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1.
Gac Med Mex ; 156(3): 246-248, 2020.
Article in English | MEDLINE | ID: covidwho-692409

ABSTRACT

Except for pregnant women, the management of critically ill patients with COVID-19 during the pandemic includes the standard procedures that are used for any patient that requires to be attended to at the intensive care unit, as well as limited administration of crystalloid solutions, orotracheal intubation, invasive mechanical ventilation in the event of patient clinical deterioration, and muscle relaxants continuous infusion only if necessary. Non-invasive mechanical ventilation and high-flow oxygen therapy are not recommended due to the generation of aerosol (associated with risk of viral spread among health personnel), and neither is extracorporeal membrane oxygenation or the use of steroids. So far, there is no specific antiviral treatment for patients with COVID-19, and neither are there results of controlled trials supporting the use of any.


Subject(s)
Coronavirus Infections/therapy , Critical Care/methods , Intensive Care Units , Pneumonia, Viral/therapy , Coronavirus Infections/physiopathology , Coronavirus Infections/transmission , Critical Illness , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Pandemics , Pneumonia, Viral/physiopathology , Pneumonia, Viral/transmission
3.
Int J Infect Dis ; 95: 376-383, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-687543

ABSTRACT

OBJECTIVES: This study aimed to compare clinical courses and outcomes between pregnant and reproductive-aged non-pregnant women with COVID-19, and to assess the vertical transmission potential of COVID-19 in pregnancy. METHODS: Medical records of pregnant and reproductive-aged non-pregnant women hospitalized with COVID-19 from January 15 to March 15, 2020 were retrospectively reviewed. The severity of disease, virus clearance time, and length of hospital stay were measured as the primary objective, while the vertical transmission potential of COVID-19 was also assessed. RESULTS: Eighty-two patients (28 pregnant women, 54 reproductive-aged non-pregnant women) with laboratory-confirmed COVID-19 were enrolled in this study. Univariate regression indicated no association between pregnancy and severity of disease (OR 0.73, 95% CI 0.08-5.15; p=0.76), virus clearance time (HR 1.16, 95% CI 0.65-2.01; p=0.62), and length of hospital stay (HR 1.10, 95% CI 0.66-1.84; p=0.71). Of the pregnant women, 22 delivered 23 live births, either by cesarean section (17, 60.7%) or vaginal delivery (5, 17.9%), and no neonate was infected with SARS-CoV-2. CONCLUSIONS: Pregnant women have comparable clinical courses and outcomes with reproductive-aged non-pregnant women when infected with SARS-CoV-2. No evidence supported vertical transmission of COVID-19 in the late stage of pregnancy, including vaginal delivery.


Subject(s)
Betacoronavirus , Coronavirus Infections/transmission , Infectious Disease Transmission, Vertical , Pneumonia, Viral/transmission , Pregnancy Complications, Infectious , Adult , Cesarean Section , Coronavirus Infections/complications , Female , Humans , Pandemics , Pneumonia, Viral/complications , Pregnancy , Pregnancy Complications, Infectious/virology , Retrospective Studies
4.
Am J Trop Med Hyg ; 102(5): 924-925, 2020 05.
Article in English | MEDLINE | ID: covidwho-686952

ABSTRACT

This article describes similarities and differences in the response of governments and the international community to the current 2019 coronavirus disease (COVID-19) and the 2014 West African Ebola epidemic. It expresses the opinion that the speed and scale of the response to COVID-19 are affected by the important role that China plays in the global economy. By contrast, insufficient and less timely action was initially undertaken in West African countries during the 2014 Ebola epidemic. It concludes by stating why preparedness for and response to all disease outbreaks, also in countries of lower economic importance, should become a priority in the global health agenda.


Subject(s)
Coronavirus Infections , Disaster Planning , Ebolavirus , Global Burden of Disease/economics , Global Health , Hemorrhagic Fever, Ebola , Pneumonia, Viral , Africa, Western/epidemiology , Betacoronavirus , China/epidemiology , Coronavirus Infections/economics , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Disease Outbreaks , Global Health/economics , Hemorrhagic Fever, Ebola/economics , Hemorrhagic Fever, Ebola/epidemiology , Hemorrhagic Fever, Ebola/transmission , Humans , International Cooperation , Pandemics , Pneumonia, Viral/economics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission
5.
Cardiol Young ; 30(7): 946-954, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-685828

ABSTRACT

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.


