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1.
Psychosom Med ; 83(4): 368-372, 2021 05 01.
Article in English | MEDLINE | ID: covidwho-1931979

ABSTRACT

OBJECTIVE: Infectious diseases can cause psychological changes in patients. This study aimed to evaluate the prevalence and related risk factors for anxiety and depression in patients with COVID-19. METHODS: A cross-sectional study was performed on patients with COVID-19 admitted to the Sino-French New City branch of Wuhan Tongji Hospital from January to February 2020. The Zung Self-Rating Anxiety and Depression Scales were used to evaluate the prevalence of anxiety and depression. Demographic, clinical, and sociological data were also collected. Multivariable logistic regression analysis was used to identify independent risk factors of anxiety and depression in patients with COVID-19. RESULTS: In the current study, 183 patients were enrolled (mean age = 53 ± 9 years; 41.1% women). The prevalences of anxiety and depression were 56.3% and 39.3%, respectively. Logistic regression analysis revealed that older age, female sex, being divorced or widowed, COVID-19 disease duration, renal disease, and depression were identified as independent risk factors for anxiety in patients with COVID-19. Factors that were associated with depression were female sex, being widowed, COVID-19 disease duration, and anxiety. CONCLUSIONS: This study demonstrates a high prevalence of anxiety and depression in patients with COVID-19 at the peak of the epidemic in Wuhan, China. The identification of demographic, clinical, and social factors may help identify health care professionals to provide psychological care as part of treatment for patients with COVID-19 and other life-threatening infectious diseases.


Subject(s)
Anxiety/epidemiology , COVID-19/psychology , Depression/epidemiology , Anxiety/etiology , COVID-19/complications , China/epidemiology , Cross-Sectional Studies , Depression/etiology , Female , Humans , Logistic Models , Male , Middle Aged , Prevalence , Psychiatric Status Rating Scales , Risk Factors
2.
J Am Coll Emerg Physicians Open ; 2020 Jun 04.
Article in English | MEDLINE | ID: covidwho-1898671

ABSTRACT

There is limited guidance on the use of helicopter medical personnel to facilitate care of critically ill COVID-19 patients. This manuscript describes the emergence of this novel virus, its mode of transmission, and the potential impacts on patient care in the unique environment of rotor wing aircraft. It details the development of clinical and operational guidelines for flight crew members. This allows other out-of-hospital clinicians to utilize our framework to augment or supplement their own for the current response effort to COVID-19. It further serves as a road map for future response to the care of high consequence infectious disease patients.

3.
Turk Kardiyol Dern Ars ; 48(Suppl 1): 1-48, 2020 03.
Article in Turkish | MEDLINE | ID: covidwho-1835514

ABSTRACT

In December 2019, in the city of Wuhan, in the Hubei province of China, treatment-resistant cases of pneumonia emerged and spread rapidly for reasons unknown. A new strain of coronavirus (severe acute respiratory syndrome coronavirus-2 [SARS-CoV-2]) was identified and caused the first pandemic of the 21st century. The virus was officially detected in our country on March 11, 2020, and the number of cases increased rapidly; the virus was isolated in 670 patients within 10 days. The rapid increase in the number of patients has required our physicians to learn to protect both the public and themselves when treating patients with this highly infectious disease. The group most affected by the outbreak and with the highest mortality rate is elderly patients with known cardiovascular disease. Therefore, it is necessary for cardiology specialists to take an active role in combating the epidemic. The aim of this article is to make a brief assessment of current information regarding the management of cardiovascular patients affected by COVID-19 and to provide practical suggestions to cardiology specialists about problems and questions they have frequently encountered.


Subject(s)
Betacoronavirus , Cardiology/standards , Cardiovascular Diseases/therapy , Cardiovascular Diseases/virology , Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , COVID-19 , Cardiovascular Diseases/epidemiology , Consensus , Humans , Pandemics , SARS-CoV-2 , Societies, Medical , Turkey
4.
Turk Kardiyol Dern Ars ; 48(Suppl 1): 1-87, 2020 05.
Article in Turkish | MEDLINE | ID: covidwho-1835513

ABSTRACT

In December 2019, in the city of Wuhan, in the Hubei province of China, treatment-resistant cases of pneumonia emerged and spread rapidly for reasons unknown. A new strain of coronavirus (severe acute respiratory syndrome coronavirus-2 [SARS-CoV-2]) was identified and caused the first pandemic of the 21st century. The virus was officially detected in our country on March 11, 2020, and the number of cases increased rapidly; the virus was isolated in 670 patients within 10 days. The rapid increase in the number of patients has required our physicians to learn to protect both the public and themselves when treating patients with this highly infectious disease. The group most affected by the outbreak and with the highest mortality rate is elderly patients with known cardiovascular disease. Therefore, it is necessary for cardiology specialists to take an active role in combating the epidemic. The aim of this article is to make a brief assessment of current information regarding the management of cardiovascular patients affected by COVID-19 and to provide practical suggestions to cardiology specialists about problems and questions they have frequently encountered.


