Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 731
Filter
Add filters

Year range
3.
Signal Transduct Target Ther ; 5(1): 125, 2020 07 13.
Article in English | MEDLINE | ID: covidwho-654479

ABSTRACT

Stress proteins (SPs) including heat-shock proteins (HSPs), RNA chaperones, and ER associated stress proteins are molecular chaperones essential for cellular homeostasis. The major functions of HSPs include chaperoning misfolded or unfolded polypeptides, protecting cells from toxic stress, and presenting immune and inflammatory cytokines. Regarded as a double-edged sword, HSPs also cooperate with numerous viruses and cancer cells to promote their survival. RNA chaperones are a group of heterogeneous nuclear ribonucleoproteins (hnRNPs), which are essential factors for manipulating both the functions and metabolisms of pre-mRNAs/hnRNAs transcribed by RNA polymerase II. hnRNPs involve in a large number of cellular processes, including chromatin remodelling, transcription regulation, RNP assembly and stabilization, RNA export, virus replication, histone-like nucleoid structuring, and even intracellular immunity. Dysregulation of stress proteins is associated with many human diseases including human cancer, cardiovascular diseases, neurodegenerative diseases (e.g., Parkinson's diseases, Alzheimer disease), stroke and infectious diseases. In this review, we summarized the biologic function of stress proteins, and current progress on their mechanisms related to virus reproduction and diseases caused by virus infections. As SPs also attract a great interest as potential antiviral targets (e.g., COVID-19), we also discuss the present progress and challenges in this area of HSP-based drug development, as well as with compounds already under clinical evaluation.


Subject(s)
Antiviral Agents/pharmacology , Betacoronavirus/drug effects , Coronavirus Infections/drug therapy , Heat-Shock Proteins/genetics , Heterogeneous-Nuclear Ribonucleoproteins/genetics , Host-Pathogen Interactions/drug effects , Pneumonia, Viral/drug therapy , Antiviral Agents/chemical synthesis , Betacoronavirus/genetics , Betacoronavirus/pathogenicity , Chromatin Assembly and Disassembly/drug effects , Coronavirus Infections/genetics , Coronavirus Infections/pathology , Coronavirus Infections/virology , Gene Expression Regulation , Heat-Shock Proteins/agonists , Heat-Shock Proteins/antagonists & inhibitors , Heat-Shock Proteins/metabolism , Heterogeneous-Nuclear Ribonucleoproteins/agonists , Heterogeneous-Nuclear Ribonucleoproteins/antagonists & inhibitors , Heterogeneous-Nuclear Ribonucleoproteins/metabolism , Host-Pathogen Interactions/genetics , Humans , Molecular Targeted Therapy/methods , Pandemics , Pneumonia, Viral/genetics , Pneumonia, Viral/pathology , Pneumonia, Viral/virology , RNA Polymerase II/genetics , RNA Polymerase II/metabolism , RNA Precursors/genetics , RNA Precursors/metabolism , Severity of Illness Index , Signal Transduction , Transcription, Genetic/drug effects , Virus Replication/drug effects
4.
Psychiatry Res ; 291: 113294, 2020 09.
Article in English | MEDLINE | ID: covidwho-640985

ABSTRACT

To cope with Covid-19 and limits its spread among residents, retirement homes have prohibited physical contact between residents and families and friend and, in some cases, even between residents or between residents and caregivers. We investigated the effects of measures against Covid-19 on the mental health of participants with Alzheimer's disease (AD) who live in retirement homes in France. We instructed on-site caregivers to assess depression and anxiety in participants with mild AD who live in retirement homes. Fifty-eight participants consented to participate in the study. The participants rated their depression and anxiety during and before the Covid-19 crisis. Participants reported higher depression (p = .005) and anxiety (p = .004) during than before the Covid-19 crisis. These increases can be attributed to the isolation of the residents and/or to the drastic changes in their daily life and care they receive. While, in their effort to prevent infections, retirement homes are forced to physically separate residents from the outside world and to drastically reduce residents' activities, these decisions are likely to come at a cost to residents with AD and their mental health.


Subject(s)
Alzheimer Disease/complications , Anxiety/diagnosis , Coronavirus Infections , Depression/diagnosis , Homes for the Aged , Pandemics , Pneumonia, Viral , Aged , Aged, 80 and over , Alzheimer Disease/psychology , Anxiety/complications , Anxiety/psychology , Betacoronavirus , Caregivers , Depression/complications , Depression/psychology , Female , France , Humans , Male , Nursing Homes , Severity of Illness Index
5.
Rheumatol Int ; 40(9): 1353-1360, 2020 09.
Article in English | MEDLINE | ID: covidwho-640396

