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JMIR Public Health Surveill ; 6(3): e21163, 2020 07 17.
Article in English | MEDLINE | ID: covidwho-690445


BACKGROUND: The coronavirus disease (COVID-19) pandemic has caused an unprecedented worldwide public health crisis that requires new management approaches. COVIDApp is a mobile app that was adapted for the management of institutionalized individuals in long-term care facilities. OBJECTIVE: The aim of this paper is to report the implementation of this innovative tool for the management of long-term care facility residents as a high-risk population, specifically for early identification and self-isolation of suspected cases, remote monitoring of mild cases, and real-time monitoring of the progression of the infection. METHODS: COVIDApp was implemented in 196 care centers in collaboration with 64 primary care teams. The following parameters of COVID-19 were reported daily: signs/symptoms; diagnosis by reverse transcriptase-polymerase chain reaction; absence of symptoms for ≥14 days; total deaths; and number of health care workers isolated with suspected COVID-19. The number of at-risk centers was also described. RESULTS: Data were recorded from 10,347 institutionalized individuals and up to 4000 health care workers between April 1 and 30, 2020. A rapid increase in suspected cases was seen until day 6 but decreased during the last two weeks (from 1084 to 282 cases). The number of confirmed cases increased from 419 (day 6) to 1293 (day 22) and remained stable during the last week. Of the 10,347 institutionalized individuals, 5,090 (49,2%) remained asymptomatic for ≥14 days. A total of 854/10,347 deaths (8.3%) were reported; 383 of these deaths (44.8%) were suspected/confirmed cases. The number of isolated health care workers remained high over the 30 days, while the number of suspected cases decreased during the last 2 weeks. The number of high-risk long-term care facilities decreased from 19/196 (9.5%) to 3/196 (1.5%). CONCLUSIONS: COVIDApp can help clinicians rapidly detect and remotely monitor suspected and confirmed cases of COVID-19 among institutionalized individuals, thus limiting the risk of spreading the virus. The platform shows the progression of infection in real time and can aid in designing new monitoring strategies.

Coronavirus Infections/prevention & control , Homes for the Aged , Mobile Applications , Nursing Homes , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Aged , Coronavirus Infections/epidemiology , Diffusion of Innovation , Humans , Long-Term Care , Pneumonia, Viral/epidemiology , Spain/epidemiology
Int J Environ Res Public Health ; 17(8)2020 04 21.
Article in English | MEDLINE | ID: covidwho-688452


During an epidemic, almost all healthcare facilities restrict the visiting of patients to prevent disease transmission. For hospices with terminally ill patients, the trade-off between compassion and infection control becomes a difficult decision. This study aimed to survey the changes in visiting policy for all 76 hospice wards in Taiwan during the COVID-19 pandemic in March 2020. The altered visiting policies were assessed by the number of visitors per patient allowed at one time, the daily number of visiting slots, the number of hours open daily, and requisites for hospice ward entry. The differences in visiting policies between hospice wards and ordinary wards were also investigated. Data were collected by reviewing the official website of each hospital and were supplemented by phone calls in cases where no information was posted on the website. One quarter (n = 20) of hospice wards had different visiting policies to those of ordinary wards in the same hospital. Only one hospice ward operated an open policy, and in contrast, nine (11.8%) stopped visits entirely. Among the 67 hospice wards that allowed visiting, at most, two visitors at one time per patient were allowed in 46 (68.6%), one visiting time daily was allowed in 32 (47.8%), one hour of visiting per day was allowed in 29 (43.3%), and checking of identity and travel history was carried out in 12 wards (17.9%). During the COVID-19 pandemic, nearly all hospice wards in Taiwan changed their visiting policies, but the degree of restriction varied. Further studies could measure the impacts of visiting policy changes on patients and healthcare professionals.

Coronavirus Infections/prevention & control , Hospices/organization & administration , Organizational Policy , Pandemics/prevention & control , Patients' Rooms/organization & administration , Pneumonia, Viral/prevention & control , Visitors to Patients , Betacoronavirus , Coronavirus Infections/epidemiology , Female , Health Care Surveys , Hospices/statistics & numerical data , Humans , Infection Control , Male , Pneumonia, Viral/epidemiology , Surveys and Questionnaires , Taiwan
Acta Biomed ; 91(2): 207-213, 2020 05 11.
Article in English | MEDLINE | ID: covidwho-687634