Subject(s)
Cardiovascular Diseases , Coronavirus Infections , Pandemics , Pneumonia, Viral , Betacoronavirus , COVID-19 , Cardiology/standards , Cardiovascular Diseases/complications , Cardiovascular Diseases/therapy , Consensus , Coronavirus Infections/complications , Coronavirus Infections/epidemiology , Humans , Pneumonia, Viral/complications , Pneumonia, Viral/epidemiology , Practice Guidelines as Topic , SARS-CoV-2
5.
Indian J Crit Care Med ; 24(9): 763-770, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-1792080

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19) and has been declared as a pandemic. COVID-19 patients may require transport for diagnostic or therapeutic purposes intra- or interhospital or transport from an outside hospital to a healthcare facility. Transport of critically ill or infectious patients is always challenging and involves the integration of various tasks and manpower. The adverse events have been attributed to various factors such as a multidisciplinary team and lack of appropriate communication among team members, absence of equipment, or failure during transport, apart from physiological alteration inherent to the disease of the patient. The transport of COVID-19 patients carries an additional risk of not only the disease itself but also due to the risk of its transmission to the transport team. The human-to-human transmission of the virus can occur via respiratory droplets. So, the person involved in the transport of such patients shall be at risk and warrants appropriate steps for their safety. Appropriate planning by a well-trained transport team is an essence for the safe transport of the suspected or confirmed COVID-19 patients. The Transport Medicine Society guidelines present consensus guidelines for the safe transport of COVID-19 patients. DISCLAIMER: These consensus guidelines are applicable for the safe transport of suspected or confirmed COVID-19 adult patients. These recommendations should be used in conjunction with medical management guidelines and advisories related to COVID-19. These recommendations should be adapted to the local policies prevalent at the workplace and also per agreement among the hospitals for transport (agreement between referring and receiving facilities). With the emergence of new scientific evidence, these guidelines may require modification. HOW TO CITE THIS ARTICLE: Munjal M, Ahmed SM, Garg R, Das S, Chatterjee N, Mittal K, et al. The Transport Medicine Society Consensus Guidelines for the Transport of Suspected or Confirmed COVID-19 Patients. Indian J Crit Care Med 2020;24(9):763-770.

6.
QJM ; 114(9): 625-635, 2021 Nov 13.
Article in English | MEDLINE | ID: covidwho-1746245

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been linked to the Guillain-Barré syndrome (GBS). The objective of the present study is to identify specific clinical features of cases of GBS reported in the literature associated with SARS-CoV-2 infection. We searched Pubmed, and included single case reports and case series with full text in English, reporting original data of patients with GBS and a confirmed recent SARS-CoV-2 infection. Clinical data were extracted. We identified 28 articles (22 single case reports and 6 case series), reporting on a total of 44 GBS patients with confirmed SARS-CoV-2 infection. SARS-CoV-2 infection was confirmed through serum reverse transcriptase-polymerase chain reaction in 72.7% of cases. A total of 40 patients (91%) had symptoms compatible with SARS-CoV-2 infection before the onset of the GBS. The median period between the onset of symptoms of SARS-CoV-2 infection and symptoms of the GBS was 11.2 days (range, 2-23). The most common clinical features were: leg weakness (61.4%), leg paresthesia (50%), arm weakness (50.4%), arm paresthesia (50.4%), hyporeflexia/areflexia (48%) and ataxia (22.7%). In total, 38.6% (n = 17) were found to have facial paralysis. Among 37 patients in whom nerve-conduction studies and electromyography were performed, of which 26 patients (59.1%) were consistent with the acute inflammatory demyelinating polyneuropathy subtype of the GBS. The present retrospective analysis support the role of the SARS-CoV-2 infection in the development of the GBS, may trigger GBS as para-infectious disease, and lead to SARS-CoV-2-associated GBS.