Subject(s)
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
9.
Washington; Organización Panamericana de la Salud; jul. 21, 2020. 5 p.
Non-conventional in Spanish | LILACS (Americas) | ID: covidwho-677295

ABSTRACT

El SARS-CoV-2 es un agente patógeno que causa la enfermedad por COVID-19, la cual fue notificada por primera vez en diciembre de 2019. Se cree que el SARS-CoV-2 fue originado de una fuente animal y posteriormente diseminado a la población humana. A pesar de que se han aislado virus genéticamente relacionados en murciélagos Rhinolophus, no se ha establecido el origen exacto de SARS-CoV-2 y la ruta de introducción de este virus a la población humana sigue siendo objeto de investigación.


Subject(s)
Humans , Animals , Pneumonia, Viral/transmission , Pneumonia, Viral/veterinary , Coronavirus Infections/transmission , Coronavirus Infections/veterinary , Epidemiological Monitoring/veterinary , Betacoronavirus/pathogenicity
10.
Psychother Psychosom Med Psychol ; 70(7): 272-282, 2020 Jul.
Article in German | MEDLINE | ID: covidwho-680660

ABSTRACT

BACKGROUND: International studies point to increased mental health problems of medical staff during the Corona pandemic (COVID-19). This is the first study to investigate mental health, i. e. adjustment disorder, depression, stress symptoms, Corona related fears as well as coping mechanisms in this group in a German-speaking country. MATERIAL AND METHODS: In April 2020, N=100 subjects were recruited that currently are engaged in a hospital. A series of standardized assessments were included: adjustment disorder (ADNM-20), depression (PHQ-9), stress symptoms and coping strategies (SCI). Currently, cross-sectional data are analyzed, because the study is still going on and longitudinal data is not yet assessed. RESULTS: Frequencies of adjustment disorder and depression are 8 and 15%, respectively. Two hierarchical regression models were run to predict adjustment disorder and depression; predictive power was higher for the first (41 vs. 35%). Fear of infection was reported to be higher regarding one's family than oneself. Nursing staff, those with preloads, and women were found to report more mental health problems. Those with direct contact to people that fell ill with COVID-19 did not differ from those with no direct contact. DISCUSSION: Currently, medical staff has a high risk for being mentally stressed. China, being epidemically experienced, has published principles for psychiatric interventions in January 2020. This might be relevant for Switzerland, too. Specific psychotherapeutic interventions, targeting at cognitive restructuring and sensitizing regarding dealing with alcohol and cigarettes, may be needed in order to protect this vulnerable group of person during and after the Corona pandemic.


Subject(s)
Adjustment Disorders/psychology , Anxiety/psychology , Coronavirus Infections/psychology , Depression/psychology , Pandemics , Personnel, Hospital/psychology , Pneumonia, Viral/psychology , Stress, Psychological/psychology , Adaptation, Psychological , Adjustment Disorders/epidemiology , Adjustment Disorders/etiology , Adult , Aged , Anxiety/epidemiology , Anxiety/etiology , Coronavirus Infections/transmission , Cross-Sectional Studies , Depression/epidemiology , Depression/etiology , Family , Fear , Female , Humans , Male , Medical Staff , Middle Aged , Neuropsychological Tests , Pneumonia, Viral/transmission , Stress, Psychological/epidemiology , Stress, Psychological/etiology , Switzerland/epidemiology
12.
Environ Microbiol ; 22(7): 2445-2456, 2020 07.
Article in English | MEDLINE | ID: covidwho-679961

ABSTRACT

In the absence of an efficient drug treatment or a vaccine, the control of the COVID-19 pandemic relies on classic infection control measures. Since these means are socially disruptive and come with substantial economic loss for societies, a better knowledge of the epidemiology of the new coronavirus epidemic is crucial to achieve control at a sustainable cost and within tolerable restrictions of civil rights.