ABSTRACT

As of June 10th 2020 about 7.2 million individuals have tested positive for, and more than 410,000 have died due to COVID-19. In this review we outline the pathophysiology that underpins the potential use of anti-rheumatic therapies for severe COVID-19 infection and summarize the current evidence regarding the risk and outcome of COVID-19 in patients with systemic autoimmune diseases. Thus far there is no convincing evidence that any disease-modifying anti-rheumatic drug (conventional synthetic, biologic or targeted synthetic) including hydroxychloroquine, may protect against severe COVID-19 infection; answers about their possible usefulness in the management of the cytokine storm associated with severe COVID-9 infection will only arise from ongoing randomized controlled trials. Evidence on COVID-19 risk and outcome in patients with systemic autoimmune diseases is extremely limited; thus, any conclusions would be unsafe and should be seen with great caution. At present, the risk and severity (hospitalization, intensive care unit admission and death) of COVID-19 infection in people with autoimmune diseases do not appear particularly dissimilar to the general population, with the possible exception of hospitalization in patients exposed to high glucocorticoid doses. At this stage it is impossible to draw any conclusions for differences in COVID-19 risk and outcome between different autoimmune diseases and between the various immunomodulatory therapies used for them. More research in the field is obviously required, including as a minimum careful and systematic epidemiology and appropriately controlled clinical trials.


Subject(s)
Antirheumatic Agents/therapeutic use , Autoimmune Diseases/drug therapy , Coronavirus Infections/drug therapy , Cytokine Release Syndrome/drug therapy , Pneumonia, Viral/drug therapy , Antibodies, Monoclonal, Humanized/therapeutic use , Autoimmune Diseases/epidemiology , Autoimmune Diseases/immunology , Betacoronavirus , Comorbidity , Coronavirus Infections/epidemiology , Coronavirus Infections/immunology , Cytokine Release Syndrome/immunology , Humans , Janus Kinase Inhibitors/therapeutic use , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/immunology , Risk Factors , Severity of Illness Index , Tumor Necrosis Factor Inhibitors/therapeutic use
7.
Clinics (Sao Paulo) ; 75: e2209, 2020.
Article in English | MEDLINE | ID: covidwho-749235

ABSTRACT

OBJECTIVES: To assess the outcomes of pediatric patients with laboratory-confirmed coronavirus disease (COVID-19) with or without multisystem inflammatory syndrome in children (MIS-C). METHODS: This cross-sectional study included 471 samples collected from 371 patients (age<18 years) suspected of having severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The study group comprised 66/371 (18%) laboratory-confirmed pediatric COVID-19 patients: 61 (92.5%) patients tested positive on real-time reverse transcription-polymerase chain reaction tests for SARS-CoV-2, and 5 (7.5%) patients tested positive on serological tests. MIS-C was diagnosed according to the criteria of the Center for Disease Control. RESULTS: MIS-C was diagnosed in 6/66 (9%) patients. The frequencies of diarrhea, vomiting, and/or abdominal pain (67% vs. 22%, p=0.034); pediatric SARS (67% vs. 13%, p=0.008); hypoxemia (83% vs. 23%, p=0.006); and arterial hypotension (50% vs. 3%, p=0.004) were significantly higher in patients with MIS-C than in those without MIS-C. The frequencies of C-reactive protein levels >50 mg/L (83% vs. 25%, p=0.008) and D-dimer levels >1000 ng/mL (100% vs. 40%, p=0.007) and the median D-dimer, troponin T, and ferritin levels (p<0.05) were significantly higher in patients with MIS-C. The frequencies of pediatric intensive care unit admission (100% vs. 60%, p=0.003), mechanical ventilation (83% vs. 7%, p<0.001), vasoactive agent use (83% vs. 3%, p<0.001), shock (83% vs. 5%, p<0.001), cardiac abnormalities (100% vs. 2%, p<0.001), and death (67% vs. 3%, p<0.001) were also significantly higher in patients with MIS-C. Similarly, the frequencies of oxygen therapy (100% vs. 33%, p=0.003), intravenous immunoglobulin therapy (67% vs. 2%, p<0.001), aspirin therapy (50% vs. 0%, p<0.001), and current acute renal replacement therapy (50% vs. 2%, p=0.002) were also significantly higher in patients with MIS-C. Logistic regression analysis showed that the presence of MIS-C was significantly associated with gastrointestinal manifestations [odds ratio (OR)=10.98; 95%CI (95% confidence interval)=1.20-100.86; p=0.034] and hypoxemia [OR=16.85; 95%CI=1.34-211.80; p=0.029]. Further univariate analysis showed a positive association between MIS-C and death [OR=58.00; 95%CI=6.39-526.79; p<0.0001]. CONCLUSIONS: Pediatric patients with laboratory-confirmed COVID-19 with MIS-C had a severe clinical spectrum with a high mortality rate. Our study emphasizes the importance of investigating MIS-C in pediatric patients with COVID-19 presenting with gastrointestinal involvement and hypoxemia.