Subject(s)
COVID-19 , Communicable Diseases , Guillain-Barre Syndrome , Guillain-Barre Syndrome/complications , Humans , Retrospective Studies , SARS-CoV-2
7.
Int J Environ Res Public Health ; 17(10)2020 05 22.
Article in English | MEDLINE | ID: covidwho-1725630

ABSTRACT

Coronavirus disease 2019 (COVID-19) has spread rapidly across the globe, becoming a major public health challenge not for China only, but also for countries around the world. Despite worldwide efforts to contain viral spread, the outbreak has not been stopped yet. Among healthcare personnel, dentists seem to be at elevated risk of exposure to COVID-19. This risk is even more serious in pediatric dentistry, since affected children, frequently, present an asymptomatic, mild or moderate clinical viral infection and, therefore, they may play a major role in community-based COVID-19 transmission. To date, despite no universal guidelines are available for dental procedures in pediatric dentistry during COVID-19 outbreak, routine dental practice should be postponed and only severe dental emergencies must be treated. In the case of a dental emergency, involving a pediatric patient, dentists should be aware of which recommended management protocol can be adopted during the practice to protect patient health, to safeguard their-self and to prevent viral transmission. The aim of this paper is to provide clinical recommendations, presenting a needed tool for dentists to allow a valid and safe how-to-do protocol. Pediatric dentists should keep a high level of awareness to help patients, minimize risk and prevent viral spread.


Subject(s)
Betacoronavirus/isolation & purification , Coronavirus Infections/epidemiology , Dentists/psychology , Disease Outbreaks/prevention & control , Pneumonia, Viral/epidemiology , COVID-19 , Child , Coronavirus Infections/virology , Humans , Italy/epidemiology , Pandemics , Pneumonia, Viral/virology , Public Health , SARS-CoV-2
8.
J Med Virol ; 93(10): 5783-5788, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1432409

ABSTRACT

More and more rapid antigen tests for the diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) appear in the market with varying performance. The sensitivity of these tests heavily depends on the viral load, extrapolated by the threshold cycle (Ct). It is therefore essential to verify their performance before their inclusion in routine. The Coronavirus Ag Rapid Test Cassette Bio-Rad, the GSD NovaGen SARS-CoV-2 (COVID-19) Antigen Rapid Test, and the Aegle Coronavirus Ag Rapid Test Cassette were evaluated on 199 samples: 150 fresh samples from the routine and positive in quantitative reverse-transcription polymerase chain reaction (RT-qPCR), nine fresh samples negative in RT-qPCR, and 40 frozen samples, taken before the discovery of SARS-CoV-2 but positive for other respiratory viruses. Positive RT-qPCR samples were categorized according to their Ct: Ct < 20 (18.7%), ≥ 20-< 25 (27.3%), ≥ 25-< 30 (18.7%), ≥ 30-35 (17.3%), and > 35 (18.0%). Sensitivities (95% confidence interval) for Ct below 25 were 95.7% (92.4-98.9), 97.1% (94.4-99.8), and 97.1% (94.4-99.8) for GSD NovaGen, Bio-Rad, and Aegle, respectively but drastically dropped when Ct exceeded 27. Among samples with previously diagnosed viruses, seven false-positive results were found with GSD NovaGen only (specificity 85.7%). Equivalent, high sensitivities were observed with the highest viral load samples. The GSD NovaGen assay showed less specificity. Although the three kits tested in this study are inadequate for routine testing in a high throughput laboratory, they can help to quickly identify the most infectious patients and screen their close contacts in an environment where molecular tests are not readily available.


Subject(s)
COVID-19 Serological Testing , COVID-19/diagnosis , Point-of-Care Testing , SARS-CoV-2/isolation & purification , Viral Load , Antigens, Viral/analysis , COVID-19/virology , COVID-19 Nucleic Acid Testing/statistics & numerical data , Humans , RNA, Viral/analysis , RNA, Viral/genetics , SARS-CoV-2/genetics , SARS-CoV-2/immunology , Sensitivity and Specificity
10.
West J Emerg Med ; 21(4): 790-794, 2020 Jun 29.
Article in English | MEDLINE | ID: covidwho-1383995

ABSTRACT

Emergency physicians are on the front lines of treating patients with highly infectious respiratory diseases. Personal protective equipment is one defense against contamination from droplet and aerosol secretions. Intubation is a procedure that greatly can increase provider's risk of exposure. Utilization of an intubation box has been discussed and recommended on social media platforms. There has been scant literature demonstrating the effectiveness of such devices. This study aimed to determine degree of droplet contamination to the intubator utilizing a novel barrier enclosure with a fluorescent simulated respiratory contagion. This model confirmed both added protection to the providers preforming intubation, and reduction of spread of the droplets when such a device is applied to patient care.


