Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 351
Filter
Add filters

Year range
1.
Lancet Infect Dis ; 20(6): 669-677, 2020 06.
Article in English | MEDLINE | ID: covidwho-688245

ABSTRACT

BACKGROUND: In the face of rapidly changing data, a range of case fatality ratio estimates for coronavirus disease 2019 (COVID-19) have been produced that differ substantially in magnitude. We aimed to provide robust estimates, accounting for censoring and ascertainment biases. METHODS: We collected individual-case data for patients who died from COVID-19 in Hubei, mainland China (reported by national and provincial health commissions to Feb 8, 2020), and for cases outside of mainland China (from government or ministry of health websites and media reports for 37 countries, as well as Hong Kong and Macau, until Feb 25, 2020). These individual-case data were used to estimate the time between onset of symptoms and outcome (death or discharge from hospital). We next obtained age-stratified estimates of the case fatality ratio by relating the aggregate distribution of cases to the observed cumulative deaths in China, assuming a constant attack rate by age and adjusting for demography and age-based and location-based under-ascertainment. We also estimated the case fatality ratio from individual line-list data on 1334 cases identified outside of mainland China. Using data on the prevalence of PCR-confirmed cases in international residents repatriated from China, we obtained age-stratified estimates of the infection fatality ratio. Furthermore, data on age-stratified severity in a subset of 3665 cases from China were used to estimate the proportion of infected individuals who are likely to require hospitalisation. FINDINGS: Using data on 24 deaths that occurred in mainland China and 165 recoveries outside of China, we estimated the mean duration from onset of symptoms to death to be 17·8 days (95% credible interval [CrI] 16·9-19·2) and to hospital discharge to be 24·7 days (22·9-28·1). In all laboratory confirmed and clinically diagnosed cases from mainland China (n=70 117), we estimated a crude case fatality ratio (adjusted for censoring) of 3·67% (95% CrI 3·56-3·80). However, after further adjusting for demography and under-ascertainment, we obtained a best estimate of the case fatality ratio in China of 1·38% (1·23-1·53), with substantially higher ratios in older age groups (0·32% [0·27-0·38] in those aged <60 years vs 6·4% [5·7-7·2] in those aged ≥60 years), up to 13·4% (11·2-15·9) in those aged 80 years or older. Estimates of case fatality ratio from international cases stratified by age were consistent with those from China (parametric estimate 1·4% [0·4-3·5] in those aged <60 years [n=360] and 4·5% [1·8-11·1] in those aged ≥60 years [n=151]). Our estimated overall infection fatality ratio for China was 0·66% (0·39-1·33), with an increasing profile with age. Similarly, estimates of the proportion of infected individuals likely to be hospitalised increased with age up to a maximum of 18·4% (11·0-37·6) in those aged 80 years or older. INTERPRETATION: These early estimates give an indication of the fatality ratio across the spectrum of COVID-19 disease and show a strong age gradient in risk of death. FUNDING: UK Medical Research Council.


Subject(s)
Coronavirus Infections/mortality , Pandemics/statistics & numerical data , Pneumonia, Viral/mortality , Adolescent , Adult , Aged , Aged, 80 and over , Betacoronavirus , Child , Child, Preschool , China/epidemiology , Hospitalization/statistics & numerical data , Humans , Incidence , Infant , Infant, Newborn , Middle Aged , Models, Statistical , Young Adult
3.
Am J Phys Med Rehabil ; 99(8): 669-673, 2020 08.
Article in English | MEDLINE | ID: covidwho-682738

ABSTRACT

Severe acute respiratory syndrome coronavirus 2-also known as COVID-19-is primarily known for respiratory illness. Although it is clear that patients with moderate to severe cases of COVID-19 will require pulmonary rehabilitation, physiatrists will need to consider effective management plans for COVID-19 survivors with extrapulmonary involvement. This report will summarize key nonpulmonary considerations to guide rehabilitation clinicians who may be involved in the care of COVID-19 survivors with the best available early evidence.