Subject(s)
Coronavirus Infections/complications , Coronavirus Infections/mortality , Coronavirus , Pandemics , Pneumonia, Viral/complications , Pneumonia, Viral/mortality , Systemic Inflammatory Response Syndrome/epidemiology , Systemic Inflammatory Response Syndrome/virology , Abdominal Pain/etiology , Betacoronavirus , Child , Coronavirus Infections/diagnosis , Coronavirus Infections/therapy , Cross-Sectional Studies , Diarrhea/etiology , Fever/etiology , Glucocorticoids/therapeutic use , Humans , Immunoglobulins, Intravenous/therapeutic use , Male , Mucocutaneous Lymph Node Syndrome/epidemiology , Mucocutaneous Lymph Node Syndrome/therapy , Mucocutaneous Lymph Node Syndrome/virology , Pneumonia, Viral/diagnosis , Pneumonia, Viral/therapy , Respiration, Artificial , Severity of Illness Index , Systemic Inflammatory Response Syndrome/therapy , Vomiting/etiology
8.
Lipids Health Dis ; 19(1): 204, 2020 Sep 07.
Article in English | MEDLINE | ID: covidwho-745682

ABSTRACT

BACKGROUND: The purpose of the study is to describe the blood lipid levels of patients diagnosed with coronavirus disease 2019 (COVID-19) and to analyze the correlation between blood lipid levels and the prognosis of COVID-19 patients. METHODS: In the clinical retrospective analysis, a total of 228 adults infected with COVID-19 were enrolled between January 17, 2020 and March 14, 2020, in Changsha, China. One thousand one hundred and forty healthy participants with matched age and gender were used as control. Median with interquartile range and Mann-Whitney test were adopted to describe and analyze clinical data. The Kaplan-Meier (KM) curve and Cox regression analysis were used to analyze the correlation between high-density lipoprotein cholesterol (HDL-C) and the severity of COVID-19. RESULTS: Compared with control, COVID-19 patients showed significantly lower levels of total cholesterol (TC) [median, 3.76 vs 4.65 mmol/L, P = 0.031], triglyceride [median, 1.08 vs 1.21 mmol/L, P <  0.001], low-density lipoprotein cholesterol (LDL-C) [median, 2.63 vs 2.83 mmol/L, P <  0.001], and HDL-C [median, 0.78 vs 1.37 mmol/L, P <  0.001], while compared with non-severe patients, severe COVID-19 patients only presented lower levels of HDL-C [median, 0.69 vs 0.79 mmol/L, P = 0.032]. In comparison with patients with high HDL-C, patients with low HDL-C showed a higher proportion of male (69.57% vs 45.60%, P = 0.004), higher levels of C-reactive protein (CRP) (median, 27.83 vs 12.56 mg/L, P <  0.001) and higher proportion of severe events (36.96% vs 14.84%, P = 0.001). Moreover, patients with low HDL-C at admission showed a higher risk of developing severe events compared with those with high HDL-C (Log Rank P = 0.009). After adjusting for age, gender and underlying diseases, they still had elevated possibility of developing severe cases than those with high HDL-C (HR 2.827, 95% CI 1.190-6.714, P = 0.019). CONCLUSIONS: HDL-C level was lower in COVID-19 adult patients, and low HDL-C in COVID-19 patients was correlated with a higher risk of developing severe events.


Subject(s)
Betacoronavirus , Cholesterol, HDL/blood , Cholesterol, LDL/blood , Coronavirus Infections/physiopathology , Pneumonia, Viral/physiopathology , Adult , C-Reactive Protein/analysis , China , Cholesterol/blood , Coronavirus Infections/blood , Female , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/blood , Retrospective Studies , Risk Factors , Severity of Illness Index , Sex Factors , Triglycerides/blood
9.
Monaldi Arch Chest Dis ; 90(3)2020 Sep 04.
Article in English | MEDLINE | ID: covidwho-745209

ABSTRACT

COVID-19 has been affecting mankind round the globe. The incidence of this infectious disease of respiratory origin is constantly on rise. Another infectious disease widely prevalent is tuberculosis (TB). During past corona virus pandemics of Severe Acute Respiratory Syndrome and Middle East Respiratory Syndrome, coinfection with TB was seen. We present this review as the co-infection of COVID-19 with TB has not been assessed yet, imposing a greater global threat. We suggest few measures to be implemented without delay for effectively screening the suspects of co-infection and also follow up of non-suspect patients in the post-pandemic phase.


Subject(s)
Coinfection , Coronavirus Infections/complications , Pneumonia, Viral/complications , Severe Acute Respiratory Syndrome/complications , Tuberculosis, Pulmonary/complications , Asymptomatic Infections , Betacoronavirus , Humans , Mass Screening , Pandemics , Patient Isolation , Severity of Illness Index , Tuberculosis, Pulmonary/diagnosis
10.
Yonsei Med J ; 61(9): 826-830, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-745127

ABSTRACT

We retrospectively reviewed patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections who were admitted to an intensive care unit in Daegu, South Korea. The outcomes of patients who did (cases) or did not (controls) receive darunavir-cobicistat (800-150 mg) therapy were compared. Fourteen patients received darunavir-cobicistat treatment, and 96 received other antiviral therapy (controls). Overall, the darunavir-cobicistat group comprised patients with milder illness, and the crude mortality rate of all patients in the darunavir-cobicistat group was lower than that in the controls [odds ratio (OR) 0.20, 95% confidence interval (CI) 0.04-0.89, p=0.035]. After 1:2 propensity-score matching, there were 14 patients in the darunavir-cobicistat group, and 28 patients in the controls. In propensity score-matched analysis, the darunavir-cobicistat group had lower mortality than the controls (OR 0.07, 95% CI 0.01-0.52, p=0.009). In conclusion, darunavir-cobicistat therapy was found to be associated with a significant survival benefit in critically ill patients with SARS-CoV-2 infection.