Since the beginning of the COVID-19 epidemic, a possible explanation for the high heterogeneity of infection/mortality rates across involved countries was hinted in the prevalence of tuberculosis vaccination with Bacille Calmette-Guérin (BCG). A systematic review was therefore performed on May 2, 2020. A total of 13 articles were ultimately retrieved, 12 of them as preprint papers. All articles were ecological studies of low quality. Most of them did not include main confounding factors (i.e. demographic of the assessed countries, share of peo- ple residing in urban settings, etc.), and simply assessed the differences among incidence/mortality of COVID-19 with vaccination rates or by having vs. having not any vaccination policy for BCG. Even though all studies shared the very same information sources (i.e. international registries for BCG vaccination rates and open source data for COVID-19 epidemics), results were conflicting, with later studies apparently denying any true correlation between COVID-19 occurrence and BCG vaccination rates and/or policies. As a consequence, there is no sound evidence to recommend BCG vaccination for the prevention of COVID-19.

BCG Vaccine/immunology , Betacoronavirus , Coronavirus Infections/prevention & control , Mycobacterium bovis/immunology , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Coronavirus Infections/immunology , Humans , Pneumonia, Viral/immunology , Tuberculosis/immunology , Tuberculosis/prevention & control
Nurse Educ Pract ; 44: 102775, 2020 Mar.
Article in English | MEDLINE | ID: covidwho-686472


Prior to the Covid-19 global pandemic, we reviewed literature and identified comprehensive evidence of the efficacy of blended learning for pre-registration nursing students who learn across distances and/or via satellite campuses. Following a methodological framework, a scoping literature review was undertaken. We searched six databases (EBSCOHOST (CINHAL plus; Education research Complete; Australia/New Zealand Reference Centre); Google Scholar; EMBASE (Ovid) [ERIC (Ovid); Medline (Ovid)]; PubMed: ProQuest Education Journals & ProQuest Nursing & Allied Health Source) for the period 2005-December 2015. Critical appraisal for critiquing qualitative and quantitative studies was undertaken, as was a thematic analysis. Twenty-eight articles were included for review, which reported nursing research (n = 23) and student experiences of blended learning in higher education (n = 5). Four key themes were identified in the literature: active learning, technological barriers, support, and communication. The results suggest that when delivered purposefully, blended learning can positively influence and impact on the achievements of students, especially when utilised to manage and support distance education. Further research is needed about satellite campuses with student nurses, to assist with the development of future educational practice.

Education, Distance , Education, Nursing, Baccalaureate/organization & administration , Learning , Students, Nursing/psychology , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Humans , Nursing Education Research , Nursing Evaluation Research , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control
Cardiol Young ; 30(7): 946-954, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-685828


Coronavirus disease 2019 (COVID-19), caused by a novel betacoronavirus (SARS-CoV-2), has led to an unexpected outbreak affecting people of all ages. The first data showed that COVID-19 could cause severe pulmonary disease, cardiac injury, and death in adults, especially the elderly and those with concomitant diseases. Currently, it was demonstrated that severe COVID-19 may also develop in neonatal age, although rarely. Newborns with CHD are known to be at high risk for increased morbidity from viral lower respiratory tract infections because of underlying anatomical cardiac lesions. There are limited data on the implications of COVID-19 on patients with cardiovascular disease, especially for those with CHD. Herein, we aimed to summarise the COVID-19-specific perioperative management issues for newborns with CHD by combining available data from the perspectives of neonatology and paediatric cardiovascular surgery.

Betacoronavirus , Coronavirus Infections/prevention & control , Heart Defects, Congenital/surgery , Pandemics/prevention & control , Perioperative Care , Pneumonia, Viral/prevention & control , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Humans , Infant, Newborn , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission
Riv Psichiatr ; 55(3): 131-136, 2020.
Article in Italian | MEDLINE | ID: covidwho-685352


CoViD-19 pandemic is causing serious consequences on mental health, consequences that are considered that bad that World Health Organization has affirmed that mental health defence is priority in this particular moment of development of pandemic. In light of this alertness, what we are interested in approaching in this work, is the specific stress condition caused by pandemic, which underlies and precedes the described classification of diseases and which is going towards an increase in the entire world, including Italy. The stress caused by pandemic is a new condition in comparison with what is known in clinical practice and with what is included in the classification of mental disorder. The ongoing stress condition and the mixture of different types of unconventional stress, which not only hits the present but also disrupts the future, create an entirely new form of clinical condition given by pandemic.