Subject(s)
Chronic Disease/rehabilitation , Coronavirus Infections/complications , Pandemics/statistics & numerical data , Physiatrists/standards , Physical and Rehabilitation Medicine/standards , Pneumonia, Viral/complications , Practice Guidelines as Topic/standards , Coronavirus Infections/rehabilitation , Female , Follow-Up Studies , Global Health , Humans , Male , Pneumonia, Viral/rehabilitation , Risk Assessment , Severe Acute Respiratory Syndrome/physiopathology , Severe Acute Respiratory Syndrome/rehabilitation , Severity of Illness Index , Survivors/statistics & numerical data , Time Factors , Treatment Outcome
4.
Washington; Organización Panamericana de la Salud; Jun. 30, 2020. 16 p.
Non-conventional in Spanish | LILACS (Americas) | ID: covidwho-677318

ABSTRACT

Este es el reporte de situación COVID-19 Colombia No. 92 - 30 de junio de 2020.


Subject(s)
Humans , Pneumonia, Viral/epidemiology , Coronavirus Infections/epidemiology , Pandemics/statistics & numerical data , Betacoronavirus , Colombia/epidemiology
5.
Bogotá; Organización Panamericana de la Salud; July 1, 2020. 14 p.
Non-conventional in Spanish | LILACS (Americas) | ID: covidwho-677300

ABSTRACT

Este es el reporte de situación COVID-19 Colombia No. 93 - 01 de julio de 2020.


Subject(s)
Humans , Pneumonia, Viral/epidemiology , Coronavirus Infections/epidemiology , Pandemics/statistics & numerical data , Betacoronavirus , Colombia/epidemiology
6.
Bogotá; Organización Panamericana de la Salud; jul. 22, 2020.
Non-conventional in Spanish | LILACS (Americas) | ID: covidwho-677299

ABSTRACT

Este es el reporte de situación COVID-19 Colombia No. 107 - 22 de julio de 2020.


Subject(s)
Humans , Pneumonia, Viral/epidemiology , Coronavirus Infections/epidemiology , Pandemics/statistics & numerical data , Betacoronavirus , Colombia/epidemiology
7.
Bogotá; Organización Panamericana de la Salud; jul. 21, 2020.
Non-conventional in Spanish | LILACS (Americas) | ID: covidwho-677297

ABSTRACT

Este es el reporte de situación COVID-19 Colombia No. 106 - 21de julio de 2020.


Subject(s)
Humans , Pneumonia, Viral/epidemiology , Coronavirus Infections/epidemiology , Pandemics/statistics & numerical data , Betacoronavirus , Colombia/epidemiology
8.
Bogotá; Organización Panamericana de la Salud; jul. 20, 2020.
Non-conventional in Spanish | LILACS (Americas) | ID: covidwho-677296

ABSTRACT

Este es el reporte de situación COVID-19 Colombia No. 105 - 20 de julio de 2020.


Subject(s)
Humans , Pneumonia, Viral/epidemiology , Coronavirus Infections/epidemiology , Pandemics/statistics & numerical data , Betacoronavirus , Colombia/epidemiology
9.
Bogotá; Organización Panamericana de la Salud; jul. 16, 2020.
Non-conventional in Spanish | LILACS (Americas) | ID: covidwho-677290

ABSTRACT

Este es el reporte de situación COVID-19 Colombia No. 104 - 16 de julio de 2020.


Subject(s)
Pneumonia, Viral/epidemiology , Coronavirus Infections/epidemiology , Pandemics/statistics & numerical data , Betacoronavirus , Colombia/epidemiology
10.
Washington; Organización Panamericana de la Salud; jul. 2, 2020. 4 p.
Non-conventional in English, Spanish | LILACS (Americas) | ID: covidwho-677284

ABSTRACT

A number of predictive models and forecasting exercises have been developed by various organizations, such as research groups, academic institutions, hospitals, and consulting companies, with the main aim to support health systems in with COVID-19 strategic decision making, planning, and health policy formulation that help in the fight against COVID19. Predictive models are helpful for estimating the number of COVID-19 cases and deaths; the resources required, e.g., such as hospital patient beds and ICU beds; and the demand for supplies, such as personal protective equipment (PPE). Because predictive models for COVID-19 must rely on a rapidly changing situation and underlying data, they produce results that may change repeatedly as data areas data is updated and revised. Nevertheless, the predictive models are meaningful and can offer crucial insights to policymakers. It is important that we understand the strengths and weaknesses of predictive models in order to use them judiciously as support and reference tools for COVID-19 planning and action.