Subject(s)
Anti-HIV Agents/therapeutic use , Cobicistat/therapeutic use , Coronavirus Infections/drug therapy , Darunavir/therapeutic use , HIV Protease Inhibitors/therapeutic use , Pneumonia, Viral/drug therapy , Adult , Anti-HIV Agents/administration & dosage , Anti-HIV Agents/adverse effects , Betacoronavirus , Case-Control Studies , Cobicistat/administration & dosage , Cobicistat/adverse effects , Coronavirus Infections/diagnosis , Coronavirus Infections/mortality , Critical Illness , Darunavir/administration & dosage , Darunavir/adverse effects , Female , HIV Protease Inhibitors/administration & dosage , HIV Protease Inhibitors/adverse effects , Humans , Intensive Care Units , Male , Middle Aged , Pandemics , Pneumonia, Viral/diagnosis , Pneumonia, Viral/mortality , Republic of Korea/epidemiology , Retrospective Studies , Severity of Illness Index , Treatment Outcome
11.
Trials ; 21(1): 758, 2020 Sep 03.
Article in English | MEDLINE | ID: covidwho-745011

ABSTRACT

OBJECTIVES: Tocilizumab is a humanized monoclonal antibody which targets and inhibits interleukin-6 (IL-6) and has demonstrated efficacy in treating diseases associated with hyper-inflammation. Data are suggestive of tocilizumab as a potential treatment for patients with COVID-19 infection. The aim of this study is to determine the safety and efficacy of standard dose versus low dose tocilizumab in adults with severe, non-critical, PCR-confirmed COVID-19 infection with evidence of progressive decline in respiratory function and evolving systemic inflammation on time to intubation, non-invasive ventilation and/or all-cause mortality. TRIAL DESIGN: This trial is a phase 2, open label, two-stage, multicentre, randomised trial. PARTICIPANTS: Adult subjects with severe, non-critical, PCR-confirmed COVID-19 infection with evidence of progressive decline in respiratory function and evolving systemic inflammation requiring admission to hospital at St. Vincent's University Hospital and Mater Misericordiae University Hospital, Dublin, Ireland. Inclusion criteria Aged 18 years or older. Confirmed SARS-CoV2 infection (as defined by positive PCR). Evidence of hyper inflammatory state as evidenced by at least three of the following: Documented temperature >38°C in the past 48 hours, IL6 >40 pg/ml, or in its absence D-dimer >1.5 µgFEU /ml, Elevated CRP (>100mg/L) and/or a three-fold increase since presentation, Elevated ferritin X5 ULN, Elevated LDH (above the ULN), Elevated fibrinogen (above the ULN). Pulmonary infiltrates on chest imaging. Moderate to severe respiratory failure as defined by PaO2/FiO2≤300mmHg. INTERVENTION AND COMPARATOR: Intervention for participants in this trial is SOC plus Tocilizumab compared to SOC alone (comparator). For Stage 1, following randomisation, subjects will receive either (Arm 1) SOC alone or (Arm 2) SOC plus Tocilizumab (standard single dose - 8mg/kg, infused over 60 minutes. Once stage 1 has fully recruited, subsequent participants will be enrolled directly into Stage 2 and receive either (Arm 1) SOC plus Tocilizumab (standard single dose - 8mg/kg, infused over 60 minutes or (Arm 2) SOC plus Tocilizumab (standard single dose - 4mg/kg, infused over 60 minutes). MAIN OUTCOMES: The primary endpoint for this study is the time to a composite primary endpoint of progression to intubation and ventilation, non-invasive ventilation or death within 28 days post randomisation. RANDOMISATION: Eligible patients will be randomised (1:1) using a central register. Randomisation will be performed through an interactive, web-based electronic data capturing database. In stage 1, eligible participants will be randomised (1:1) to (Arm 1) SOC alone or to (Arm 2) SOC with single dose (8mg/kg, maximum 800mg) intravenous tocilizumab infused over 60 minutes. In stage 2, eligible participants will be randomised (1:1) to receive either (Arm 1) single, standard dose (8mg/kg, maximum 800mg) intravenous tocilizumab infused over 60 minutes or (Arm 2) reduced dose (4mg/kg, maximum 800mg) intravenous tocilizumab infused over 60 minutes. BLINDING: This study is open label. The study will not be blinded to investigators, subjects, or medical or nursing staff. The trial statistician will be blinded for data analysis and will be kept unaware of treatment group assignments. To facilitate this, the randomisation schedule will be drawn up by an independent statistician and objective criteria were defined for the primary outcome to minimize potential bias. NUMBERS TO BE RANDOMISED: In stage 1, 90 subjects will be randomised 1:1, 45 to SOC and 45 subjects to SOC plus Tocilizumab (8mg/kg, infused over 60 minutes). In stage 2, sample size calculation for the dose evaluation stage will use data generated from stage 1 using the same primary endpoint as in stage 1. TRIAL STATUS: The COVIRL002 trial (Protocol version 1.4, 13th May 2020) commenced in May 2020 at St. Vincent's University Hospital and Mater Misericordiae University Hospital, Dublin, Ireland. Recruitment is proceeding with the aim to achieve the target sample size on or before April 2021. TRIAL REGISTRATION: COVIRL002 was registered 25 June 2020 under EudraCT number: 2020-001767-86 and Protocol identification: UCDCRC/20/02. FULL PROTOCOL: The full protocol for COVIRL002 is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol. The study protocol has been reported in accordance with the Standard Protocol Items: Recommendations for Clinical Interventional Trials (SPIRIT) guidelines (Additional file 2).


