, Human/metabolism , TOR Serine-Threonine Kinases/metabolism , Viral Proteins/metabolism , A549 Cells , Coronavirus/drug effects , Coronavirus/genetics , Gene Expression Regulation, Viral/drug effects , Humans , Protein Biosynthesis/drug effects , Protein Kinase Inhibitors/pharmacology , Protein Kinase Inhibitors/therapeutic use , RNA Interference , RNA, Small Interfering/metabolism , Rapamycin-Insensitive Companion of mTOR Protein/antagonists & inhibitors , Rapamycin-Insensitive Companion of mTOR Protein/genetics , Rapamycin-Insensitive Companion of mTOR Protein/metabolism , Regulatory-Associated Protein of mTOR/antagonists & inhibitors , Regulatory-Associated Protein of mTOR/genetics , Regulatory-Associated Protein of mTOR/metabolism , Respiratory Syncytial Virus Infections/drug therapy , Respiratory Syncytial Virus Infections/pathology , Respiratory Syncytial Virus Infections/virology , Respiratory Syncytial Virus, Human/drug effects , Respiratory Syncytial Virus, Human/isolation & purification , TOR Serine-Threonine Kinases/antagonists & inhibitors , TOR Serine-Threonine Kinases/genetics , Viral Proteins/genetics
12.
BMC Res Notes ; 14(1): 461, 2021 Dec 20.
Article in English | MEDLINE | ID: covidwho-1577156

ABSTRACT

OBJECTIVE: Coronaviruses (CoVs) are natural commensals of bats. Two subgenera, namely Sarbecoviruses and Merbecoviruses have a high zoonotic potential and have been associated with three separate spillover events in the past 2 decades, making surveillance of bat-CoVs crucial for the prevention of the next epidemic. The study was aimed to elucidate the presence of coronavirus in fresh bat guano sampled from Wind Cave Nature Reserve (WCNR) in Sarawak, Malaysian Borneo. Samples collected were placed into viral transport medium, transported on ice within the collection day, and preserved at - 80 °C. Nucleic acid was extracted using the column method and screened using consensus PCR primers targeting the RNA-dependent RNA polymerase (RdRp) gene. Amplicons were sequenced bidirectionally using the Sanger method. Phylogenetic tree with maximum-likelihood bootstrap and Bayesian posterior probability were constructed. RESULTS: CoV-RNA was detected in ten specimens (47.6%, n = 21). Six alphacoronavirus and four betacoronaviruses were identified. The bat-CoVs can be phylogenetically grouped into four novel clades which are closely related to Decacovirus-1 and Decacovirus-2, Sarbecovirus, and an unclassified CoV. CoVs lineages unique to the Island of Borneo were discovered in Sarawak, Malaysia, with one of them closely related to Sarbecovirus. All of them are distant from currently known human coronaviruses.


Subject(s)
Chiroptera , Coronavirus , Animals , Bayes Theorem , Borneo , Coronavirus/genetics , Humans , Malaysia/epidemiology , Phylogeny
13.
Iatreia ; 34(4): 375-382, oct.-dic. 2021. tab, graf
Article in Spanish | LILACS (Americas) | ID: covidwho-1573008

ABSTRACT

RESUMEN Introducción: el SARS-CoV-2 es un nuevo coronavirus descrito por primera vez en China y con alta capacidad de propagación. Su presentación clínica más frecuente son los síntomas respiratorios, aunque se han descrito otros como los gastrointestinales. La transmisión ocurre por gotas, aerosoles, vía fecal oral, conjuntiva, fómites y por contacto directo con fluidos corporales del paciente. En este sentido, los procedimientos realizados en las salas de endoscopia deben considerarse de alto riesgo. Objetivo: describir y analizar las medidas de prevención frente al SARS-CoV-2 para la práctica endoscópica-anestésica u otros procedimientos que requieran sedación, con el fin de disminuir la exposición y así minimizar el contagio del personal de salud. Resultados: la respuesta global se ha enfocado en la utilización de elementos de protección personal para tratar de disminuir el riesgo al que se encuentra expuesto el personal de salud. Sin embargo, debido a la prontitud de la emergencia, no se han podido generar evidencias de alta calidad que permitan dar recomendaciones definitivas. Reflexión: el personal de salud debe tomar todas las medidas de protección que puedan ser consideradas como efectivas, además deconstruir protocolos y fomentar la adherencia a los mismos.


SUMMARY Introduction: SARS-CoV-2 is a new coronavirus described for the first time in China, with high capacity of propagation. Its most frequent clinical presentation is respiratory symptoms; however, others have been described as gastrointestinal. Transmission occurs by droplets, aerosols, oral fecal route, conjunctiva, fomites and by direct contact with body fluids of the patient. In this sense, the procedures performed in endoscopy rooms should be considered high risk. Objective: To describe and analyze preventive measures against SARS-CoV-2 for endoscopic-anesthesia practice or other procedures that require sedation, in order to reduce exposure and thus minimize contagion of health personnel. Results: The global response has focused on the use of personal protective equipment to try to reduce the risk to which health care personnel are exposed, but due to the urgency of the emergency, it has not been possible to generate high quality evidence to give definitive recommendations. Reflection: Health personnel should take all protective measures that can be considered effective, and also deconstruct protocols and encourage adherence to them.