Adaptation, Psychological , Betacoronavirus , Coronavirus Infections/epidemiology , Coronavirus Infections/psychology , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/psychology , Stress, Psychological/etiology , Coronavirus Infections/prevention & control , Humans , Italy/epidemiology , Mental Health , Pandemics/prevention & control , Pneumonia, Viral/prevention & control
Geriatr Gerontol Int ; 20(7): 715-719, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-682347


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

Coronavirus Infections , Hospitals, Chronic Disease/statistics & numerical data , Long-Term Care , Pandemics , Pneumonia, Viral , Skilled Nursing Facilities/statistics & numerical data , Aged , Betacoronavirus/isolation & purification , Cluster Analysis , Coronavirus Infections/mortality , Coronavirus Infections/prevention & control , Female , Humans , Infection Control/organization & administration , Japan/epidemiology , Long-Term Care/methods , Long-Term Care/organization & administration , Long-Term Care/trends , Male , Mortality , Pandemics/prevention & control , Pneumonia, Viral/mortality , Pneumonia, Viral/prevention & control
Gastroenterol. latinoam ; 31(1): 35-38, mayo 2020.
Article in Spanish | LILACS (Americas) | ID: covidwho-678085


The pandemic of the novel coronavirus SARS-CoV-2 has caused more than 2.5 millions of confirmed cases worldwide, with a mortality rate around 7%. Most cases appear to be mild with the most common symptoms being fever, dry cough, myalgia, fatigue, and dyspnea but can result in more severe disease. Also, there are described gastrointestinal manifestations: anorexia 27%, diarrhea 12%, nausea/vomiting 10%, and abdominal pain 9%. In Chile, diarrhea has been described in 7.3%, and abdominal pain 3.7%. The primary mechanism proposed is the entry of SARS-CoV-2 into the enterocytes binding the Angiotensin-converting enzyme 2 (ACE2), which is widely distributed among the gastrointestinal tract. Also, SARS-CoV-2 can cause elevated liver enzymes in up to 40% of cases. This alteration could also be caused by the binding to the ACE2 receptor in hepatocytes and cholangiocytes. Gastrointestinal symptoms and elevated liver enzymes are more frequent in severe cases. Viral RNA has been detected in stools, which may suggest a possible fecal-oral transmission. It is essential to pay attention to gastrointestinal manifestations because they are frequent and more prevalent in severe cases. The presence of viral RNA in stool forces us to take preventive measures faced with a possible mechanism of fecal-oral transmission, mainly in the gastroenterology and endoscopy services.

La pandemia por el nuevo coronavirus SARS-CoV-2 ha causado más de 2,5 millones de casos confirmados en el mundo, con una mortalidad cercana al 7%. La mayoría de los casos parecen ser leves y los síntomas más comunes son fiebre, tos seca, mialgia, fatiga y disnea, pero pueden provocar una enfermedad más grave. También se han descrito síntomas gastrointestinales: anorexia 27%, diarrea 12%, náuseas/vómitos 10%, y dolor abdominal 9%. En Chile, se ha descrito diarrea en 7,3%, y dolor abdominal 3,7%. El principal mecanismo fisiopatológico propuesto es el ingreso al enterocito utilizando la Enzima Convertidora de Angiotensina 2 (ECA2) como receptor, el cual es ampliamente distribuido a lo largo del tracto gastrointestinal. También se ha descrito alteración de pruebas hepáticas hasta en 40% de los casos. Esta alteración también podría ser causada por el ingreso a los hepatocitos y colangiocitos mediante la ECA2. Los síntomas gastrointestinales, y las alteraciones de pruebas hepáticas son más frecuentes en los pacientes graves. Se ha detectado la presencia de ARN viral en deposiciones de pacientes, lo que podría sugerir una posible vía de transmisión fecal-oral. Es importante prestar atención a las manifestaciones gastrointestinales, ya que son comunes y más frecuentes en pacientes graves. La presencia viral en las heces nos obliga a tomar medidas de precaución y prevención de un posible mecanismo de transmisión fecal-oral, especialmente en los servicios de gastroenterología y endoscopia.

Humans , Pneumonia, Viral/prevention & control , Coronavirus Infections/prevention & control , Betacoronavirus , Gastrointestinal Diseases/etiology , Pneumonia, Viral/diagnosis , Comorbidity , Coronavirus Infections/diagnosis , Gastrointestinal Diseases/diagnosis
Gastroenterol. latinoam ; 31(1): 21-27, mayo 2020. tab
Article in Spanish | LILACS (Americas) | ID: covidwho-678083