Subject(s)
Anti-Inflammatory Agents/therapeutic use , Antibodies, Monoclonal, Humanized/therapeutic use , Betacoronavirus/drug effects , Coronavirus Infections/drug therapy , Pneumonia, Viral/drug therapy , Anti-Inflammatory Agents/adverse effects , Antibodies, Monoclonal, Humanized/adverse effects , Betacoronavirus/pathogenicity , Clinical Trials, Phase II as Topic , Coronavirus Infections/diagnosis , Coronavirus Infections/mortality , Coronavirus Infections/virology , Disease Progression , Host Microbial Interactions , Humans , Intubation, Intratracheal , Ireland , Multicenter Studies as Topic , Pandemics , Pneumonia, Viral/diagnosis , Pneumonia, Viral/mortality , Pneumonia, Viral/virology , Randomized Controlled Trials as Topic , Respiration, Artificial , Severity of Illness Index , Time Factors , Treatment Outcome
12.
Eur Respir J ; 56(2)2020 08.
Article in English | MEDLINE | ID: covidwho-744960

ABSTRACT

BACKGROUND: The outbreak of coronavirus disease 2019 (COVID-19) has globally strained medical resources and caused significant mortality. OBJECTIVE: To develop and validate a machine-learning model based on clinical features for severity risk assessment and triage for COVID-19 patients at hospital admission. METHOD: 725 patients were used to train and validate the model. This included a retrospective cohort from Wuhan, China of 299 hospitalised COVID-19 patients from 23 December 2019 to 13 February 2020, and five cohorts with 426 patients from eight centres in China, Italy and Belgium from 20 February 2020 to 21 March 2020. The main outcome was the onset of severe or critical illness during hospitalisation. Model performances were quantified using the area under the receiver operating characteristic curve (AUC) and metrics derived from the confusion matrix. RESULTS: In the retrospective cohort, the median age was 50 years and 137 (45.8%) were male. In the five test cohorts, the median age was 62 years and 236 (55.4%) were male. The model was prospectively validated on five cohorts yielding AUCs ranging from 0.84 to 0.93, with accuracies ranging from 74.4% to 87.5%, sensitivities ranging from 75.0% to 96.9%, and specificities ranging from 55.0% to 88.0%, most of which performed better than the pneumonia severity index. The cut-off values of the low-, medium- and high-risk probabilities were 0.21 and 0.80. The online calculators can be found at www.covid19risk.ai. CONCLUSION: The machine-learning model, nomogram and online calculator might be useful to access the onset of severe and critical illness among COVID-19 patients and triage at hospital admission.


Subject(s)
Coronavirus Infections/diagnosis , Hospital Mortality/trends , Machine Learning , Pneumonia, Viral/diagnosis , Triage/methods , Adult , Age Factors , Aged , Area Under Curve , Belgium , China , Clinical Laboratory Techniques , Cohort Studies , Coronavirus Infections/epidemiology , Decision Support Systems, Clinical , Female , Hospitalization/statistics & numerical data , Humans , Internationality , Italy , Male , Middle Aged , Pandemics/statistics & numerical data , Pneumonia, Viral/epidemiology , Predictive Value of Tests , ROC Curve , Reproducibility of Results , Retrospective Studies , Risk Assessment , Severity of Illness Index , Sex Factors , Survival Analysis
13.
Adv Biol Regul ; 77: 100745, 2020 08.
Article in English | MEDLINE | ID: covidwho-741319

ABSTRACT

Coronavirus disease 2019 caused by SARS-CoV-2 originated from China and spread across every corner of the world. The scientific interest on COVID-19 increased after WHO declared it a pandemic in the early February of 2020. In fact, this pandemic has had a worldwide impact on economy, health, and lifestyle like no other in the last 100 years. SARS-CoV-2 belongs to Coronaviridae family and causes the deadliest clinical manifestations when compared to other viruses in the family. COVID-19 is an emerging zoonotic disease that has resulted in over 383,000 deaths around the world. Scientists are scrambling for ideas to develop treatment and prevention strategies to thwart the disease condition. In this review, we have attempted to summarize the latest information on the virus, disease, prevention, and treatment strategies. The future looks promising.