Subject(s)
Aerosols , COVID-19/prevention & control , COVID-19/transmission , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Intubation, Intratracheal/methods , Personal Protective Equipment , SARS-CoV-2/physiology , Biofouling/prevention & control , COVID-19/virology , Cough/virology , Humans , Simulation Training
11.
Cochrane Database Syst Rev ; 4: CD013582, 2020 04 21.
Article in English | MEDLINE | ID: covidwho-1372688

ABSTRACT

BACKGROUND: This review is one of a series of rapid reviews that Cochrane contributors have prepared to inform the 2020 COVID-19 pandemic. When new respiratory infectious diseases become widespread, such as during the COVID-19 pandemic, healthcare workers' adherence to infection prevention and control (IPC) guidelines becomes even more important. Strategies in these guidelines include the use of personal protective equipment (PPE) such as masks, face shields, gloves and gowns; the separation of patients with respiratory infections from others; and stricter cleaning routines. These strategies can be difficult and time-consuming to adhere to in practice. Authorities and healthcare facilities therefore need to consider how best to support healthcare workers to implement them. OBJECTIVES: To identify barriers and facilitators to healthcare workers' adherence to IPC guidelines for respiratory infectious diseases. SEARCH METHODS: We searched OVID MEDLINE on 26 March 2020. As we searched only one database due to time constraints, we also undertook a rigorous and comprehensive scoping exercise and search of the reference lists of key papers. We did not apply any date limit or language limits. SELECTION CRITERIA: We included qualitative and mixed-methods studies (with a distinct qualitative component) that focused on the experiences and perceptions of healthcare workers towards factors that impact on their ability to adhere to IPC guidelines for respiratory infectious diseases. We included studies of any type of healthcare worker with responsibility for patient care. We included studies that focused on IPC guidelines (local, national or international) for respiratory infectious diseases in any healthcare setting. These selection criteria were framed by an understanding of the needs of health workers during the COVID-19 pandemic. DATA COLLECTION AND ANALYSIS: Four review authors independently assessed the titles, abstracts and full texts identified by our search. We used a prespecified sampling frame to sample from the eligible studies, aiming to capture a range of respiratory infectious disease types, geographical spread and data-rich studies. We extracted data using a data extraction form designed for this synthesis. We assessed methodological limitations using an adapted version of the Critical Skills Appraisal Programme (CASP) tool. We used a 'best fit framework approach' to analyse and synthesise the evidence. This provided upfront analytical categories, with scope for further thematic analysis. We used the GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research) approach to assess our confidence in each finding. We examined each review finding to identify factors that may influence intervention implementation and developed implications for practice. MAIN RESULTS: We found 36 relevant studies and sampled 20 of these studies for our analysis. Ten of these studies were from Asia, four from Africa, four from Central and North America and two from Australia. The studies explored the views and experiences of nurses, doctors and other healthcare workers when dealing with severe acute respiratory syndrome (SARS), H1N1, MERS (Middle East respiratory syndrome), tuberculosis (TB), or seasonal influenza. Most of these healthcare workers worked in hospitals; others worked in primary and community care settings. Our review points to several barriers and facilitators that influenced healthcare workers' ability to adhere to IPC guidelines. The following factors are based on findings assessed as of moderate to high confidence. Healthcare workers felt unsure as to how to adhere to local guidelines when they were long and ambiguous or did not reflect national or international guidelines. They could feel overwhelmed because local guidelines were constantly changing. They also described how IPC strategies led to increased workloads and fatigue, for instance because they had to use PPE and take on additional cleaning. Healthcare workers described how their responses to IPC guidelines were influenced by the level of support they felt that they received from their management team. Clear communication about IPC guidelines was seen as vital. But healthcare workers pointed to a lack of training about the infection itself and about how to use PPE. They also thought it was a problem when training was not mandatory. Sufficient space to isolate patients was also seen as vital. A lack of isolation rooms, anterooms and shower facilities was a problem. Other important practical measures described by healthcare workers included minimising overcrowding, fast-tracking infected patients, restricting visitors, and providing easy access to handwashing facilities. A lack of PPE, and equipment that was of poor quality, was a serious concern for healthcare workers and managers. They also pointed to the need to adjust the volume of supplies as infection outbreaks continued. Healthcare workers believed that they followed IPC guidance more closely when they saw the value of it. Some healthcare workers felt motivated to follow the guidance because of fear of infecting themselves or their families, or because they felt responsible for their patients. Some healthcare workers found it difficult to use masks and other equipment when it made patients feel isolated, frightened or stigmatised. Healthcare workers also found masks and other equipment uncomfortable to use. The workplace culture could also influence whether healthcare workers followed IPC guidelines or not. Across many of the findings, healthcare workers pointed to the importance of including all staff, including cleaning staff, porters, kitchen staff and other support staff when implementing IPC guidelines. AUTHORS' CONCLUSIONS: Healthcare workers point to several factors that influence their ability and willingness to follow IPC guidelines when managing respiratory infectious diseases. These include factors tied to the guideline itself and how it is communicated, support from managers, workplace culture, training, physical space, access to and trust in personal protective equipment, and a desire to deliver good patient care. The review also highlights the importance of including all facility staff, including support staff, when implementing IPC guidelines.