Subject(s)
Asymptomatic Infections/epidemiology , Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , Betacoronavirus , Child , China/epidemiology , Coronavirus , Coronavirus Infections/mortality , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Europe/epidemiology , Humans , Immunity, Herd , Masks , Models, Theoretical , Molecular Epidemiology/statistics & numerical data , Nursing Homes/statistics & numerical data , Olfaction Disorders/virology , Pandemics/prevention & control , Pneumonia, Viral/mortality , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , Public Health , Risk Factors , Seroepidemiologic Studies , Singapore , United States/epidemiology
14.
Dtsch Arztebl Int ; 117(33-34): 553-560, 2020 07 21.
Article in English | MEDLINE | ID: covidwho-676459

ABSTRACT

BACKGROUND: Six months into the COVID-19 pandemic, children appear largely spared from the direct effects of disease, suggesting age as an important predictor of infection and severity. They remain, however, impacted by far-reaching public health interventions. One crucial question often posed is whether children generally transmit SARS-CoV-2 effectively. METHODS: We assessed the components of transmission and the different study designs and considerations necessary for valid assessment of transmission dynamics. We searched for published evidence about transmission of SARS-CoV-2 by children employing a narrative review methodology through 25 June, 2020. RESULTS: Transmission dynamics must be studied in repre - sentative pediatric populations with a combination of study designs including rigorous epidemiological studies (e.g. in households, schools, daycares, clinical settings) and laboratory studies while taking into account the social and socio-economic contexts. Viral load (VL) estimates from representative pediatric samples of infected children are missing so far. Currently available evidence suggests that the secondary attack rate stratified by age of the infector is lower for children, however this age pattern needs to be better quantified and understood. CONCLUSION: A generalizable pediatric evidence base is urgently needed to inform policy making now, later when facing potential subsequent waves, and extending through a future in which endemicity alongside vaccination may become the enduring reality.


Subject(s)
Coronavirus Infections/transmission , Pandemics , Pneumonia, Viral/transmission , Child , Coronavirus Infections/epidemiology , Humans , Pneumonia, Viral/epidemiology
15.
Medicine (Baltimore) ; 99(29): e21359, 2020 Jul 17.
Article in English | MEDLINE | ID: covidwho-675946

ABSTRACT

RATIONALE: In December 2019, an outbreak of coronavirus disease 2019 (COVID-19) occurred in Wuhan, China. The initial epidemiological investigations showed that COVID-19 occurred more likely in adults, with patients younger than 10 years old accounting for less than 1% of the total number of confirmed cases, and infant infections were more rare. In our case, we present an infant who was only 35 days old when he was tested positive for COVID-19. PATIENT CONCERNS: In this report, a 35 day-old male infant with atypical symptoms had close contact with 2 confirmed patients of COVID-19 who were his grandmother and mother. DIAGNOSIS: The patient was diagnosed as COVID-19 after his oropharyngeal swab tested positive for severe acute respiratory syndrome coronavirus 2 by reverse transcription-polymerase chain reaction assay. INTERVENTIONS: The therapeutic schedule included aerosol inhalation of recombinant human interferon α-2b and supportive therapy. OUTCOMES: Two consecutive (1 day apart) oropharyngeal swabs tested negative for severe acute respiratory syndrome coronavirus 2; then, the patient was discharged on February 27, 2020. LESSONS: Strengthening infants' virus screening in families with infected kins is important for early diagnosis, isolation, and treatment when symptoms are atypical. The infectivity of infants with mild or asymptomatic COVID-19 should not be ignored because this may be a source of transmission in the community.


Subject(s)
Betacoronavirus/genetics , Coronavirus Infections/diagnosis , Oropharynx/virology , Pneumonia, Viral/diagnosis , Administration, Inhalation , Antiviral Agents/administration & dosage , Antiviral Agents/therapeutic use , Betacoronavirus/isolation & purification , Coronavirus Infections/drug therapy , Coronavirus Infections/transmission , Coronavirus Infections/virology , Disease Transmission, Infectious/prevention & control , Humans , Infant , Interferon alpha-2/administration & dosage , Interferon alpha-2/therapeutic use , Male , Pandemics , Patient Isolation/methods , Pneumonia, Viral/drug therapy , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , Polymerase Chain Reaction/methods , Polymerase Chain Reaction/standards , Specimen Handling/methods , Treatment Outcome
16.
Infect Dis Poverty ; 9(1): 104, 2020 Jul 23.
Article in English | MEDLINE | ID: covidwho-672011

ABSTRACT

From December 25, 2019 to January 31, 2020, 33 cases of the coronavirus disease 2019 (COVID-19) were identified in the Department of Respiratory and Critical Care Medicine of Zhongnan Hospital of Wuhan University, China, yet none of the affiliated HCWs was infected. Here we analyzed the infection control measures used in three different departments in the Zhongnan Hospital of Wuhan University and correlated the measures with the corresponding infection data of HCWs affiliated with these departments. We found that three infection control measures, namely the isolation of the presumed positive patients, the use of facemasks and intensified hand hygiene play important roles in preventing nosocomial transmission of COVID-19.