Subject(s)
Betacoronavirus/pathogenicity , Communicable Disease Control/organization & administration , Coronavirus Infections/epidemiology , Pandemics , Pneumonia, Viral/epidemiology , Antiviral Agents/therapeutic use , Ataxia/diagnosis , Ataxia/physiopathology , Ataxia/virology , Communicable Disease Control/methods , Coronavirus Infections/prevention & control , Coronavirus Infections/therapy , Coronavirus Infections/transmission , Humans , Hydroxychloroquine/therapeutic use , Nausea/diagnosis , Nausea/physiopathology , Nausea/virology , Pandemics/prevention & control , Personal Protective Equipment/supply & distribution , Pneumonia, Viral/prevention & control , Pneumonia, Viral/therapy , Pneumonia, Viral/transmission , Quarantine/methods , Quarantine/organization & administration , Risk Factors , Severity of Illness Index , Social Distance , Vomiting/diagnosis , Vomiting/physiopathology , Vomiting/virology
14.
Medicine (Baltimore) ; 99(35): e21699, 2020 Aug 28.
Article in English | MEDLINE | ID: covidwho-740199

ABSTRACT

The aim of this study was to survey the prevalence of dry eye symptoms (DES) among doctors and nurses in the period of 2019, novel coronavirus (COVID-19) outbreak.To evaluate the DES of doctors and nurses worked at front-line hospitals with protective glasses for a mean time of 4 to 6 hours, a questionnaire developed by the researchers with the Ocular Surface Disease Index (OSDI) was used. These data were evaluated using descriptive statistics and correlation test with SPSS 22.0.The study included 13 doctors and 40 nurses, among which 16 were male and 37 were female, and the mean age of the participants was 32.43 ±â€Š5.15 years old. According to the OSDI scores, 64.15, 24.52, 7.54, and 3.77% of the participants experienced occasional, mild, moderate, and severe DES, respectively. The factors significantly correlated with OSDI scores were age and duration of wearing protective glasses, while the duration of wearing protective glasses may be a protective factor of dry eye symptoms.Our study showed that most of the doctors and nurses worked at the front-line of combating COVID-19 did not experience DES, while the symptoms of those who experienced DES might be improved by wearing protective glasses.


Subject(s)
Coronavirus Infections , Dry Eye Syndromes , Eye Protective Devices , Infection Control , Occupational Exposure/prevention & control , Pandemics , Pneumonia, Viral , Adult , Age Factors , Betacoronavirus , China , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Cross-Sectional Studies , Dry Eye Syndromes/diagnosis , Dry Eye Syndromes/etiology , Dry Eye Syndromes/prevention & control , Female , Humans , Infection Control/instrumentation , Infection Control/methods , Male , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Severity of Illness Index , Surveys and Questionnaires , Symptom Assessment , Time Factors
15.
Medicine (Baltimore) ; 99(33): e21618, 2020 Aug 14.
Article in English | MEDLINE | ID: covidwho-740197

ABSTRACT

BACKGROUND: Coronavirus disease 2019, (COVID-19) is a major problem in public health in the world. Up to June, 2020, the number of infections arising to 8,690,000 and cause 410,000 deaths all over the world. Identification the clinical symptoms from non-severe to severe is important for clinician. This meta-analysis aimed to compare the clinical symptoms between severe and non-severe COVID-19 pneumonia. METHODS: Electronic databases including PubMed, EMBASE, Web of Science, China National Knowledge Infrastructure database, Wanfang Database and Chinese Biomedical Literature Database were searched from its inception to June 21, 2020. We only included severe versus non-severe COVID-19 pneumonia patients and pooled results were summarized by STATA 12.0 software.Two researchers independently selected the study and assessed the quality of the included studies. The heterogeneity was measured by I tests (I < 50 indicates little heterogeneity, I≥50 indicates high heterogeneity). Publication bias was ruled out by funnel plot and statistically assessed by Begg test (P > .05 as no publication bias). RESULTS: Results will be published in relevant peer-reviewed journals. CONCLUSION: Our study aims to systematically present the clinical symptoms between non-severe and severe of COVID-19 patients, which will be provide clinical guidance for COVID-19 patients.