The new Coronavirus (SARS-CoV-2) appeared in China in December 2019. Since then and until April 2020 it spread worldwide affecting more than three million people. Its exponential rise is still growing all over the world, taking thousands of lives. SARS-CoV-2 is very contagious, person to person, by droplets which can generate a respiratory infection known as COVID-19. Some patients are at higher risk: Older people, those with cardiovascular disease, diabetes and hypertension are the most prone to an unfavorable outcome. Our Inflammatory Bowel Disease (IBD) patients are a special cluster, with many of them taking immunosuppressive treatment for long periods, which could pose an important risk. Scientifics societies all over the world have joined efforts to generate data, share experiences and make recommendations for good clinical management. This is a review of the available evidence, expert opinion, and proposed ways of working during the pandemic

El nuevo coronavirus (SARS-CoV-2) apareció en China en diciembre de 2019. Desde su inicio hasta abril de 2020 se ha expandido por todo el mundo, afectando a más de tres millones de personas. Su ascenso exponencial sigue creciendo, generando miles de muertes. Su contagiosidad es persona a persona por gotitas, pudiendo llegar a generar un cuadro clínico de infección respiratoria conocido como COVID-19. Algunos pacientes tienen más riesgos de tener un curso desfavorable; adultos mayores, pacientes con enfermedad cardiovascular, hipertensos y diabéticos. Nuestros pacientes con enfermedad inflamatoria intestinal son un grupo de pacientes con características particulares, muchos de ellos reciben tratamiento inmunosupresor por largos períodos, lo que pudiese suponer un riesgo específico. Las sociedades científicas de Europa y Norteamérica han realizado un esfuerzo conjunto para generar datos, compartir experiencias y dictar recomendaciones de buen manejo clínico. Esta es una revisión de la evidencia disponible, opiniones de expertos y formas de trabajo propuestos durante la pandemia.

Humans , Pneumonia, Viral/prevention & control , Inflammatory Bowel Diseases/complications , Practice Guideline , Coronavirus Infections/prevention & control , Betacoronavirus , Inflammatory Bowel Diseases/therapy , Medical Care/standards , Hospital Units/standards
Washington; Organización Panamericana de la Salud; July 1, 2020. 17 p.
Non-conventional in English, Spanish | LILACS (Americas) | ID: covidwho-677331


La pandemia de COVID-19 es una amenaza de gran proporción tanto para la salud física como para la salud mental y el bienestar de sociedades enteras que se han visto gravemente afectadas por esta crisis, siendo ésta una prioridad que debe abordarse con urgencia (1). La adversidad asociada con las consecuencias socioeconómicas, el miedo al virus y su propagación, así como las preocupaciones asociadas, tienen un impacto indudable en la salud mental de la población. Este documento describe las intervenciones de salud mental y apoyo psicosocial (SMAPS) fundamentales que se recomienda desarrollar de manera intersectorial en los países y en las comunidades. Para ello se propone utilizar como marco de referencia la pirámide de intervenciones para los servicios de SMAPS (2)del Comité Permanente entre Organismos (IASC). La pirámide ilustra diferentes niveles de apoyo que varían desde la integración de sociales, de seguridad y relativas a las necesidades básicas, hasta la prestación de servicios especializados para el manejo de condiciones más graves, así como la dimensión probable de demanda para cada unode los niveles establecidos.

The COVID-19 pandemic is a major threat both to physical and mental health and to the well-being of entire societies that have been critically affected by this crisis, making it a priority that must be urgently addressed. Hardships associated with socioeconomic effects, fear of the virus and its spread, and other related concerns have an unquestionable impact on the mental health of the population. This document describes the essential interventions in mental health and psychosocial support (MHPSS) that should be developed on an intersectoral basis in countries and communities. Its frame of reference is the Inter-Agency Standing Committee (IASC) intervention pyramid for MHPSS services. The pyramid shows different levels of support, ranging from social considerations, safety, and basic needs, to the provision of specialized services for the management of more severe conditions, as well as the probable volume of demand at each established level.

Humans , Pneumonia, Viral/prevention & control , Quarantine/psychology , Mental Health , Coronavirus Infections/psychology , Coronavirus Infections/epidemiology , Pandemics/prevention & control , Betacoronavirus , Mental Health Services/organization & administration
Washington; Organización Panamericana de la Salud; jun. 2, 2020. 3 p.
Non-conventional in English, Spanish | LILACS (Americas) | ID: covidwho-677315


La situación que enfrentamos es grave, pero siempre y cuando nuestro enfoque para derrotar al virus se base en la solidaridad, no debemos perder las esperanzas. Debemos trabajar juntos, compartir recursos y aplicar las estrategias comprobadas que hemos aprendido en el camino: esa es la salida.

Humans , Pneumonia, Viral/prevention & control , Coronavirus Infections/prevention & control , Coronavirus Infections/epidemiology , Pandemics/prevention & control , Betacoronavirus , Pan American Health Organization , Americas/epidemiology