Subject(s)
Coronavirus Infections , Cross Infection/prevention & control , Guideline Adherence , Health Personnel , Infection Control , Pandemics , Pneumonia, Viral , COVID-19 , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Guideline Adherence/standards , Health Knowledge, Attitudes, Practice , Humans , Pandemics/prevention & control , Patient Isolation , Personal Protective Equipment , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , Practice Guidelines as Topic , Universal Precautions
12.
Dig Liver Dis ; 53(12): 1539-1545, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1260397

ABSTRACT

Treatment of inflammatory bowel disease (IBD) frequently requires administration of immunosuppressive therapies, which increases susceptibility to a number of infectious pathogens. However, many infections can be prevented by correct and appropriate utilization of vaccinations. While several guidelines have been published on vaccination schedules in patients with IBD, vaccination rates remain suboptimal and even lower than those in the general population. This is due to many factors including poor awareness of the importance of vaccines by gastroenterologists and general practitioners as well as potential prejudices of patients regarding the safety and benefits of vaccines. With the aim of increasing awareness about the key role of immunization in the management of patients with IBD, the present review examines the existing literature relating to the main vaccinations and their application in these patients. We also summarize current evidence in order to provide clinicians with an easy source of reference for the principal recommendations for prevention of infectious diseases in patients with IBD. In addition, the recommendations about traveling for IBD patients are briefly explored. Lastly, since it is important for gastroenterologists to be aware of recommendations on vaccination, we recommend implementing educational programs to ensure compliance with current guidelines.


Subject(s)
Colitis, Ulcerative/immunology , Crohn Disease/immunology , Immunosuppressive Agents/adverse effects , Vaccination/standards , COVID-19 Vaccines/administration & dosage , Gastroenterology/standards , Health Knowledge, Attitudes, Practice , Humans , Immunocompetence , Immunosuppressive Agents/administration & dosage
13.
Am J Emerg Med ; 49: 172-177, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1260367

ABSTRACT

BACKGROUND: Airborne personal protective equipment is required for healthcare workers when performing aerosol-generating procedures on patients with infectious diseases. Chest compressions, one of the main components of cardiopulmonary resuscitation, require intense and dynamic movements of the upper body. We aimed to investigate the protective effect of tight-fitting powered air-purifying respirators (PAPRs) during chest compressions. METHODS: This single-center simulation study was performed from February 2021 to March 2021. The simulated workplace protection factor (SWPF) is the concentration ratio of ambient particles and particles inside the PAPR mask; this value indicates the level of protection provided by a respirator when subjected to a simulated work environment. Participants performed continuous chest compressions three times for 2 min each time, with a 4-min break between each session. We measured the SWPF of the tight-fitting PAPR during chest compression in real-time mode. The primary outcome was the ratio of any failure of protection (SWPF <500) during the chest compression sessions. RESULTS: Fifty-four participants completed the simulation. Overall, 78% (n = 42) of the participants failed (the measured SWPF value was less than 500) at least one of the three sessions of chest compressions. The median value and interquartile range of the SWPF was 4304 (685-16,191). There were no reports of slipping down of the respirator or mechanical failure during chest compressions. CONCLUSIONS: Although the median SWPF value was high during chest compressions, the tight-fitting PAPR did not provide adequate protection.