Los modelos predictivos son útiles para estimar el número de casos y de muertes por la COVID-19; los recursos necesarios, como las camas de hospital y de UCI; y la demanda de suministros, como la de equipos de protección personal (EPP). Dado que los modelos predictivos para la COVID-19 deben basarse en situaciones y datos subyacentes que cambian rápidamente, los resultados que producen pueden cambiar repetidamente a medida que se actualizan y revisan los datos. No obstante, los modelos predictivos tienen interés y pueden aportar perspectivas que son cruciales para los responsables de las políticas. Es importante que conozcamos los puntos fuertes y las limitaciones de los modelos predictivos para usarlos de forma juiciosa como elementos de apoyo y herramientas de referencia para la planificación y la actuación en torno a la COVID-19.


Subject(s)
Neural Networks, Computer , Telemedicine , Public Health Informatics/statistics & numerical data , Information Technology/statistics & numerical data , Pneumonia, Viral/epidemiology , Coronavirus Infections/epidemiology , Pandemics/statistics & numerical data , Betacoronavirus
11.
J Am Med Dir Assoc ; 21(7): 951-953, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-680411

ABSTRACT

Residents of congregate care settings have been severely impacted by the current Coronavirus disease 2019 (COVID-19) pandemic. In this report, we describe the methods our home-based primary care practice has developed to mitigate the spread of COVID-19 in assisted living facilities (ALFs) and we present an initial evaluation of this innovation. Shortly after the first COVID-19 case was reported in the United States, our organization assembled an outbreak committee, designed to support the 1794 ALF residents and the 101 communities in which they reside. The committee led the development and deployment of a comprehensive COVID-19 prevention and suppression strategy. The average age of the cohort was 83 ± 11 years, and 74% were female. Seven individuals (0.4% of census) tested positive for SARS-CoV-2. The positive individuals were located in 3 ALFs, representing 3% of our total number of ALFs. There has been 1 death. Home-based primary care-led outbreak mitigation may be an enabler to suppress COVID-19 in ALFs.


Subject(s)
Assisted Living Facilities/organization & administration , Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Delivery of Health Care/organization & administration , Home Care Services/organization & administration , Pneumonia, Viral/epidemiology , Pneumonia, Viral/therapy , Primary Health Care/methods , Aged , Aged, 80 and over , Cohort Studies , Communicable Disease Control/organization & administration , Coronavirus Infections/prevention & control , Female , Humans , Male , Nursing Homes/organization & administration , Outcome Assessment, Health Care , Pandemics/prevention & control , Pandemics/statistics & numerical data , Pneumonia, Viral/prevention & control , Program Evaluation , Retrospective Studies , Risk Assessment , United States
14.
G Ital Cardiol (Rome) ; 21(8): 565-569, 2020 Aug.
Article in Italian | MEDLINE | ID: covidwho-680055

ABSTRACT

In Italy, the epidemic explosion stage of COVID-19 seems to have been overcome; however, the virus has not been eradicated and the re-emergence of some outbreaks of infection substantiates the danger that the disease may persist. It is therefore necessary to keep the level of surveillance high, to maintain social distancing measures and to act in the control of disease risk factors of a serious or complicated course. Among the risk factors of severe COVID-19 in addition to age, male gender, hypertension and cardiovascular diseases, a major role seems to be played by other cardiovascular risk factors conditioned by an unhealthy lifestyle such as obesity, metabolic syndrome, diabetes and smoking. The new phase requires the maintenance of measures that avoid crowding and close interpersonal contact especially during exercise, in addition to controlled access to hospitals. This will require the reorganization of the traditional methods of cardiovascular prevention and rehabilitation activities, such as gyms and collective educational sessions, and the dilution of outpatient checks. The risk that this scenario may worsen the already suboptimal control of cardiovascular risk factors is therefore real. We do not currently know how long this new phase will last, therefore it is necessary to give impetus to new tele-health initiatives to stimulate the adoption of a healthy lifestyle in primary prevention and tele-monitoring and tele-rehabilitation programs in secondary prevention.