Subject(s)
Humans , Coronavirus , Personal Protection , Endoscopy , Conscious Sedation , Anesthesia
16.
Medicina (Kaunas) ; 57(12)2021 Nov 24.
Article in English | MEDLINE | ID: covidwho-1539976

ABSTRACT

Background and Objectives: This retrospective study evaluated the clinical impact of enhanced personal protective equipment (PPE) on the clinical outcomes in patients with out-of-hospital cardiac arrest. Moreover, by focusing on the use of a powered air-purifying respirator (PAPR), we investigated the medical personnel's perceptions of wearing PAPR during cardiopulmonary resuscitation. Materials and Methods: According to the arrival time at the emergency department, the patients were categorized into a conventional PPE group (1 August 2019 to 20 January 2020) and an enhanced PPE group (21 January 2020, to 31 August 2020). The primary outcomes of this analysis were the return of spontaneous circulation (ROSC) rate. Additionally, subjective perception of the medical staff regarding the effect of wearing enhanced PPE during cardiopulmonary resuscitation (CPR) was evaluated by conducting a survey. Results: This study included 130 out-of-hospital cardiac arrest (OHCA) patients, with 73 and 57 patients in the conventional and enhanced PPE groups, respectively. The median time intervals to first intubation and to report the first arterial blood gas analysis results were longer in the enhanced PPE group than in the conventional PPE group (3 min vs. 2 min; p = 0.020 and 8 min vs. 3 min; p < 0.001, respectively). However, there were no significant differences in the ROSC rate (odds ratio (OR) = 0.79, 95% confidence interval (CI): 0.38-1.67; p = 0.542) and 1 month survival (OR 0.38, 95% CI: 0.07-2.10; p = 0.266) between the two groups. In total, 67 emergent department (ED) professionals responded to the questionnaire. Although a significant number of respondents experienced inconveniences with PAPR use, they agreed that PAPR was necessary during the CPR procedure for protection and reduction of infection transmission. Conclusion: The use of enhanced PPE, including PAPR, affected the performance of CPR to some extent but did not alter patient outcomes. PAPR use during the resuscitation of OHCA patients might positively impact the psychological stability of the medical staff.


Subject(s)
Coronavirus , Out-of-Hospital Cardiac Arrest , Humans , Out-of-Hospital Cardiac Arrest/therapy , Pandemics , Personal Protective Equipment , Retrospective Studies
17.
Evid Based Dent ; 21(3): 84-86, 2020 09.
Article in English | MEDLINE | ID: covidwho-1526067

ABSTRACT

Aim This systematic review sought to assess and scrutinise the validity and practicality of published and preprint reports of prediction models for the diagnosis of coronavirus disease 2019 (COVID-19) in patients with suspected infection, for prognosis of patients with COVID-19, and for identifying individuals in the general population at increased risk of infection with COVID-19 or being hospitalised with the illness.Data sources A systematic, online search was conducted in PubMed and Embase. In order to do so, the authors used Ovid as the host platform for these two databases and also investigated bioRxiv, medRxiv and arXiv as repositories for the preprints of studies. A public living systematic review list of COVID-19-related studies was used as the baseline searching platform (Institute of Social and Preventive Medicine's repository for living evidence on COVID-19).Study selection Studies which developed or validated a multivariable prediction model related to COVID-19 patients' data (individual level data) were included. The authors did not put any restrictions on the models included in their study regarding the model setting, prediction horizon or outcomes.Data extraction and synthesis Checklists of critical appraisal and data extraction for systematic reviews of prediction modelling studies (CHARMS) and prediction model risk of bias assessment tool (PROBAST) were used to guide developing of a standardised data extraction form. Each model's predictive performance was extracted by using any summaries of discrimination and calibration. All these steps were done according to the aspects of the transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD) and preferred reporting items for systematic reviews and meta-analyses (PRISMA).Results One hundred and forty-five prediction models (107 studies) were selected for data extraction and critical appraisal. The most common predictors of diagnosis and prognosis of COVID-19 were age, body temperature, lymphocyte count and lung imaging characteristics. Influenza-like symptoms and neutrophil count were regularly predictive in diagnostic models, while comorbidities, sex, C-reactive protein and creatinine were common prognostic items. C-indices (a measure of discrimination for models) ranged from 0.73 to 0.81 in prediction models for the general population, from 0.65 to more than 0.99 in diagnostic models, and from 0.68 to 0.99 in the prognostic models. All the included studies were reported to have high risks of bias.Conclusions Overall, this study did not recommend applying any of the predictive models in clinical practice yet. High risk of bias, reporting problems and (probably) optimistic reported performances are all among the reasons for the previous conclusion. Prompt actions regarding accurate data sharing and international collaborations are required to achieve more rigorous prediction models for COVID-19.


Subject(s)
Coronavirus Infections/epidemiology , Coronavirus , Models, Theoretical , Pandemics , Pneumonia, Viral , Betacoronavirus , COVID-19 , Forecasting , Humans , SARS-CoV-2
19.
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