Subject(s)
Cardiopulmonary Resuscitation/adverse effects , Protective Factors , Respiratory Protective Devices/standards , Adult , Air Filters/standards , Air Filters/statistics & numerical data , Cardiopulmonary Resuscitation/methods , Female , Humans , Infection Control/methods , Infection Control/standards , Infection Control/statistics & numerical data , Male , Respiratory Protective Devices/statistics & numerical data , Surveys and Questionnaires
14.
J Digit Imaging ; 34(2): 297-307, 2021 04.
Article in English | MEDLINE | ID: covidwho-1317571

ABSTRACT

COVID-19 is a highly contagious disease that can cause severe pneumonia. Patients with pneumonia undergo chest X-rays (XR) to assess infiltrates that identify the infection. However, the radiographic characteristics of COVID-19 are similar to the other acute respiratory syndromes, hindering the imaging diagnosis. In this work, we proposed identifying quantitative/radiomic biomarkers for COVID-19 to support XR assessment of acute respiratory diseases. This retrospective study used different cohorts of 227 patients diagnosed with pneumonia; 49 of them had COVID-19. Automatically segmented images were characterized by 558 quantitative features, including gray-level histogram and matrices of co-occurrence, run-length, size zone, dependence, and neighboring gray-tone difference. Higher-order features were also calculated after applying square and wavelet transforms. Mann-Whitney U test assessed the diagnostic performance of the features, and the log-rank test assessed the prognostic value to predict Kaplan-Meier curves of overall and deterioration-free survival. Statistical analysis identified 51 independently validated radiomic features associated with COVID-19. Most of them were wavelet-transformed features; the highest performance was the small dependence matrix feature of "low gray-level emphasis" (area under the curve of 0.87, sensitivity of 0.85, [Formula: see text]). Six features presented short-term prognostic value to predict overall and deterioration-free survival. The features of histogram "mean absolute deviation" and size zone matrix "non-uniformity" yielded the highest differences on Kaplan-Meier curves with a hazard ratio of 3.20 ([Formula: see text]). The radiomic markers showed potential as quantitative measures correlated with the etiologic agent of acute infectious diseases and to stratify short-term risk of COVID-19 patients.


Subject(s)
COVID-19 , Biomarkers , Humans , Retrospective Studies , SARS-CoV-2 , Tomography, X-Ray Computed
15.
Int J Mol Sci ; 22(8)2021 Apr 08.
Article in English | MEDLINE | ID: covidwho-1299441

ABSTRACT

Pneumonia due to respiratory infection with most prominently bacteria, but also viruses, fungi, or parasites is the leading cause of death worldwide among all infectious disease in both adults and infants. The introduction of modern antibiotic treatment regimens and vaccine strategies has helped to lower the burden of bacterial pneumonia, yet due to the unavailability or refusal of vaccines and antimicrobials in parts of the global population, the rise of multidrug resistant pathogens, and high fatality rates even in patients treated with appropriate antibiotics pneumonia remains a global threat. As such, a better understanding of pathogen virulence on the one, and the development of innovative vaccine strategies on the other hand are once again in dire need in the perennial fight of men against microbes. Recent data show that the secretome of bacteria consists not only of soluble mediators of virulence but also to a significant proportion of extracellular vesicles-lipid bilayer-delimited particles that form integral mediators of intercellular communication. Extracellular vesicles are released from cells of all kinds of organisms, including both Gram-negative and Gram-positive bacteria in which case they are commonly termed outer membrane vesicles (OMVs) and membrane vesicles (MVs), respectively. (O)MVs can trigger inflammatory responses to specific pathogens including S. pneumonia, P. aeruginosa, and L. pneumophila and as such, mediate bacterial virulence in pneumonia by challenging the host respiratory epithelium and cellular and humoral immunity. In parallel, however, (O)MVs have recently emerged as auspicious vaccine candidates due to their natural antigenicity and favorable biochemical properties. First studies highlight the efficacy of such vaccines in animal models exposed to (O)MVs from B. pertussis, S. pneumoniae, A. baumannii, and K. pneumoniae. An advanced and balanced recognition of both the detrimental effects of (O)MVs and their immunogenic potential could pave the way to novel treatment strategies in pneumonia and effective preventive approaches.