Subject(s)
Cardiovascular Diseases/epidemiology , Communicable Disease Control/organization & administration , Coronavirus Infections/epidemiology , Pandemics/statistics & numerical data , Pneumonia, Viral/epidemiology , Telemedicine/organization & administration , Cardiologists , Cardiovascular Diseases/diagnosis , Coronavirus Infections/prevention & control , Female , Follow-Up Studies , Hospitals, University , Humans , Italy/epidemiology , Male , Pandemics/prevention & control , Physician's Role , Pneumonia, Viral/prevention & control , Risk Assessment , Time Factors
15.
G Ital Cardiol (Rome) ; 21(8): 575-583, 2020 Aug.
Article in Italian | MEDLINE | ID: covidwho-680054

ABSTRACT

The new coronavirus disease 2019 (COVID-19), which is causing hundreds of thousands of deaths worldwide, is complex and can present with a multi-organ localization. One of its worst complications is an interstitial pneumonia with acute respiratory failure also known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which requires non-invasive or invasive ventilation. A severe coagulopathy with poor prognosis is found in 5-10% of cases. SARS-CoV-2 is manifesting as a multi-dimensional disease and, recently, unique co-existing pathophysiological and clinical aspects are being defined: (i) an increased immune and inflammatory response with the activation of a cytokine storm and consequent coagulopathy, which promote both venous thromboembolic events and in situ thrombosis localized in small arterioles and pulmonary alveolar capillaries; (ii) a high intrapulmonary shunt, which often accounts for the severity of respiratory failure, due to reduced hypoxic pulmonary vasoconstriction with pulmonary neo-angiogenetic phenomena. Furthermore, the high incidence of venous thromboembolism in COVID-19 patients admitted to the intensive care unit and the autoptic findings of in situ micro-thrombosis at the pulmonary vascular level, suggest that in this disease coagulopathy, unlike septic disseminated intravascular coagulation, is driven towards a hyper-thrombogenic state, giving rise to a debate (with ongoing studies) about the preventive use of anticoagulant doses of heparin to reduce mortality. The aim of this position paper from the Italian Association of Hospital Cardiologists (ANMCO) is to highlight the main implications that COVID-19 infection has on the pulmonary circulation from a pathophysiological, clinical and management point of view.


Subject(s)
Cause of Death , Coronavirus Infections/epidemiology , Lung Diseases, Interstitial/mortality , Pandemics/statistics & numerical data , Pneumonia, Viral/epidemiology , Severe Acute Respiratory Syndrome/epidemiology , Venous Thromboembolism/etiology , Cardiology , Communicable Diseases, Emerging/epidemiology , Coronavirus Infections/diagnosis , Disease Progression , Female , Humans , Incidence , Italy/epidemiology , Lung Diseases, Interstitial/etiology , Lung Diseases, Interstitial/physiopathology , Male , Pneumonia, Viral/diagnosis , Pulmonary Circulation/physiology , Risk Assessment , Severe Acute Respiratory Syndrome/diagnosis , Societies, Medical , Survival Analysis , Venous Thromboembolism/mortality , Venous Thromboembolism/physiopathology
16.
G Ital Cardiol (Rome) ; 21(8): 570-574, 2020 Aug.
Article in Italian | MEDLINE | ID: covidwho-680052

ABSTRACT

Several important gender differences in susceptibility, clinical manifestation and response to treatments for a number of diseases are known since a long time, although they continue to be underestimated by a multiplicity of operators, especially men. The recent COVID-19 pandemic has provided a further evidence of the importance of gender medicine. The epidemiological analysis of COVID-19 data has highlighted the presence of multiple and important gender differences, with more unfavourable scenarios for the male gender. The mechanisms underlying these gender differences are varied (including socio-behavioral, immune and viral factors) and not yet fully clarified. A gender-based approach to clinical practice also in the context of this pandemic seems to be mandatory, as it could significantly contribute to health promotion by improving the effectiveness of diagnostic and/or therapeutic approaches and, therefore, leading to important benefits primarily for the patients but also for the sustainability of the National Health System.