Subject(s)
Betacoronavirus , Coronavirus Infections/diagnosis , Pneumonia, Viral/diagnosis , Severity of Illness Index , Symptom Assessment/methods , Cohort Studies , Female , Humans , Male , Meta-Analysis as Topic , Pandemics , Randomized Controlled Trials as Topic , Research Design , Systematic Reviews as Topic
16.
J Int Med Res ; 48(8): 300060520949039, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-739220

ABSTRACT

OBJECTIVE: This study was performed to investigate the clinical characteristics of patients with coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). METHODS: We analyzed the electronic medical records of 405 hospitalized patients with laboratory-confirmed COVID-19 in the Third Hospital of Wuhan. RESULTS: The patients' median age was 56 years, 54.1% were female, 11.4% had a history of smoking, and 10.6% had a history of drinking. All cases of COVID-19 were community-acquired. Fever (76.8%) and cough (53.3%) were the most common clinical manifestations, and circulatory system diseases were the most common comorbidities. Gastrointestinal symptoms were present in 61.2% of the patients, and 2.9% of the patients were asymptomatic. Computed tomography showed ground-glass opacities in most patients (72.6%) and consolidation in 30.9%. Lymphopenia (72.3%) and hypoproteinemia (71.6%) were observed in most patients. About 20% of patients had abnormal liver function. Patients with severe disease had significantly more prominent laboratory abnormalities, including an abnormal lymphocyte count and abnormal C-reactive protein, procalcitonin, alanine aminotransferase, aspartate aminotransferase, D-dimer, and albumin levels. CONCLUSION: SARS-CoV-2 causes a variety of severe respiratory illnesses similar to those caused by SARS-CoV-1. Older age, chronic comorbidities, and laboratory abnormalities are associated with disease severity.


Subject(s)
Coronavirus Infections/diagnosis , Coronavirus Infections/pathology , Gastrointestinal Diseases/diagnosis , Pneumonia, Viral/diagnosis , Pneumonia, Viral/pathology , Adolescent , Adult , Aged , Aged, 80 and over , Aging/physiology , Alanine Transaminase/blood , Aspartate Aminotransferases/blood , Betacoronavirus , C-Reactive Protein/analysis , China , Community-Acquired Infections/diagnosis , Community-Acquired Infections/pathology , Community-Acquired Infections/virology , Comorbidity , Coronavirus Infections/transmission , Female , Gastrointestinal Diseases/pathology , Gastrointestinal Diseases/virology , Humans , Lymphocyte Count , Male , Middle Aged , Pandemics , Pneumonia, Viral/transmission , Retrospective Studies , Severity of Illness Index , Young Adult
17.
Dtsch Arztebl Int ; 117(29-30): 500-506, 2020 07 20.
Article in English | MEDLINE | ID: covidwho-738337

ABSTRACT

BACKGROUND: The histomorphological changes of lung damage in severe coronavirus disease 2019 (COVID-19) have not yet been adequately characterized. In this article, we describe the sequence of pathological changes in COVID-19 and discuss the implications for approaches to treatment. METHODS: Standardized autopsies were performed on thirteen patients who had died of COVID-19. The findings were analyzed together with clinical data from the patients' medical records. RESULTS: Most (77%) of the deceased patients were men. Their median age at death was 78 years (range, 41-90). Most of them had major pre-existing chronic diseases, most commonly arterial hypertension. The autopsies revealed characteristic COVID-19-induced pathological changes in the lungs, which were regarded as the cause of death in most patients. The main histological finding was sequential alveolar damage, apparently due in large measure to focal capillary microthrombus formation. Alveolar damage leads to the death of the patient either directly or by the induction of pulmonary parenchymal fibrosis. Diffuse lung damage was seen exclusively in invasively ventilated patients. CONCLUSION: Autopsies are crucial for the systematic assessment of new diseases such as COVID-19: they provide a basis for further investigations of disease mechanisms and for the devising of potentially effective modes of treatment. The autopsy findings suggest that focal damage of the microvascular pulmonary circulation is a main mechanism of lethal lung disease due to the SARS-CoV-2 virus. It may also be a cause of persistent lung damage in patients who recover from severe COVID-19.


Subject(s)
Coronavirus Infections/complications , Lung Injury/pathology , Lung Injury/virology , Pneumonia, Viral/complications , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Pandemics , Severity of Illness Index
18.
J Int Med Res ; 48(8): 300060520949077, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-737978

ABSTRACT

The emergence of coronavirus disease 2019 (COVID-19) in December 2019 has resulted in over 20 million cases and 741,808 deaths globally, affecting more than 200 countries. COVID-19 was declared a pandemic on 11 March 2020 by the World Health Organization. The disease is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). There is limited information on COVID-19, and treatment has so far focused on supportive care and use of repurposed drugs. COVID-19 can be transmitted via person-to-person contact through droplet spread. Some of the recommended precautionary measures to reduce the rate of disease spread include social distancing, good hygiene practices, and avoidance of crowded areas. These measures are effective because the droplets are heavy and can only travel approximately 1 meter in the air, settling quickly on fixed surfaces. Promising strategies to combat SARS-CoV-2 include discovery of therapeutic targets/drugs and vaccines. In this review, we summarize the epidemiology, pathophysiology, and diagnosis of COVID-19. We also address the mechanisms of action of approved repurposed drugs for therapeutic management of the disease.