Subject(s)
Bacteria/metabolism , Bacterial Outer Membrane/metabolism , Extracellular Vesicles/metabolism , Pneumonia, Bacterial/microbiology , Adaptive Immunity , Animals , Antigens, Bacterial/immunology , Bacteria/immunology , Bacterial Outer Membrane/immunology , Bacterial Vaccines/immunology , Host-Pathogen Interactions/immunology , Humans , Pneumonia, Bacterial/immunology , Pneumonia, Bacterial/prevention & control , Respiratory Mucosa/immunology , Respiratory Mucosa/microbiology , Respiratory Tract Infections/immunology , Respiratory Tract Infections/microbiology , Respiratory Tract Infections/prevention & control , Virulence
16.
Tetrahedron ; 77: 131761, 2021 Jan 01.
Article in English | MEDLINE | ID: covidwho-1279699

ABSTRACT

Originated in China, coronavirus disease 2019 (COVID-19)- the highly contagious and fatal respiratory disease caused by SARS-CoV-2 has already infected more than 29 million people worldwide with a mortality rate of 3.15% (according to World Health Organization's (WHO's) report, September 2020) and the number is exponentially increasing with no remedy whatsoever discovered till date. But it is not the first time this infectious viral disease has appeared, in 2002 SARS-CoV infected more than 8000 individuals of which 9.6% patients died and in 2012 approximately 35% of MERS-CoV infected patients have died. Literature reports indicate that a chymotripsin-like cystein protease (3CLpro) is responsible for the replication of the virus inside the host cell. Therefore, design and synthesis of 3CLpro inhibitor molecules play a great impact in drug development against this COVID-19 pandemic. In this review, we are discussing the anti-SARS effect of some small molecule 3CLpro inhibitors with their various binding modes of interactions to the target protein.

17.
Infection ; 49(5): 1039-1043, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1274987

ABSTRACT

INTRODUCTION: The CoSHeP study provides novel data on SARS-CoV-2 seroconversion rates in healthcare professionals (HP) at risk at the University Hospital Bonn, a maximum healthcare provider in a region of 900.000 inhabitants. METHODS: Single-center, longitudinal observational study investigating rate of SARS-CoV-2 IgG seroconversion in HP at 2 time-points. SARS-CoV-2 IgG was measured with Roche Elecsys Anti-SARS-CoV-2 assay. RESULTS: Overall, 150 HP were included. Median age was 35 (range: 19-68). Main operational areas were intensive care unit (53%, n = 80), emergency room (31%, n = 46), and infectious disease department (16%, n = 24). SARS-CoV-2-IgG was detected in 5 participants (3%) at inclusion in May/June 2020, and in another 11 participants at follow-up (December 2020/ January 2021). Of the 16 seropositive participants, 14 had already known their SARS-CoV-2 infection because they had performed a PCR-test previously triggered by symptoms. Trailing chains of infection by self-assessment, 31% (n = 5) of infections were acquired through private contacts, 25% (n = 4) most likely through semi-private contacts during work. 13% (n = 2) were assumed to result through contact with contagious patients, further trailing was unsuccessful in 31% (n = 5). All five participants positive for SARS-CoV-2 IgG at inclusion remained positive with a median of 7 months after infection. DISCUSSION: Frontline HP caring for hospitalized patients with COVID-19 are at higher risk of SARS-CoV-2 infections. Noteworthy, based upon identified chains of infection most of the infections were acquired in private environment and semi-private contacts during work. The low rate of infection through infectious patients reveals that professional hygiene standards are effective in preventing SARS-CoV-2 infections in HP. Persisting SARS-CoV-2-IgG might indicate longer lasting immunity supporting prioritization of negative HP for vaccination.


Subject(s)
COVID-19 , SARS-CoV-2 , Adult , Antibodies, Viral , Delivery of Health Care , Health Personnel , Humans , Seroconversion
18.
Wien Klin Wochenschr ; 133(17-18): 892-901, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1274847

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) infection has caused huge impacts on all of people's lives and health systems. In response to the COVID-19 pandemic, China was the first country to impose lockdown. We aimed to study the influence of COVID-19 on the outpatient visits of rheumatic patients in a non-outbreak area of China. METHODS: We selected three provincial or ministerial hospitals in Jinan, and collected the outpatient appointments data in rheumatology and immunology departments during the Shandong Province first-level public health emergency response period from 25 January 2020 to 8 March 2020. RESULTS: In the early stage, the number of outpatient appointments in the rheumatology and immunology departments of the three provincial or ministerial hospitals were significantly reduced, and gradually restored in the late stage. It showed that in the face of major infectious diseases, strict quarantine measures with the cooperation of the public not only controls the epidemic in a short time, but also lifts the quarantine measures and opens general outpatient clinics in hospitals as soon as possible, thus minimizing the impact on other patients. INTERPRETATION: The impact on the western hospital was greater than that on the Chinese medicine hospital, and the impact on the back-up designated hospitals for COVID-19 was the greatest. Online appointment can reduce the risk of infection in outpatients, but not completely solve the follow-up problem of rheumatic patients. Telemedicine provides a new solution for both management of rheumatic patients and control of COVID-19.