Subject(s)
Coronavirus Infections/prevention & control , Cross Infection/prevention & control , Hand Hygiene/statistics & numerical data , Health Personnel/statistics & numerical data , Masks/statistics & numerical data , Pandemics/prevention & control , Patient Isolation/statistics & numerical data , Pneumonia, Viral/prevention & control , Adult , Aged , Betacoronavirus/physiology , China , Coronavirus Infections/transmission , Cross Infection/transmission , Female , Hospitals, University , Humans , Male , Middle Aged , Pneumonia, Viral/transmission , Young Adult
17.
BMC Res Notes ; 13(1): 352, 2020 Jul 23.
Article in English | MEDLINE | ID: covidwho-671179

ABSTRACT

OBJECTIVE: Coronavirus disease 2019 (COVID-19) is a pandemic respiratory illness spreading from person-to-person caused by a novel coronavirus and poses a serious public health risk. The goal of this study was to apply a modified susceptible-exposed-infectious-recovered (SEIR) compartmental mathematical model for prediction of COVID-19 epidemic dynamics incorporating pathogen in the environment and interventions. The next generation matrix approach was used to determine the basic reproduction number [Formula: see text]. The model equations are solved numerically using fourth and fifth order Runge-Kutta methods. RESULTS: We found an [Formula: see text] of 2.03, implying that the pandemic will persist in the human population in the absence of strong control measures. Results after simulating various scenarios indicate that disregarding social distancing and hygiene measures can have devastating effects on the human population. The model shows that quarantine of contacts and isolation of cases can help halt the spread on novel coronavirus.


Subject(s)
Betacoronavirus , Coronavirus Infections/transmission , Environmental Exposure , Guideline Adherence , Infection Control/methods , Models, Theoretical , Pandemics , Pneumonia, Viral/transmission , Contact Tracing , Convalescence , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Disease Susceptibility , Forecasting , Hand Hygiene , Humans , Infection Control/statistics & numerical data , Masks , Pandemics/prevention & control , Patient Compliance , Patient Isolation , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Quarantine , Time Factors , Travel
18.
Emerg Infect Dis ; 26(7): 1470-1477, 2020 07.
Article in English | MEDLINE | ID: covidwho-668858

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 is the causative agent of the ongoing coronavirus disease pandemic. Initial estimates of the early dynamics of the outbreak in Wuhan, China, suggested a doubling time of the number of infected persons of 6-7 days and a basic reproductive number (R0) of 2.2-2.7. We collected extensive individual case reports across China and estimated key epidemiologic parameters, including the incubation period (4.2 days). We then designed 2 mathematical modeling approaches to infer the outbreak dynamics in Wuhan by using high-resolution domestic travel and infection data. Results show that the doubling time early in the epidemic in Wuhan was 2.3-3.3 days. Assuming a serial interval of 6-9 days, we calculated a median R0 value of 5.7 (95% CI 3.8-8.9). We further show that active surveillance, contact tracing, quarantine, and early strong social distancing efforts are needed to stop transmission of the virus.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , Basic Reproduction Number , China/epidemiology , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Disease Outbreaks , Humans , Models, Theoretical , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , Travel
19.
Int J Infect Dis ; 95: 376-383, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-666010

ABSTRACT

OBJECTIVES: This study aimed to compare clinical courses and outcomes between pregnant and reproductive-aged non-pregnant women with COVID-19, and to assess the vertical transmission potential of COVID-19 in pregnancy. METHODS: Medical records of pregnant and reproductive-aged non-pregnant women hospitalized with COVID-19 from January 15 to March 15, 2020 were retrospectively reviewed. The severity of disease, virus clearance time, and length of hospital stay were measured as the primary objective, while the vertical transmission potential of COVID-19 was also assessed. RESULTS: Eighty-two patients (28 pregnant women, 54 reproductive-aged non-pregnant women) with laboratory-confirmed COVID-19 were enrolled in this study. Univariate regression indicated no association between pregnancy and severity of disease (OR 0.73, 95% CI 0.08-5.15; p=0.76), virus clearance time (HR 1.16, 95% CI 0.65-2.01; p=0.62), and length of hospital stay (HR 1.10, 95% CI 0.66-1.84; p=0.71). Of the pregnant women, 22 delivered 23 live births, either by cesarean section (17, 60.7%) or vaginal delivery (5, 17.9%), and no neonate was infected with SARS-CoV-2. CONCLUSIONS: Pregnant women have comparable clinical courses and outcomes with reproductive-aged non-pregnant women when infected with SARS-CoV-2. No evidence supported vertical transmission of COVID-19 in the late stage of pregnancy, including vaginal delivery.