Subject(s)
Antiviral Agents/therapeutic use , Betacoronavirus/pathogenicity , Communicable Disease Control/organization & administration , Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/therapy , Adenosine Monophosphate/analogs & derivatives , Adenosine Monophosphate/therapeutic use , Age Factors , Alanine/analogs & derivatives , Alanine/therapeutic use , Antibodies, Monoclonal, Humanized/therapeutic use , Betacoronavirus/drug effects , Betacoronavirus/genetics , Chloroquine/therapeutic use , Communicable Disease Control/methods , Coronavirus Infections/diagnosis , Coronavirus Infections/physiopathology , Drug Repositioning , Humans , Incidence , Personal Protective Equipment/supply & distribution , Pneumonia, Viral/diagnosis , Pneumonia, Viral/physiopathology , Quarantine/methods , Quarantine/organization & administration , Severity of Illness Index , Social Distance , Survival Analysis
19.
Commun Dis Intell (2018) ; 442020 Aug 07.
Article in English | MEDLINE | ID: covidwho-737046

ABSTRACT

Confirmed cases in Australia: 12,636 notifications and 147 deaths as at 19 July 2020; during the latest reporting fortnight (6 to 19 July 2020) there have been 3,791 notifications and 37 deaths. The number of new cases reported nationally increased from 897 in the previous fortnight (22 June to 5 July) to 3,791 (6 to 19 July). The large increase in cases is due to multiple epidemiologically-linked outbreaks across a range of settings and locations in Victoria (94%; 3,575 cases), with very few cases reported by other jurisdictions (216) in this reporting period. Of the 3,575 cases reported in Victoria, all except one were reported as locally acquired. The majority of these cases were linked to several outbreaks. Of the 216 cases reported from other jurisdictions, approximately 55% (119 cases) were locally acquired. A total of 37 deaths were reported, all from Victoria. On average, 271 cases were reported each day over the reporting period, an increase from 54 cases per day over the previous reporting period. Testing rates have increased across all jurisdictions, predominantly in Victoria, with the nationwide cumulative positivity rate remaining very low at less than 0.5%. As at 19 July, a small proportion of cases have experienced severe disease, requiring hospitalisation or intensive care, with some fatalities. The cumulative crude case fatality rate amongst Australian cases is 1.2%. People who are older and have one or more comorbidity are more likely to experience severe disease.


Subject(s)
Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , Adolescent , Adult , Age Distribution , Aged , Aged, 80 and over , Australia/epidemiology , Betacoronavirus , Child , Coronavirus Infections/mortality , Coronavirus Infections/physiopathology , European Continental Ancestry Group/statistics & numerical data , Female , Humans , Incidence , Male , Middle Aged , Mortality , Oceanic Ancestry Group/statistics & numerical data , Pandemics , Pneumonia, Viral/mortality , Pneumonia, Viral/physiopathology , Severity of Illness Index , Sex Distribution , Victoria/epidemiology , Young Adult
20.
Ann Glob Health ; 86(1): 100, 2020 08 13.
Article in English | MEDLINE | ID: covidwho-736810

ABSTRACT

Background: Brazil faces some challenges in the battle against the COVID-19 pandemic, including: the risks for cross-infection (community infection) increase in densely populated areas; low access to health services in areas where the number of beds in intensive care units (ICUs) is scarce and poorly distributed, mainly in states with low population density. Objective: To describe and intercorrelate epidemiology and geographic data from Brazil about the number of intensive care unit (ICU) beds at the onset of COVID-19 pandemic. Methods: The epidemiology and geographic data were correlated with the distribution of ICU beds (public and private health systems) and the number of beneficiaries of private health insurance using Pearson's Correlation Coefficient. The same data were correlated using partial correlation controlled by gross domestic product (GDP) and number of beneficiaries of private health insurance. Findings: Brazil has a large geographical area and diverse demographic and economic aspects. This diversity is also present in the states and the Federal District regarding the number of COVID-19 cases, deaths and case fatality rate. The effective management of severe COVID-19 patients requires ICU services, and the scenario was also dissimilar as for ICU beds and ICU beds/10,000 inhabitants for the public (SUS) and private health systems mainly at the onset of COVID-19 pandemic. The distribution of ICUs was uneven between public and private services, and most patients rely on SUS, which had the lowest number of ICU beds. In only a few states, the number of ICU beds at SUS was above 1 to 3 by 10,000 inhabitants, which is the number recommended by the World Health Organization (WHO). Conclusions: Brazil needed to improve the number of ICU beds units to deal with COVID-19 pandemic, mainly for the SUS showing a late involvement of government and health authorities to deal with the COVID-19 pandemic.


Subject(s)
Coronavirus Infections , Health Services Accessibility/organization & administration , Intensive Care Units/supply & distribution , Pandemics , Patient Care Management , Pneumonia, Viral , Private Sector/statistics & numerical data , Public Sector/statistics & numerical data , Bed Occupancy/statistics & numerical data , Betacoronavirus , Brazil/epidemiology , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Coronavirus Infections/therapy , Health Services Needs and Demand , Humans , Infection Control/organization & administration , Infection Control/standards , Organizational Innovation , Pandemics/prevention & control , Patient Care Management/organization & administration , Patient Care Management/standards , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Pneumonia, Viral/therapy , Severity of Illness Index
SELECTION OF CITATIONS
SEARCH DETAIL