Subject(s)
COVID-19 , Pandemics , Communicable Disease Control , Humans , Outpatients , Pandemics/prevention & control , SARS-CoV-2
19.
IEEE J Biomed Health Inform ; 25(8): 2836-2847, 2021 08.
Article in English | MEDLINE | ID: covidwho-1269653

ABSTRACT

Not identified as being exposed or infected, the group of asymptomatic and presymptomatic patients has become the key source of infectious hosts for the COVID-19 pandemic, triggering the re-emergence of outbreaks. Acknowledging the impacts of movement of unidentified patients and the limited testing capacity on understanding the spread of the virus, an augmented Susceptible-Exposed-Infectious-Confirmed-Recovered (SEICR) model integrating intercity migration data and testing capacity is developed to probe into the number of unidentified COVID-19 infected patients. This model allows evaluation of the effectiveness of active interventions, and more accurate prediction of the pandemic progression in a country, region or city. A pseudo-coevolutionary algorithm is adopted in the model fitting to provide an effective estimation of high-dimensional unknown parameter sets using a limited amount of historical data. The model is applied to 175 regions in Australia, Canada, Italy, Japan, Spain, the UK and USA to estimate the number of unconfirmed cases using limited historical data. Results showed that the actual number of infected cases could be 4.309 times as many as the official confirmed number. By implementing mass COVID-19 testing, the number of infected cases could be reduced by about 50%.


Subject(s)
COVID-19/epidemiology , Models, Biological , Pandemics , Algorithms , Asymptomatic Infections , COVID-19/transmission , COVID-19 Testing , Contact Tracing , Humans , Travel
20.
J Cancer Res Ther ; 17(2): 551-555, 2021.
Article in English | MEDLINE | ID: covidwho-1268377

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID 19) is a zoonotic viral infection that originated in Wuhan, China, in December 2019. It was declared a pandemic by the World Health Organization shortly thereafter. This pandemic is going to have a lasting impact on the functioning of pathology laboratories due to the frequent handling of potentially infectious samples by the laboratory personnel. To deal with this unprecedented situation, various national and international guidelines have been put forward outlining the precautions to be taken during sample processing from a potentially infectious patient. PURPOSE: Most of these guidelines are centered around laboratories that are a part of designated COVID 19 hospitals. However, proper protocols need to be in place in all laboratories, irrespective of whether they are a part of COVID 19 hospital or not as this would greatly reduce the risk of exposure of laboratory/hospital personnel. As part of a laboratory associated with a rural cancer hospital which is not a dedicated COVID 19 hospital, we aim to present our institute's experience in handling pathology specimens during the COVID 19 era. CONCLUSION: We hope this will address the concerns of small to medium sized laboratories and help them build an effective strategy required for protecting the laboratory personnel from risk of exposure and also ensure smooth and optimum functioning of the laboratory services.


Subject(s)
COVID-19/diagnosis , Clinical Laboratory Services/organization & administration , Infection Control/organization & administration , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Tertiary Care Centers/organization & administration , COVID-19/epidemiology , COVID-19/transmission , COVID-19/virology , Cancer Care Facilities/organization & administration , Cancer Care Facilities/standards , Clinical Laboratory Services/standards , Decontamination/methods , Decontamination/standards , Developing Countries , Disinfection/methods , Disinfection/organization & administration , Disinfection/standards , Hospitals, Rural/organization & administration , Hospitals, Rural/standards , Humans , India/epidemiology , Infection Control/standards , Medical Laboratory Personnel/organization & administration , Medical Laboratory Personnel/standards , Pandemics/prevention & control , SARS-CoV-2/isolation & purification , SARS-CoV-2/pathogenicity , Specimen Handling/standards , Tertiary Care Centers/standards , Workforce/organization & administration , Workforce/standards
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