Subject(s)
Cause of Death , Communicable Disease Control/methods , Coronavirus Infections/epidemiology , Disease Susceptibility/epidemiology , Pandemics/statistics & numerical data , Pneumonia, Viral/epidemiology , Coronavirus Infections/diagnosis , Delivery of Health Care/organization & administration , Female , Health Promotion , Humans , Italy/epidemiology , Male , Pneumonia, Viral/diagnosis , Prevalence , Risk Assessment , Sex Distribution , Survival Analysis
18.
Hosp Pediatr ; 10(7): 570-576, 2020 07.
Article in English | MEDLINE | ID: covidwho-662350

ABSTRACT

Identifying the optimal amount of personal protective equipment (PPE) is a formidable challenge when faced with a new contagion such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Unequivocally, there are dangers to health care workers (and by extension, their patients, colleagues, and communities) if not enough equipment is donned to safeguard them. And yet, there are also dangers to patients, colleagues, and the community if resources are overconsumed and result in hoarding, shortages, and inequitable distribution, all of which are occurring as the worldwide coronavirus disease 2019 (COVID-19) pandemic continues.Research to ascertain the precise PPE required to defend specifically against SARS-CoV-2 encompasses an area of active investigation that will likely remain unresolved for some time. While awaiting more definitive conclusions, we must look to past evidence to provide a reasonable basis on which protocols and policies might be refined. What follows is a narrative review of PPE efficacy and how existing evidence might apply to protecting health care workers against COVID-19. Findings are extrapolated from investigations in 4 general domains: early investigations into SARS-CoV-2, retrospective studies about severe acute respiratory syndrome coronavirus 1, prospective studies of influenza and other common respiratory viruses, and laboratory PPE studies.Available evidence suggests that contact and droplet precautions, in addition to eye protection and standard hygiene measures, should be adequate in the vast majority of clinical settings when caring for patients with SARS-CoV-2. Adherence to guidelines promoting appropriate levels of PPE should safeguard practitioners while mitigating against resource overuse.


Subject(s)
Coronavirus Infections/prevention & control , Disease Transmission, Infectious/prevention & control , Health Personnel/statistics & numerical data , Infection Control/organization & administration , Occupational Health , Pandemics/prevention & control , Personal Protective Equipment/statistics & numerical data , Pneumonia, Viral/prevention & control , Coronavirus Infections/epidemiology , Female , Humans , Male , Narration , Pandemics/statistics & numerical data , Pneumonia, Viral/epidemiology , Primary Prevention/methods , Safety Management
19.
Bogotá; Organización Panamericana de la Salud; jul. 15, 2020. 5 p.
Non-conventional in Spanish | LILACS (Americas) | ID: covidwho-657292

ABSTRACT

Este es el reporte de situación COVID-19 Colombia No. 103 - 15 de julio de 2020.


Subject(s)
Humans , Pneumonia, Viral/epidemiology , Coronavirus Infections/epidemiology , Pandemics/statistics & numerical data , Betacoronavirus , Colombia/epidemiology
20.
Bogotá; Organización Panamericana de la Salud; jul. 14, 2020. 5 p.
Non-conventional in Spanish | LILACS (Americas) | ID: covidwho-657291

ABSTRACT

Reporte de Situacion COVID-19 Colombia No. 102-14 de julio de 2020


Subject(s)
Humans , Pneumonia, Viral/epidemiology , Coronavirus Infections/epidemiology , Pandemics/statistics & numerical data , Betacoronavirus , Colombia/epidemiology
SELECTION OF CITATIONS
SEARCH DETAIL