Subject(s)
Betacoronavirus , Coronavirus Infections/transmission , Infectious Disease Transmission, Vertical , Pneumonia, Viral/transmission , Pregnancy Complications, Infectious , Adult , Cesarean Section , Coronavirus Infections/complications , Female , Humans , Pandemics , Pneumonia, Viral/complications , Pregnancy , Pregnancy Complications, Infectious/virology , Retrospective Studies
20.
Lancet ; 395(10223): 497-506, 2020 02 15.
Article in English | MEDLINE | ID: covidwho-665705

ABSTRACT

BACKGROUND: A recent cluster of pneumonia cases in Wuhan, China, was caused by a novel betacoronavirus, the 2019 novel coronavirus (2019-nCoV). We report the epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of these patients. METHODS: All patients with suspected 2019-nCoV were admitted to a designated hospital in Wuhan. We prospectively collected and analysed data on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR and next-generation sequencing. Data were obtained with standardised data collection forms shared by WHO and the International Severe Acute Respiratory and Emerging Infection Consortium from electronic medical records. Researchers also directly communicated with patients or their families to ascertain epidemiological and symptom data. Outcomes were also compared between patients who had been admitted to the intensive care unit (ICU) and those who had not. FINDINGS: By Jan 2, 2020, 41 admitted hospital patients had been identified as having laboratory-confirmed 2019-nCoV infection. Most of the infected patients were men (30 [73%] of 41); less than half had underlying diseases (13 [32%]), including diabetes (eight [20%]), hypertension (six [15%]), and cardiovascular disease (six [15%]). Median age was 49·0 years (IQR 41·0-58·0). 27 (66%) of 41 patients had been exposed to Huanan seafood market. One family cluster was found. Common symptoms at onset of illness were fever (40 [98%] of 41 patients), cough (31 [76%]), and myalgia or fatigue (18 [44%]); less common symptoms were sputum production (11 [28%] of 39), headache (three [8%] of 38), haemoptysis (two [5%] of 39), and diarrhoea (one [3%] of 38). Dyspnoea developed in 22 (55%) of 40 patients (median time from illness onset to dyspnoea 8·0 days [IQR 5·0-13·0]). 26 (63%) of 41 patients had lymphopenia. All 41 patients had pneumonia with abnormal findings on chest CT. Complications included acute respiratory distress syndrome (12 [29%]), RNAaemia (six [15%]), acute cardiac injury (five [12%]) and secondary infection (four [10%]). 13 (32%) patients were admitted to an ICU and six (15%) died. Compared with non-ICU patients, ICU patients had higher plasma levels of IL2, IL7, IL10, GSCF, IP10, MCP1, MIP1A, and TNFα. INTERPRETATION: The 2019-nCoV infection caused clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus and was associated with ICU admission and high mortality. Major gaps in our knowledge of the origin, epidemiology, duration of human transmission, and clinical spectrum of disease need fulfilment by future studies. FUNDING: Ministry of Science and Technology, Chinese Academy of Medical Sciences, National Natural Science Foundation of China, and Beijing Municipal Science and Technology Commission.


Subject(s)
Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Adult , Age Distribution , Aged , China/epidemiology , Comorbidity , Coronavirus Infections/complications , Coronavirus Infections/transmission , Cough/epidemiology , Cough/virology , Female , Fever/epidemiology , Fever/virology , Hospitalization/statistics & numerical data , Humans , Intensive Care Units/statistics & numerical data , Male , Middle Aged , Myalgia/epidemiology , Myalgia/virology , Pneumonia, Viral/complications , Pneumonia, Viral/transmission , Prognosis , Radiography, Thoracic , Respiratory Distress Syndrome, Adult/epidemiology , Respiratory Distress Syndrome, Adult/virology , Time Factors , Tomography, X-Ray Computed , Young Adult
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